Eszopiclone
Lunesta
Non-Benzodiazepine HypnoticSchedule IVGeneric available
The mechanism of action of eszopiclone as a hypnotic is unclear; however, its effect could be related to its interaction with GABA-receptor complexes at binding domains located close to or allosterically coupled to benzodiazepine receptors.
Compare Eszopiclone →FDA-Approved Indications
- Insomnia — sleep latency and maintenance (adults)
Common Off-Label Uses
- Comorbid insomnia with depression (adjunct)
- Comorbid insomnia with GAD (adjunct)
What Sets This Drug Apart
- Longest-acting z-drug (t1/2 ~6h vs zolpidem 2.5h) — preferred for sleep maintenance insomnia, not just sleep onset
- Non-selective GABA-A agonist (S-enantiomer of zopiclone); slightly different receptor binding profile than zolpidem
- Only hypnotic studied and approved for long-term use (6-month data) — most z-drugs are labeled for short-term only
- Unpleasant metallic/bitter taste is characteristic and dose-dependent; reported in up to 34% at 3 mg dose
- Starting dose 1 mg in elderly/hepatic impairment, up to 3 mg in younger adults; CYP3A4 substrate
Boxed Warning
COMPLEX SLEEP BEHAVIORS
Boxed Warning
COMPLEX SLEEP BEHAVIOUR