Eszopiclone

Key facts

• Eszopiclone (sold as Lunesta and in generic form) is a non-benzodiazepine sedative-hypnotic, one of the "Z-drugs." It is used for short-term treatment of insomnia.
• Take it right at bedtime, and only when you can devote a full 7 to 8 hours to sleep; taking it and then getting up early leaves you impaired.
• With regular or long-term use it can cause physical dependence, and it has been linked to complex sleep behaviours, sleep-walking, sleep-driving, and sleep-eating, that you will not remember afterward.
• Never combine it with alcohol. Stop and seek urgent care if you or someone else notices you doing things in your sleep that you don't recall.

What eszopiclone treats

Eszopiclone treats insomnia: trouble falling asleep, frequent waking during the night, or waking too early. It is prescribed for short courses, typically a few weeks, rather than as an ongoing nightly medicine. It is not used for occasional or anticipated sleeplessness, such as a single restless night, and it does not treat anxiety or depression.

How eszopiclone works

Eszopiclone binds to receptors in the brain that respond to GABA, the nervous system's main calming chemical. By boosting GABA's effect, it slows nerve activity throughout the brain, producing sedation and helping you fall and stay asleep.

Before you take it

• Do not take eszopiclone unless you can get a full night's sleep afterward; next-day drowsiness and impaired coordination or judgment are common even without feeling drowsy.
• Avoid alcohol and other sedating medicines (opioids, benzodiazepines, some antihistamines and antidepressants); combining them increases the risk of dangerously slowed breathing.
• Tell your prescriber about liver disease, a history of depression or substance use, sleep apnea, or myasthenia gravis; these can change your dose or rule the drug out.
• People over 65 are more sensitive to its effects and have a higher risk of falls and confusion.

Side effects

Common effects include an unpleasant or metallic taste, dry mouth, headache, and drowsiness the next day.

Stop and seek urgent medical care for any of these:

• Sleep-walking, sleep-driving, or preparing and eating food while asleep, with no memory of it afterward.
• Severe allergic reaction: facial or throat swelling, difficulty breathing.
• New or worsening depression, agitation, hallucinations, or thoughts of self-harm.
• Severe drowsiness or confusion that makes normal activities unsafe.

Safety essentials

• Complex sleep behaviours are a defining risk of eszopiclone. If they happen, stop the medicine and tell your prescriber immediately; do not simply lower the dose and continue.
• Use it short-term only. Taking it nightly for months increases the risk of dependence and tolerance, and stopping suddenly after prolonged use can cause rebound insomnia.
• Never drink alcohol while taking eszopiclone; the combination increases sedation and can suppress breathing.
• Do not drive or operate machinery until you know how you feel the next morning, since impairment can persist even after you feel awake.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.