What is the maximum dose of Lunesta (eszopiclone)?

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From the Guidelines

The maximum recommended dose of Lunesta (eszopiclone) is 3 mg per day, taken immediately before bedtime 1.

Important Considerations

  • It is generally recommended to start with a dose of 1 mg and increase as needed, under the guidance of a healthcare provider 1.
  • The dose should not exceed 3 mg per day in non-elderly or non-debilitated patients, and 2 mg per day in elderly or debilitated patients, or those with severe hepatic impairment 1.
  • Taking more than the recommended dose can increase the risk of adverse effects, such as next-day drowsiness, dizziness, and difficulty with coordination.
  • It is recommended to use the lowest effective dose for the shortest duration necessary to treat insomnia 1.

Special Populations

  • In elderly or debilitated patients, the recommended dose is 1 mg per day, and should not exceed 2 mg per day 1.
  • In patients with severe hepatic impairment, the recommended dose is 1 mg per day, and should not exceed 2 mg per day 1.

From the FDA Drug Label

The total dose of eszopiclone tablets should not exceed 3 mg, once daily immediately before bedtime

  • The maximum dose of Lunesta (eszopiclone) is 3 mg per day, for adults, taken immediately before bedtime 2.
  • However, the maximum dose is lower for certain patient populations, such as:
    • Geriatric or debilitated patients: 2 mg per day
    • Patients with severe hepatic impairment, or taking potent CYP3A4 inhibitors: 2 mg per day

From the Research

Maximum Dose of Lunesta (Eszopiclone)

  • The maximum dose of Lunesta (eszopiclone) is 3 mg for adult patients (aged 18-64 years) 3, 4, 5.
  • For older adult patients (aged 65 years or older), the recommended dose is 2 mg, but it can be increased to 3 mg if necessary 4.
  • The 1mg dose is recommended for sleep onset in older adult patients whose primary complaint is difficulty falling asleep 4.
  • No dosage adjustment is required for patients with renal dysfunction, but patients with severe hepatic disease may require a reduced dose 3, 6.

Dosage Adjustment

  • Dosing should be individualized, and the lowest effective dose should be used to minimize the risk of adverse events 3.
  • Dosage adjustment is necessary in patients with severe hepatic disease and in those receiving concomitant potent cytochrome P-450 isoenzyme 3A4 inhibitors 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Eszopiclone.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2006

Research

Eszopiclone (Lunesta): a new nonbenzodiazepine hypnotic agent.

Proceedings (Baylor University. Medical Center), 2006

Research

Eszopiclone: its use in the treatment of insomnia.

Neuropsychiatric disease and treatment, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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