Which is safer, Dayvigo (lemborexant) or Lunesta (eszopiclone)?

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Last updated: June 13, 2025View editorial policy

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From the Guidelines

Neither Dayvigo (lemborexant) nor Lunesta (eszopiclone) can be definitively declared safer than the other, as both medications have similar safety profiles and the better choice depends on individual patient factors. Both are FDA-approved for insomnia and belong to different medication classes - Dayvigo is an orexin receptor antagonist while Lunesta is a non-benzodiazepine hypnotic. Dayvigo may have a slightly lower risk of next-day impairment and less potential for dependence, while Lunesta has been on the market longer with more established safety data, as suggested by studies such as 1. Common side effects for both include headache, drowsiness, and dizziness. Dayvigo typically starts at 5mg taken at bedtime, while Lunesta usually begins at 1mg (2mg for maintenance). The safety profile varies based on a patient's age, other medications, liver function, and medical history. Patients should avoid alcohol with either medication and discuss their complete medical history with their doctor before starting either treatment. Some key points to consider when choosing between these medications include:

  • The patient's specific health profile and insomnia characteristics
  • Potential side effects and interactions with other medications
  • The patient's medical history, including any history of substance abuse or dependence
  • The need for dose adjustments based on age, liver function, or other factors, as noted in studies such as 1 and 1. Ultimately, the safest option is the one that best matches an individual's specific health profile and insomnia characteristics.

From the Research

Safety Comparison of Dayvigo and Lunesta

  • Dayvigo (lemborexant) and Lunesta (eszopiclone) are both used to treat insomnia, but their safety profiles differ.
  • According to a study on lemborexant 2, it has minimal residual effects on morning alertness or next-day function, and patients are able to respond to an external auditory stimulus in the middle of the night.
  • In contrast, eszopiclone has been associated with adverse events such as unpleasant taste, dry mouth, somnolence, and dizziness 3.
  • A review of eszopiclone's efficacy and safety profile found that it appears to be an efficient drug with moderate effects on sleep onset and maintenance, but with some evidence of harm if not taken as recommended 3.
  • Lemborexant may offer an improved treatment option compared to other pharmacotherapies for insomnia, including eszopiclone, due to its effectiveness over the long term and its ability to help people who experience early morning awakenings 2.
  • Overall, the safety profile of lemborexant appears to be more favorable compared to eszopiclone, with fewer reported adverse events and minimal residual effects on next-day function.

Key Findings

  • Lemborexant improves latency to sleep onset and sleep maintenance, and is able to help people who experience early morning awakenings 2.
  • Eszopiclone has been associated with adverse events such as unpleasant taste, dry mouth, somnolence, and dizziness 3.
  • Lemborexant has minimal residual effects on morning alertness or next-day function 2.
  • Eszopiclone appears to be an efficient drug with moderate effects on sleep onset and maintenance, but with some evidence of harm if not taken as recommended 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Evaluating lemborexant for the treatment of insomnia.

Expert opinion on pharmacotherapy, 2021

Research

Eszopiclone for insomnia.

The Cochrane database of systematic reviews, 2018

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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