Lunesta (Eszopiclone) Is Effective Immediately Upon Administration
Lunesta (eszopiclone) is effective immediately after taking it, with an onset of action within 1-2 hours of administration, and does not need to build up in your system to be effective. 1, 2
Pharmacokinetic Properties
- Eszopiclone is rapidly absorbed following oral administration, with peak plasma concentrations achieved within approximately 1-1.6 hours after taking the medication 1, 3
- The drug has a relatively short half-life of approximately 6 hours in adults under 65 years of age, which increases to about 9 hours in elderly patients (65 years or older) 1, 3
- Eszopiclone works by interacting with GABA-receptor complexes in the brain, similar to but distinct from benzodiazepines, producing its hypnotic effect 1, 2
Clinical Efficacy
- Clinical studies demonstrate that eszopiclone provides immediate sleep benefits on the first night of use, improving both sleep onset (reducing the time it takes to fall asleep) and sleep maintenance (reducing nighttime awakenings) 2, 4
- Eszopiclone has been shown to reduce sleep onset latency by approximately 19 minutes compared to placebo in controlled trials 5
- For sleep maintenance, eszopiclone increases total sleep time by approximately 45 minutes and reduces wake time after sleep onset by 11 minutes compared to placebo 5
Administration Considerations
- Eszopiclone should be taken immediately before bedtime and only when patients are able to stay in bed for a full night (7-8 hours) 1
- The medication should not be taken with or immediately after a meal, as this may reduce its effectiveness 1
- For non-elderly adults, the recommended starting dose is 2 mg immediately before bedtime, with adjustment to 3 mg if clinically indicated 5, 1
- For elderly patients (≥65 years), the recommended dose is 1-2 mg due to their slower metabolism of the drug 5, 1
Important Precautions
- Patients should be cautioned about potential next-day impairment, even when used as prescribed, particularly with the 3 mg dose 1
- Common side effects include unpleasant taste, headache, dry mouth, and somnolence 5, 2
- Alcohol should not be consumed in the evening or before bed when taking eszopiclone, as this can increase the risk of complex sleep behaviors and CNS depression 1
- Unlike some medications that require time to build therapeutic levels, there is no evidence of tolerance developing to eszopiclone's effects during short-term use, and efficacy has been maintained in studies lasting up to 12 months 2, 4
Clinical Implications
- The immediate effectiveness of eszopiclone makes it suitable for both short-term and chronic insomnia management 5, 2
- Patients should be informed that the medication works on the first night of use and does not require multiple doses to achieve its therapeutic effect 2, 4
- For patients with difficulty falling asleep (sleep onset insomnia), the rapid onset of action makes eszopiclone particularly appropriate 5
- For those with difficulty staying asleep (sleep maintenance insomnia), eszopiclone's duration of action (6 hours) helps maintain sleep throughout the night 5, 3
Remember that eszopiclone, like other sleep medications, should be used as part of a comprehensive approach to managing insomnia that may include cognitive behavioral therapy for insomnia (CBT-I) when appropriate 5.