Available Doses of Lunesta (Eszopiclone)
Lunesta (eszopiclone) is available in three dosage strengths: 1 mg, 2 mg, and 3 mg tablets for oral administration. 1
Tablet Characteristics
- 1 mg tablets are blue colored, circular, film-coated tablets, debossed with 'S' on one side and '1' on the other side 1
- 2 mg tablets are white colored, circular, film-coated tablets, debossed with 'S' on one side and '2' on the other side 1
- 3 mg tablets are dark blue colored, circular, film-coated tablets, debossed with 'S' on one side and '3' on the other side 1
Dosing Recommendations
- The recommended starting dose for adults is 1 mg, which can be increased to 2 mg or 3 mg if clinically indicated 1
- For elderly or debilitated patients, the total dose should not exceed 2 mg 1
- For patients with severe hepatic impairment or those taking potent CYP3A4 inhibitors, the total dose should not exceed 2 mg 1
- The maximum recommended dose is 3 mg once daily, taken immediately before bedtime 1
Clinical Efficacy by Dose
- 1 mg dose is primarily indicated for sleep onset difficulties in elderly patients 1, 2
- 2 mg dose has shown improvements in sleep latency, total sleep time, and sleep quality in clinical studies 2
- 3 mg dose demonstrates greater efficacy for both sleep onset and maintenance insomnia 2
Important Considerations
- Higher doses (2 mg and 3 mg) may increase the risk of next-day impairment of driving and other activities requiring full alertness 1
- Taking Lunesta with or immediately after a heavy, high-fat meal can reduce its effectiveness on sleep latency 1
- The most common side effect is unpleasant taste (bitter or metallic), which appears to be dose-related with higher incidence at higher doses 3
Special Populations
- In elderly patients (≥65 years), the elimination half-life increases to about 9 hours compared to 6 hours in younger adults 4
- Dosage adjustment is not required for patients with renal dysfunction 5
Lunesta was the first non-benzodiazepine hypnotic approved for long-term treatment of insomnia, unlike most other hypnotics which were limited to short-term use at the time of its approval 6, 7.