Generic Lunesta (Eszopiclone)
The generic name for Lunesta is eszopiclone, available in 1 mg, 2 mg, and 3 mg tablets, with a recommended starting dose of 1 mg that can be increased to 2-3 mg based on clinical response. 1
Dosage Formulations
Eszopiclone tablets are available in three strengths for oral administration: 1
- 1 mg tablets: Blue, circular, film-coated
- 2 mg tablets: White, circular, film-coated
- 3 mg tablets: Dark blue, circular, film-coated
Standard Dosing Recommendations
Non-Elderly Adults (18-64 years)
- Starting dose: 1 mg immediately before bedtime 1
- Maintenance dose: Can be increased to 2 mg or 3 mg if clinically indicated 1
- Maximum dose: 3 mg once daily 1
- The 2-3 mg doses are primarily used for both sleep-onset and sleep maintenance insomnia 2
Elderly or Debilitated Patients (≥65 years)
- Maximum dose: 2 mg 1
- For sleep onset complaints: 1 mg at bedtime 2
- Higher doses increase risk of next-day impairment in elderly patients 1
Special Populations
Severe hepatic impairment: Maximum dose 2 mg 1
Patients taking potent CYP3A4 inhibitors: Maximum dose 2 mg 1
Renal dysfunction: No dosage adjustment required 3
Clinical Characteristics
Pharmacokinetics
- Absorption: Rapid, with peak concentrations at 1.0-1.6 hours after dosing 3, 4
- Half-life: Approximately 6 hours in adults; increases to 9 hours in patients ≥65 years 4
- Bioavailability: Approximately 80% 3
Duration of Action
- Intermediate-acting hypnotic with effects lasting up to 6 hours 5
- No short-term usage restriction unlike other hypnotics 2
- Approved for long-term treatment of chronic insomnia 5, 6
Administration Guidelines
Timing: Take immediately before bedtime 1
Food interactions: Avoid taking with or immediately after a heavy, high-fat meal, as this slows absorption and reduces effectiveness on sleep latency 1
Empty stomach: Administration on an empty stomach is advised to maximize effectiveness 2
Common Adverse Effects
The most frequently reported side effects include: 2, 3, 6
- Unpleasant or bitter taste (most common)
- Headache
- Dry mouth
- Dizziness
- Somnolence
Important Safety Warnings
Complex sleep behaviors: FDA warns of potential sleepwalking, sleep-driving, sleep-eating, and other disruptive behaviors 2
Next-day impairment: The 2 mg and 3 mg doses increase risk of impaired driving and activities requiring full alertness the following morning 1
CNS depression: Dosage adjustments necessary when combined with other CNS depressants due to additive effects 1
Contraindications: Not recommended during pregnancy or nursing 2
Cost Considerations
The cost is approximately $3.70 per tablet for all dosage strengths (1 mg, 2 mg, and 3 mg) 3