From the Guidelines
The equivalent dose of Lunesta (eszopiclone) to zopiclone 7.5 mg is 3 mg of Lunesta. This is based on the fact that Lunesta is the S-isomer of zopiclone, making it about twice as potent, which explains why the equivalent dose is lower 1. When switching from zopiclone to Lunesta, patients should start with the 3 mg dose, taking it immediately before bedtime for the treatment of insomnia. Some key points to consider when using Lunesta include:
- Taking the medication on an empty stomach to maximize effectiveness
- Avoiding use during pregnancy or nursing
- Exercising caution if signs/symptoms of depression, compromised respiratory function, or hepatic heart failure are present
- Being aware of the potential for additive effects on psychomotor performance with concomitant CNS depressants and/or alcohol use
- Gradually tapering the dose when discontinuing the medication to avoid withdrawal symptoms. Like zopiclone, Lunesta should be used for short-term treatment when possible to minimize the risk of dependence. Patients should be aware that Lunesta may cause similar side effects to zopiclone, including a bitter or metallic taste, drowsiness the next day, and potential for dependency with prolonged use. It's essential to take Lunesta only when you have a full night (7-8 hours) available for sleep to avoid next-day impairment. If switching between these medications, it's advisable to do so under medical supervision as individual responses may vary 1.
From the Research
Equivalent Dosage
- The equivalent dosage of Lunesta (eszopiclone) for zopiclone 7.5mg is not directly stated in the provided studies.
- However, it is known that eszopiclone is the S-enantiomer of racemic zopiclone 2.
- The standard dosing of eszopiclone should begin at 2 mg for nonelderly patients and may be initiated at or increased to 3 mg if clinically indicated 3.
- There is no direct comparison of eszopiclone and zopiclone dosages in the provided studies.
Pharmacology and Efficacy
- Zopiclone has been shown to be effective in the treatment of insomnia, with efficacy equivalent to or greater than that of benzodiazepines 4, 5.
- Eszopiclone has also been shown to be effective in the treatment of insomnia, with no evidence of tolerance or dependence 2, 6.
- The pharmacokinetic and pharmacodynamic parameters of eszopiclone are similar to those of other nonbenzodiazepine hypnotics, such as zolpidem and zaleplon 3.
Tolerability and Safety
- Zopiclone has been shown to be well tolerated, with a low propensity for rebound insomnia and dependence 4, 5.
- Eszopiclone has also been shown to be well tolerated, with mild and transient side effects, such as unpleasant taste, headache, and dizziness 3, 6.
- There is no evidence of significant rebound insomnia or withdrawal reactions with eszopiclone 2, 6.