From the Guidelines
Eszopiclone is sold under the brand name Lunesta in the United States. It is a non-benzodiazepine sedative-hypnotic medication primarily used for the treatment of insomnia, as suggested by the American Academy of Sleep Medicine clinical practice guideline 1. Lunesta is available in 1 mg, 2 mg, and 3 mg tablets, with typical starting doses of 1 mg for elderly patients and 2 mg for adults, taken immediately before bedtime. The maximum recommended dose is 3 mg. Patients should ensure they have 7-8 hours available for sleep after taking this medication to avoid next-day impairment. Eszopiclone works by enhancing the activity of GABA, an inhibitory neurotransmitter in the brain that promotes sleep. Common side effects include unpleasant taste, headache, dizziness, and morning drowsiness. As a controlled substance (Schedule IV), it has potential for dependence and should be used for short-term treatment when possible, as recommended by the American College of Physicians guideline 1. In some countries outside the US, eszopiclone may be marketed under different brand names.
Some key points to consider when prescribing eszopiclone include:
- The medication should be used for short-term treatment of insomnia, as the evidence for long-term use is limited 1
- Patients should be informed of the potential risks of dependence and next-day impairment 1
- The medication should be used in conjunction with cognitive behavioral therapy for insomnia (CBT-I) when possible, as recommended by the American College of Physicians guideline 1
- The dosage should be individualized based on the patient's response and tolerance, with a maximum recommended dose of 3 mg 1
From the FDA Drug Label
The chemical name of eszopiclone is (+)-(5S)-6-(5-chloropyridin-2-yl)-7-oxo-6,7-dihydro-5H-pyrrolo[3,4-b] pyrazin-5-yl 4-methylpiperazine-1-carboxylate. The brand name of Eszopiclone is Lunesta 2 2.
From the Research
Eszopiclone Brand Name
Key Characteristics of Eszopiclone
- Eszopiclone is a nonbenzodiazepine hypnotic agent 3, 5
- It is approved in the US as an oral, once-nightly therapy for insomnia in adults 3
- Eszopiclone is rapidly absorbed after oral administration without any next-day clinical residual effects being detected 3
Efficacy and Tolerability
- Eszopiclone significantly improves both sleep onset and sleep maintenance compared with placebo in adult and elderly patients with primary insomnia 3
- It is generally well tolerated, with the main treatment-emergent side effects being unpleasant taste, headache, and dizziness 5
- No evidence of tolerance during 12 months' treatment with this agent, and no rebound insomnia or serious withdrawal effects on discontinuation 3