Eszopiclone

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 10, 2022

Warnings

Eszopiclone (Lunesta) Risks, Warnings, and Complications

Eszopiclone can cause serious medical problems in certain people. You may opt out of taking this medicine if you are at a high risk of complications. Some of the risks of eszopiclone use include:

CNS DEPRESSANT EFFECTS: Eszopiclone has a CNS depressant effect, meaning it slows down activity in the brain. This can lead to impaired alertness and motor coordination. There is an increased risk of this occurring in people taking higher doses of eszopiclone and those taking other CNS depressants and muscle relaxants. You should know that this medicine can affect your driving skills, especially if you are on the 3-mg dose of eszopiclone. Do not drive, operate machinery, or do other activities that require alertness the morning after taking eszopiclone until you know how this medicine affects you.
SEVERE ALLERGIC REACTION: In a small number of people, eszopiclone can cause allergic reactions, including severe reactions like anaphylaxis (closing of the throat) and skin reactions (peeling skin rash). Seek emergency medical attention if this occurs.
ABNORMAL THINKING AND BEHAVIOR CHANGES: Eszopiclone can cause serious and potentially life-threatening complex sleep behaviors such as sleepwalking, driving, making phone calls, preparing food, or having sex while not fully awake. People who do these behaviors cannot remember doing them the next morning. Stop taking eszopiclone and call your doctor right away if you do anything unusual while not fully awake during your treatment with eszopiclone. Tell members of your household to be aware of these symptoms and to contact your doctor if they occur.
DEPRESSION AND SUICIDAL THOUGHTS: Some people can experience worsening mental illness or develop new symptoms of depression or suicidal thoughts while on eszopiclone. You should take the lowest dose of this medicine that is effective. Call your doctor immediately if you notice any changes in thinking or behavior.
WITHDRAWAL SYMPTOMS: Abruptly stopping or rapidly lowering the dose of eszopiclone can lead to withdrawal symptoms like anxiety, stomach cramps, nausea, vomiting, muscle cramps, sweating, shakiness, and even seizures in rare cases. Do not stop taking eszopiclone without talking to your doctor first.
SIDE EFFECTS IN ELDERLY PATIENTS: Older adults should use a lower dose of eszopiclone because higher doses can lead to impaired motor performance, memory problems, and cognitive changes. The risk is higher in elderly patients taking other similar drugs that also have a CNS depressant effect.
RISKS IN PATIENTS WITH HEPATIC IMPAIRMENT: Eszopiclone should be used with caution in people with liver disease as this can lead to impaired drug metabolism. Tell your doctor if you have a history of liver problems before starting this medicine.

Talk to your doctor or pharmacist about other treatment options for insomnia if you are at high risk of complications from eszopiclone use.

Precautions Before Starting Eszopiclone (Lunesta)

Tell your doctor if you are allergic to eszopiclone, any of the active or inactive ingredients in eszopiclone tablets, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. Eszopiclone may not be right for people with certain health conditions, such as breathing problems, lung disease, liver disease, depression, or other mental illnesses.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between eszopiclone and your other medications.

Tell your doctor if you currently drink or have ever consumed large amounts of alcohol, overused prescription drugs, or abused street drugs. Also tell your doctor if you have ever had thoughts of killing yourself (suicidal ideation).

Talk to your doctor about the safety of drinking grapefruit juice while on eszopiclone.

Older adults should talk to their doctor about the risks versus benefits of taking eszopiclone. There may be other safer drugs available to treat insomnia in elderly patients (age 65 years and above).

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding.

Precautions During Use of Eszopiclone (Lunesta)

Keep all your doctors’ and laboratory appointments during treatment with eszopiclone. Your doctor may want to increase or decrease your dose and monitor you for side effects.

Eszopiclone can make you drowsy and dizzy the morning after use. It can affect your mental alertness and make you more likely to fall. Do not drive, operate machinery, or do anything that requires alertness until you know how eszopiclone affects you.

Do not drink alcohol while taking eszopiclone. Alcohol can make the side effects of this medicine worse.

Call your doctor without delay if you experience any changes in mental health or any unusual behaviors or thoughts while on this eszopiclone. This can include worsening of an existing mental illness or new symptoms that develop for the first time during your treatment with this medicine. You and your family members should be vigilant for aggression, hallucinations, strange behaviors, memory problems, feeling like you are outside your body, depression, suicidal thoughts, or any unusual or new behaviors. People in your household should know to call your doctor for medical advice if they notice any such changes.

Tell all your doctors you are on eszopiclone before any surgery, including dental procedures.

Eszopiclone (Lunesta) Drug Interactions

Certain other drugs can affect how eszopiclone works. Possible interactions between eszopiclone and other medicines can increase the risk of severe adverse effects. Your doctor may change the dose of your medications or monitor you carefully for side effects if there are known interactions between eszopiclone and your other medicines.

The following medications can have possible interactions with eszopiclone:

Antidepressants
Psychiatric medications like olanzapine (Zyprexa)
Antihistamines
Antibiotics like clarithromycin (Biaxin) and troleandomycin (not available in the US)
Certain antifungals like ketoconazole (Nizoral) and itraconazole (Onmel, Sporanox)
Certain HIV medications like ritonavir (Norvir) and nelfinavir (Viracept)
Medications used to treat mental illness, anxiety, or seizures
Anti-tuberculosis drugs like rifampin (Rifadin, Rimactane)
Sleeping pills, sedatives, tranquilizers, and other similar drugs

The above list may not include all the possible interactions of eszopiclone. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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