Eszopiclone (oral route)


    Brand Name

    US Brand Name

    Lunesta


    Description

    Eszopiclone is used to treat insomnia (trouble sleeping). It belongs to the group of medicines called central nervous system (CNS) depressants, which slow down the nervous system. Eszopiclone helps you get to sleep faster and sleep throughout the night. In most cases, sleep medicines should only be used for short periods of time, such as 1 or 2 days, and for no longer than 1 or 2 weeks.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Tablet

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of eszopiclone in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of eszopiclone in the elderly. However, elderly patients are more sensitive to the effects of this medicine (eg, confusion, dizziness, falls) than younger adults, which may require caution and an adjustment in the dose for patients receiving eszopiclone.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Calcium Oxybate
    • Magnesium Oxybate
    • Potassium Oxybate
    • Sodium Oxybate

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abametapir
    • Alfentanil
    • Alprazolam
    • Avacopan
    • Benzhydrocodone
    • Boceprevir
    • Bromazepam
    • Bromopride
    • Buprenorphine
    • Butalbital
    • Butorphanol
    • Cannabidiol
    • Cannabis
    • Carbamazepine
    • Carbinoxamine
    • Cetirizine
    • Clarithromycin
    • Clobazam
    • Clonazepam
    • Cobicistat
    • Codeine
    • Conivaptan
    • Daridorexant
    • Dexmedetomidine
    • Diazepam
    • Dihydrocodeine
    • Doxylamine
    • Esketamine
    • Fedratinib
    • Fentanyl
    • Fexinidazole
    • Flibanserin
    • Flumazenil
    • Fosnetupitant
    • Fospropofol
    • Gabapentin
    • Gabapentin Enacarbil
    • Hydrocodone
    • Hydromorphone
    • Idelalisib

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Grapefruit Juice

    Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Ethanol

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Alcohol abuse, history of or
    • Drug abuse or addiction, history of—Dependence on eszopiclone may develop.
    • Breathing problems or lung disease or
    • Depression, history of or
    • Mental illness, history of—Use with caution. May make these conditions worse.
    • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may become habit-forming (causing mental or physical dependence).

    This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

    Take eszopiclone just before going to bed, when you are ready to go to sleep, or when you are having trouble falling asleep. This medicine works very quickly to put you to sleep.

    Do not take this medicine when your schedule does not permit you to get a full night's sleep (7 to 8 hours). If you must wake up before this, you may continue to feel drowsy and have memory problems.

    Swallow the tablet whole. Do not break, crush, or chew it.

    Take this medicine on an empty stomach. Do not take eszopiclone with meals or right after a heavy, high-fat meal.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For oral dosage form (tablets):
      • For insomnia:
        • Adults—At first, 1 milligram (mg) at bedtime. Your doctor may adjust your dose as needed. However, the dose is usually not more than 3 mg per day.
        • Older adults—At first, 1 mg at bedtime. Your doctor may adjust your dose as needed. However, the dose is usually not more than 2 mg per day.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Use this medicine only when you cannot sleep. You do not need to keep a schedule for taking it.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.


    Precautions

    It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for any unwanted effects.

    If you think you need to take eszopiclone for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem.

    Eszopiclone may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

    This medicine may cause you to do things while you are still asleep that you may not remember the next morning. It is possible you could drive a car, sleepwalk, have sex, make phone calls, or prepare and eat food while you are asleep or not fully awake. Tell your doctor right away if you learn that any of these has happened.

    This medicine will add to the effects of alcohol and other CNS depressants (medicines that makes you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

    This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally, which may lead to falls. Even though eszopiclone is taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    If you develop any unusual and strange thoughts or behavior while you are using eszopiclone, be sure to discuss it with your doctor. Some changes that have occurred in people using this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

    Do not stop using it without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects.

    After taking eszopiclone for insomnia, you may have difficulty sleeping (rebound insomnia) for the first few nights after you stop taking it.

    If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of eszopiclone or taking alcohol or other CNS depressants with eszopiclone may lead to serious breathing problems and unconsciousness. Some signs of an overdose include: severe drowsiness, severe nausea or vomiting, staggering, and troubled breathing.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Chills
    • cough
    • fever
    • hoarseness
    • lower back or side pain
    • painful or difficult urination
    • sleepiness or unusual drowsiness

    Less common

    • Bladder pain
    • bloody or cloudy urine
    • confusion
    • diarrhea
    • discouragement
    • fear or nervousness
    • feeling sad or empty
    • frequent urge to urinate
    • general feeling of discomfort or illness
    • headache
    • irritability
    • joint pain
    • lack of appetite
    • loss of interest or pleasure
    • muscle aches and pains
    • nausea
    • nerve pain
    • runny nose
    • seeing, hearing, or feeling things that are not there
    • shivering
    • sore throat
    • sweating
    • trouble concentrating
    • trouble sleeping
    • unusual tiredness or weakness
    • vomiting

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Change or loss of consciousness
    • difficult or troubled breathing
    • irregular, fast or slow, or shallow breathing
    • pale or blue lips, fingernails, or skin
    • sleepiness or unusual drowsiness

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Bad, unusual, or unpleasant (after) taste
    • belching
    • change in taste
    • dizziness
    • dry mouth
    • heartburn
    • indigestion
    • pain
    • stomach discomfort, upset, or pain

    Less common

    • Abnormal dreams
    • accidental injury
    • decreased interest in sexual intercourse
    • inability to have or keep an erection
    • pain, cramps, or heavy bleeding (females)
    • rash
    • swelling of the breasts or breast soreness (in both males and females)

    Incidence not known

    • Change in sense of smell
    • loss of memory
    • problems with memory

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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