Eszopiclone | Lunesta
LUNESTA is indicated for the treatment of insomnia. LUNESTA has been shown to decrease sleep latency and improve sleep maintenance (1)
Dosage and Administration:
- Use the lowest dose effective for the patient (2)
- Recommended initial dose is 1 mg, immediately before bedtime, with at least 7-8 hours remaining before the planned time of awakening. May increase dose if clinically indicated, to a maximum of 3 mg (2.1)
- Geriatric or debilitated patients: Dose should not exceed 2 mg (2.2)
- Patients with severe hepatic impairment, or taking potent CYP3A4 inhibitors: Dose should not exceed 2 mg (2.3)
- Do not take with or immediately after a meal (2.5)
Dosage Forms and Strengths: Tablets: 1 mg, 2 mg, and 3 mg
—–INDICATIONS AND USAGE—–
- See description above.
—–DOSAGE AND ADMINISTRATION—–
- See description above.
—–CONTRAINDICATIONS—–
- Known hypersensitivity to eszopiclone (4)
—–WARNINGS & PRECAUTIONS—–
- CNS depressant effects: Impaired alertness and motor coordination, including risk of morning impairment. Risk increases with dose. Caution patients taking 3 mg dose against driving and against activities requiring complete mental alertness during the morning after use. (5.1)
- Evaluate for Co-Morbid Diagnoses: Reevaluate if insomnia persists after 7 to 10 days of use (5.2)
- Severe Anaphylactic/Anaphylactoid Reactions (angioedema and anaphylaxis have been reported): Do not rechallenge if such reactions occur (5.3)
- Abnormal Thinking, Behavioral Changes (e.g., hallucinations), Complex Behaviors (e.g., “sleep-driving”): Immediately evaluate if occurs (5.4)
- Worsening of Depression or Suicidal Thinking may occur: Prescribe the least number of tablets feasible to avoid intentional overdose (5.4, 5.7)
- Withdrawal Effects: symptoms may occur with rapid dose reduction or discontinuation (5.5, 9.3)
- Elderly Patients: Use lower dose due to impaired motor, cognitive performance and increased sensitivity (2.2, 5.7)
- Patients with hepatic impairment, impaired respiratory function, impaired drug metabolism or hemodynamic responses: Use with caution (5.7)
—–ADVERSE REACTIONS—–
- Most commonly observed adverse reactions (incidence ≥2%) were unpleasant taste, headache, somnolence, respiratory infection, dizziness, dry mouth, rash, anxiety, hallucinations, and viral infections (6.1)
—–DRUG INTERACTIONS—–
- CNS Depressants: Additive CNS-depressant effects with combination use. Use with ethanol causes additive psychomotor impairment (7.1)
- Rifampicin: Combination use may decrease exposure and effects of LUNESTA (7.2)
- Ketoconazole: Combination use increases exposure and effect of LUNESTA. Dose reduction of LUNESTA is needed (7.2)
—–USE IN SPECIFIC POPULATIONS—–
- Pregnancy: Based on animal data, may cause fetal harm (8.1)
- Pediatric Use: Safety and effectiveness not established. Dizziness, dysgeusia, hallucinations, suicidal ideation reported (8.4)