Eszopiclone
Pronunciation: es-oh-ZOP-i-klone.
- Generic name
- eszopiclone
- Brand names
- Lunesta (United States, Canada), Lunivia (United Kingdom)
- Drug class
- Non-benzodiazepine sedative-hypnotic ('Z-drug')
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only, controlled substance in the United States (Schedule IV).
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia
Australia: Eszopiclone (generic) (5) · Full directory
Boxed warning: Complex sleep behaviors, including sleepwalking and sleep-driving, with reports of serious injury and death
Complex sleep behaviors, including sleepwalking, sleep-driving, and engaging in other activities while not fully awake (such as preparing and eating food, making phone calls, or having sex), have been reported with eszopiclone. Serious injuries and death have resulted from these behaviors, which have occurred in patients with and without a history of such behaviors, and even at the lowest recommended dose. Eszopiclone is contraindicated in anyone who has previously experienced a complex sleep behavior after taking it. Contact your prescriber right away if this happens; a clinician will decide whether eszopiclone needs to be stopped. (1) (2) (4)
What eszopiclone is and how it works
Eszopiclone is a non-benzodiazepine sedative-hypnotic ('Z-drug') used for short-term or, in some cases, longer clinician-directed treatment of insomnia in adults. (1) (2)
Eszopiclone carries a serious warning about complex sleep behaviors -- doing things like walking, driving, cooking, or eating while not fully awake, with no memory of it afterward -- which can happen even at the lowest dose and even on the first night. It can also impair alertness and coordination the next day, especially at higher doses or combined with alcohol or other sedating medicines, and can lead to dependence or withdrawal symptoms with prolonged use. Because of these risks, treatment is planned and reviewed with your prescriber, including how and when it will eventually be stopped.
Mechanism of action: how eszopiclone works
Eszopiclone is a non-benzodiazepine hypnotic of the cyclopyrrolone class that binds near the benzodiazepine recognition site on the GABA-A receptor complex, enhancing GABAergic inhibitory neurotransmission. (1) (2)
What eszopiclone is used for
Insomnia
Used to help with falling asleep and staying asleep in adults, usually for the shortest effective duration. (1) (2)
Before taking eszopiclone
Do not take / not appropriate for
- Do not take eszopiclone if you have previously experienced a complex sleep behavior (such as sleepwalking or sleep-driving) after taking eszopiclone or any other sleep medicine; this is a contraindication. (all patients) (1) (2)
- Do not take eszopiclone if you have had a hypersensitivity reaction to eszopiclone, zopiclone, or any ingredient in the product. (all patients) (2)
Tell your clinician about
- Whether you have myasthenia gravis, severe breathing problems, sleep apnoea, or severe liver impairment.
- Whether you have a history of depression, suicidal thoughts, substance misuse, or drug/alcohol dependence.
- Whether you have any condition that causes frequent night-time awakenings, such as sleep apnoea, restless legs syndrome, or periodic limb movement disorder.
- Every other medicine and supplement you take, especially other sedatives, opioids, antipsychotics, anticonvulsants, or strong CYP3A4 inhibitors such as certain antifungals or antibiotics.
- Whether you are pregnant, plan to become pregnant, or are breastfeeding.
- Whether you drink alcohol regularly.
How to take eszopiclone
- Take exactly as prescribed, immediately before bedtime, only when you can devote at least 7-8 hours to sleep before you need to be fully alert again.
- Do not take with or immediately after a heavy, high-fat meal, since this can slow how quickly it works.
- Your prescriber will start you on the lowest effective dose and may adjust it based on your age, liver function, and other medicines.
- Before starting, your prescriber will typically discuss a plan for how and when treatment will eventually end, to reduce the chance of dependence or withdrawal symptoms.
- Any change to your dose, or stopping treatment, is planned with your prescriber; a gradual, clinician-directed approach is generally used after prolonged use rather than abrupt discontinuation.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)
Missed dose
Eszopiclone is taken only at bedtime when you can devote a full night to sleep, so there is no routine missed-dose schedule to make up. If you did not take a dose at bedtime, do not take it later in the night if you will not have at least 7-8 hours to sleep before you need to be fully alert. Ask your pharmacist or prescriber if you are unsure.
Overdose
Contact your prescriber, pharmacist, or a poison-control/emergency service if an overdose is suspected. Seek emergency medical help for severe drowsiness, confusion, breathing difficulty, or unresponsiveness, especially if combined with alcohol or other sedatives. (1)
Side effects
An unpleasant or bitter taste is very commonly reported. Some effects, on alertness the next day, mood, breathing, or allergic reactions, need prompt medical evaluation rather than waiting to see if they improve.
Unpleasant or bitter taste (dysgeusia)
What to notice: A very commonly reported effect, more likely at higher doses.
Headache, dizziness, or dry mouth
What to notice: Commonly reported effects.
What to do: Tell your prescriber if severe or persistent. (1) (2)
Daytime somnolence
What to notice: Sleepiness carrying into the next day.
What to do: Avoid driving or operating machinery until you know how eszopiclone affects you the next day; tell your prescriber if this persists. (1) (2)
Complex sleep behaviors
What to notice: Sleepwalking, sleep-driving, preparing or eating food, making phone calls, or other activities while not fully awake, usually with no memory of it afterward.
What to do: Contact your prescriber right away; a clinician will decide whether eszopiclone needs to be stopped. Do not take another dose until you have spoken with your prescriber. (1) (4)
Mood or behaviour changes
What to notice: New or worsening depression, unusual agitation, decreased inhibition, bizarre behaviour, or thoughts of self-harm.
What to do: Contact your prescriber promptly, or seek emergency help for any thoughts of self-harm; a clinician will assess whether treatment needs to be adjusted. (1)
Severe allergic reaction
What to notice: Facial or throat swelling, difficulty breathing, or a severe rash.
What to do: Seek emergency medical help immediately; this reaction should not be risked again with a repeat dose. (1)
Breathing difficulty
What to notice: New or worsening shortness of breath, especially if you have an existing breathing or lung condition.
What to do: Contact your prescriber promptly for assessment. (1)
Serious warnings
Complex sleep behaviors (sleepwalking, sleep-driving, and similar activities while not fully awake) — boxed_warning
Symptoms: Walking, driving, preparing or eating food, making phone calls, or other activities while not fully awake, usually with no memory of it afterward; serious injuries and death have been reported.
Action: Contact your prescriber right away; a clinician will decide whether eszopiclone needs to be stopped. This can happen even at the lowest dose and even after the very first dose. (1) (2) (4)
Next-day impairment and driving risk — high caution
Symptoms: Reduced alertness, slowed reaction time, or impaired coordination the next day, which can occur without you feeling impaired.
Action: Avoid driving or operating machinery the morning after taking eszopiclone until you know how it affects you; UK guidance advises avoiding driving for 12 hours after a dose. (1) (2)
Worsening depression or emergence of suicidal thoughts — emergency
Symptoms: New or worsening low mood, hopelessness, or thoughts of self-harm.
Action: Seek emergency help for any thoughts of self-harm; contact your prescriber promptly for any mood changes. (1)
Severe allergic reaction (angioedema, anaphylaxis) — emergency
Symptoms: Facial or throat swelling, difficulty breathing, or a severe rash.
Action: Seek emergency medical help immediately. (1)
Dependence and withdrawal symptoms — high caution
Symptoms: Anxiety, unusual or vivid dreams, nausea, or stomach upset can occur when treatment ends, particularly after prolonged use or abrupt discontinuation.
Action: Any reduction or stopping of eszopiclone is planned with your prescriber, following the treatment-ending strategy agreed before you started, to reduce the chance of these symptoms. (1) (2)
CNS depression, especially with alcohol or other sedatives — high caution
Symptoms: Excessive drowsiness, confusion, slowed breathing, or unresponsiveness.
Action: Avoid alcohol and tell your prescriber about all other sedating medicines you take; seek emergency help for severe drowsiness or breathing difficulty. (1) (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Alcohol | Markedly increases sedation and the risk of complex sleep behaviors, CNS depression, and next-day impairment. | Avoid alcohol while taking eszopiclone. (1) (2) |
| Other CNS depressants (opioids, benzodiazepines, antipsychotics, anticonvulsants) | Additive sedation and risk of breathing difficulty. | Tell your prescriber about all other sedating medicines you take. (1) (2) |
| Strong CYP3A4 inhibitors (e.g., ketoconazole and other azole antifungals, certain macrolide antibiotics) | Can roughly double eszopiclone exposure, increasing side-effect risk. | Your prescriber may reduce your dose; in the UK this combination is contraindicated in elderly patients. (1) (2) |
| Strong CYP3A4 inducers (e.g., rifampicin) | Can reduce eszopiclone levels by about 80%, potentially making it less effective. | Tell your prescriber if you take rifampicin or a similar medicine. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Older adults
A lower maximum dose (2 mg) applies because of increased sensitivity to sedative and next-day impairment effects. (1) (2)
Liver impairment
A lower maximum dose (2 mg) applies for severe hepatic impairment in the US label; the UK label contraindicates use in severe hepatic impairment. (1) (2)
Pregnancy
Not recommended during pregnancy; a baby exposed near delivery may show withdrawal-type symptoms after birth. Discuss the benefits and risks with your prescriber. (2)
Breastfeeding
Breastfeeding is generally avoided during treatment; discuss feeding options with your prescriber. (2)
Sleep disorders that cause frequent awakenings
People with sleep apnoea, restless legs syndrome, or periodic limb movement disorder may be at increased risk of complex sleep behaviors and are generally discouraged from using eszopiclone; discuss alternatives with your prescriber. (4)
Monitoring
Before starting
- Discussion with your prescriber about the risk of dependence and a plan for how treatment will eventually end.
- Review of other sedating medicines, alcohol use, and any history of complex sleep behaviors, breathing problems, or mood disorders.
During treatment
- Watch for any complex sleep behaviors, next-day impairment, or mood changes.
- Periodic review of ongoing need for treatment, since it is generally intended for short-term or clinician-reviewed use.
- Any dose change or discontinuation is planned with your prescriber.
Storage
Store at room temperature, 59-86F (15-30C). Keep secure and out of reach of children, and away from anyone who might misuse it.
Study the drug class: Z-drugs and other hypnotics
Professional information
Clinician-facing context only. Use the current local product information in full.
United States
Indication: Insomnia
Dose summary: Initial 1 mg immediately before bedtime; may increase to a maximum of 3 mg based on clinical response. Maximum 2 mg for elderly/debilitated patients, severe hepatic impairment, or concomitant strong CYP3A4 inhibitor use.
Renal context: Not specifically detailed in the source reviewed; use current local product information for renal impairment guidance. (1)
Hepatic guidance
Severe hepatic impairment requires a reduced maximum dose (US label: 2 mg) or is contraindicated (UK label), given reduced clearance.
Overdose note
Overdose has been associated with CNS depression ranging from somnolence to coma, and can be more severe when combined with alcohol or other CNS depressants; manage per local poison-control and toxicology guidance. (1) (2)
Frequently asked questions
What are 'complex sleep behaviors' and why is this eszopiclone's most serious warning?
Complex sleep behaviors are activities like sleepwalking, sleep-driving, or preparing and eating food while not fully awake, usually with no memory of it afterward. Serious injuries and deaths have been reported with eszopiclone, and this can happen even at the lowest recommended dose and even after the very first dose, which is why it carries a boxed warning, the FDA's most prominent safety warning. (1)
Can I drink alcohol while taking eszopiclone?
No. Alcohol markedly increases sedation and the risk of complex sleep behaviors, breathing difficulty, and next-day impairment. Avoid alcohol while taking eszopiclone. (1) (2)
Can I become dependent on eszopiclone?
Dependence and withdrawal symptoms (such as anxiety, vivid dreams, or nausea) can occur, particularly with prolonged use. This is why prescribers typically discuss a plan for ending treatment before you start, and why any dose reduction or stopping is done gradually with your prescriber rather than on your own. (2)
What is the mechanism of action of eszopiclone?
Eszopiclone is a non-benzodiazepine hypnotic of the cyclopyrrolone class that binds near the benzodiazepine recognition site on the GABA-A receptor complex, enhancing GABAergic inhibitory neurotransmission. (1) (2)
References
- LUNESTA (eszopiclone) tablets, CIV -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-30 · source 1
- Lunivia 1mg/2mg/3mg film-coated tablets (eszopiclone) -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Axunio Pharma · United Kingdom · accessed 2026-07-30 · source 2
- Questions and answers on the withdrawal of the marketing authorisation application for Lunivia (eszopiclone)European Medicines Agency (EMA) · European Union · accessed 2026-07-30 · source 3
- LUNESTA (eszopiclone) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-30 · source 4
- Eszopiclone 1 mg / 2 mg / 3 mg Tablet Bottle -- ARTG entriesTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
- No Medsafe data sheet or ARTG-equivalent registration record located for eszopiclone/Lunesta/LuniviaMedsafe (New Zealand regulator) -- search result · New Zealand · accessed 2026-07-30 · source 6
Brand names by country
Single-ingredient eszopiclone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Lunesta3 mg, 1 mg, 2 mg · waylis therapeutics llc
United Kingdom
- Lunivia (2)MHRA licensed emc smpc confirmed 2025-02-01 · 1 mg, 2 mg, 3 mg · Axunio Pharma GmbH
Canada
- Lunesta (4)Health Canada approved confirmed · 1 mg, 2 mg, 3 mg · Sunovion Pharmaceuticals Canada Inc.
Australia
- Eszopiclone (generic) (5)TGA ARTG registered 2014-01-16 confirmed · 1 mg, 2 mg, 3 mg · Alphapharm Pty Ltd