Medication Guide
Eszopiclone (Lunesta) Side Effects and Uses
A plain-language guide to Eszopiclone, a non-benzodiazepine sleep medication (Z-drug). Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Eszopiclone (Lunesta) is a non-benzodiazepine sleep medication (Z-drug). Common eszopiclone side effects include bitter or metallic taste, drowsiness or next-morning grogginess, dizziness and headache. The rare but serious ones, and when to get help, are listed under eszopiclone side effects below. Never stop or change your dose on your own.
How Eszopiclone Can Help You
Eszopiclone, sold as Lunesta, is a prescription sleep medicine. It boosts GABA at sleep-related receptors, so it helps you fall asleep and stay asleep. It lasts longer than regular zolpidem, which helps with waking in the middle of the night. It was also studied in longer trials than most sleep aids, so it is sometimes used for longer courses under care.
Sleep often improves on the first night. You may fall asleep faster, wake less and sleep longer overall. Better nights can bring steadier mood, sharper focus and more energy. It works best as part of a plan that also looks at sleep habits and causes, ideally including CBT-I.
Uses for Eszopiclone
- Trouble falling asleep
- Trouble staying asleep
- Long-lasting insomnia that needs longer treatment
- Insomnia along with depression or anxiety (added to other care)
- Poor sleep during a stressful time (short-term)
How to Take Eszopiclone
Your prescriber decides your dose, starting low. The FDA recommends a low starting dose because higher doses can impair alertness the next morning. Take it right before bed, and only when you can stay in bed for 7 to 8 hours. Take it on an empty stomach or well after dinner, since a heavy meal slows it. Never mix it with alcohol or other sedatives, and never take more than one dose a night.
Eszopiclone is a Schedule IV controlled drug. With long nightly use, your body can come to depend on it. At Mindful Sewa it is prescribed only when clinically appropriate and allowed under current telehealth rules. Stopping after regular use can cause a few nights of rebound insomnia, so plan the change with your prescriber. If you skip a night, resume the next night if needed. Many people notice a bitter or metallic taste.
Eszopiclone Side Effects
Common Side Effects
- Bitter or metallic taste (very common)
- Drowsiness or next-morning grogginess
- Dizziness
- Headache
- Dry mouth
- Unusual dreams
- Nausea
- Cold-like symptoms
Serious: Get Medical Help Promptly
- Complex sleep behaviors, such as sleepwalking, sleep-driving or eating with no memory of it (boxed warning). Stop and call your prescriber.
- Next-day impairment that affects driving.
- Dependence and withdrawal with long-term nightly use.
- Severe allergic reaction or swelling of the face or throat.
- Unusual thinking, agitation or hallucinations.
- New or worse depression or thoughts of suicide. If you are thinking about harming yourself, call or text 988, or call 911.
What Is Eszopiclone Used For?
Eszopiclone is used to treat insomnia in adults. It is approved for trouble falling asleep and for trouble staying asleep. It is a Z-drug, like zolpidem, and it is not a benzodiazepine.
Your prescriber sets the dose. It is kept lower for older adults, people with severe liver problems and people on some other drugs. Some antifungal drugs, antibiotics and HIV medicines can raise its levels. Never change your dose on your own.
Lunesta Warning Signs
Stop the medicine and call your prescriber if you do anything while asleep that you do not remember. That includes walking, eating, driving or making calls. Get help right away for swelling of the face or throat, or trouble breathing.
Also report new anxiety, agitation, confusion, strange behavior or worse depression. Does your sleep still not improve after 7 to 10 days? Tell your prescriber, since another problem may be the cause. Our insomnia page explains fuller care by telehealth in California.
Is Eszopiclone Right for You?
Only a full evaluation with a prescriber can tell you if Eszopiclone fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
SCHEDULE AN APPOINTMENT CALL (888) 457-8124
Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Hydroxyzine (Vistaril), antihistamine used for anxiety and sleep
- Prazosin (Minipress), alpha-1 blocker
- Ramelteon (Rozerem), melatonin receptor agonist sleep medication
- Zolpidem (Ambien), non-benzodiazepine sleep medication (Z-drug)
FAQ
Questions About Eszopiclone
What is the metallic taste everyone mentions?
A bitter or metallic taste, often noticed the next morning, is eszopiclone's best-known side effect. It is harmless and goes away after the medicine is stopped. Drinking water and brushing before bed help some people.
How is Lunesta different from Ambien?
Eszopiclone lasts longer than regular zolpidem, so it helps more with staying asleep. It also has trial data for longer courses of nightly use. Zolpidem may act a bit faster for pure trouble falling asleep.
Can I use Lunesta for months if my insomnia is chronic?
It was studied in longer trials without losing its effect, so longer courses are sometimes used with close care. Even so, pairing it with CBT-I gives you skills that outlast any medicine.
Why does my prescriber start with a low dose?
The FDA lowered the recommended starting dose after finding next-morning driving problems at higher doses in some people. Many people sleep well on a low dose and wake up clearer. Your prescriber decides if a change is needed.
Is eszopiclone habit-forming?
It is a Schedule IV controlled drug with a real, though modest, risk of dependence. The risk grows with long nightly use. Using the lowest helpful dose and having an exit plan with your prescriber keep the risk low.
Does Lunesta help you stay asleep?
Yes. Eszopiclone is approved for both falling asleep and staying asleep. It lasts long enough to help many people who wake during the night.
Can Lunesta cause anxiety?
Some people notice anxiety, agitation or unusual thoughts while taking it. Anxiety can also show up for a short time after stopping regular use. Tell your prescriber about any new or worse anxiety.
What is the usual dose of eszopiclone?
There is no one right dose, so your prescriber decides based on your age, health and other medicines. Treatment starts at a low dose, and older adults usually stay lower. Never take more than prescribed or more than once a night.