Top 300 Pharmacy Drug Cards

ESZOPICLONE: Lunesta

Class: Nonbarbiturate Hypnotic. C-IV

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Dosage Forms. Tablet: 1 mg, 2 mg, 3 mg

Common FDA Label Indication, Dosing, and Titration.

1. Insomnia: 2 mg po immediately before bedtime; dosing may be initiated at or titrated to 3 mg Off-Label Uses. None.

MOA. The exact mechanism of action of eszopiclone, a non-benzodiazepine hypnotic, is unknown. It is believed that eszopiclone binds to or interacts allosterically at the GABA-receptor complex domain.

Drug Characteristics: Eszopiclone

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Medication Safety Issues: Eszopiclone

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Drug Interactions: Eszopiclone

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Adverse Reactions: Eszopiclone

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Efficacy Monitoring Parameters. Improvement in sleep onset, duration, and quality.

Toxicity Monitoring Parameters. Excessive sedation, impaired coordination.

Key Patient Counseling Points. Instruct patient to take immediately before bedtime and to not take with heavy/high-fat meal. Severe anaphylactic/anaphylactoid reactions, some fatal, have been reported. Warn patient of the risk of “sleep-driving” and other complex behaviors (eg, preparing and eating food, making phone calls) when the patient is not fully awake. Risk is increased when drug is combined with alcohol or other CNS depressants. Patient should avoid activities requiring mental alertness or coordination until drug effects are realized. Patient should report insomnia that worsens or persists longer than 7-10 d. Advise patient to report abnormal thoughts or behavior (confusion, agitation, hallucinations, suicidal thoughts, new or worsening depression), memory loss, or anxiety. Instruct patient to take drug only when experiencing insomnia. This drug should not be taken on a regular schedule when insomnia is not present. Patient should not drink alcohol while taking this drug.

Clinical Pearls. Safety and efficacy not established in children. Elderly may be more susceptible; use a lower starting dose. Medication guide must be provided at dispensing.