Eszopiclone belongs to the class of medications called sedative-hypnotics. It is used for the short-term and symptomatic relief of sleep disturbances. Eszopiclone can help with difficulty falling asleep, frequent wake-ups during the night, or early morning awakenings. Eszopiclone should usually not be taken for more than 7 to 10 days in a row. It should be used only by people for whom disturbed sleep results in problems functioning during the day.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual starting dose of this medication is 1 mg taken just before bedtime, when needed to help with difficulty sleeping. The recommended adult dose of eszopiclone ranges from 1 mg to 3 mg. For seniors, people with reduced liver or kidney function, and people taking certain other medications, the maximum daily dose is 2 mg.

Eszopiclone tablets should be swallowed whole. Do not crush or break them. Take this medication right before going to bed. Eszopiclone may take longer to work if it is taken with or immediately after eating a large meal.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose, do not take it in the middle of the night.

Do not take this medication when at least 7 or 8 hours of uninterrupted sleep is not possible or before you would need to be active and functional. Impaired judgement and memory lapses may occur in such situations. Your body needs time to eliminate the medication from your system. Wait at least 12 hours after taking this medication before driving or engaging in other activities that require mental alertness.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

1mg
Each round, light blue, film-coated tablet, debossed with "L 34" on one side contains 1 mg of eszopiclone. Nonmedicinal ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, croscarmellose sodium, colloidal silicon dioxide, hypromellose, lactose monohydrate, and magnesium stearate; film-coating: OpadryŽ light blue: FD&C No. 2, hypromellose, macrogol, titanium dioxide, and triacetin.

2 mg
Each round, white, film-coated tablet, debossed with "L 35" on one side contains 2 mg of eszopiclone. Nonmedicinal ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, croscarmellose sodium, colloidal silicon dioxide, hypromellose, lactose monohydrate, and magnesium stearate; film-coating: OpadryŽ white: hypromellose, macrogol, titanium dioxide, and triacetin.

3 mg
Each round, dark blue, film-coated tablet, debossed with "L 36" on one side contains 3 mg of eszopiclone. Nonmedicinal ingredients: microcrystalline cellulose, dibasic calcium phosphate anhydrous, croscarmellose sodium, colloidal silicon dioxide, hypromellose, lactose monohydrate, and magnesium stearate; film-coating: OpadryŽ blue: FD&C No. 2, hypromellose, macrogol, titanium dioxide, and triacetin.

Do not take this medication if you:

• are allergic to eszopiclone or any ingredients of the medication
• are allergic to zopiclone
• have myasthenia gravis
• have severe breathing difficulties
• have sleep apnea (interrupted breathing when you are asleep)
• have severe liver disease
• have experienced complex behaviours while sleeping, such as walking, cooking, or driving, after taking eszopiclone or other medications for sleep
• are taking certain other medications, such as:
• "azole" antifungal medications (e.g., fluconazole, ketoconazole, voriconazole)
• clarithromycin
• diltiazem
• erythromycin
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• verapamil

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abnormal dreams
• agitation (more common for seniors)
• back pain
• bitter taste in the mouth
• changed appetite
• diarrhea
• dizziness
• drowsiness
• dry mouth
• fatigue
• headache
• lightheadedness
• nausea
• nervousness
• rash, itching
• stomach upset
• vomiting
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• aggressiveness
• behavior changes
• clumsiness or unsteadiness (more common for seniors)
• confusion (more common for seniors)
• decreased coordination
• decreased muscle tone
• difficulty or labored breathing
• drowsiness (severe)
• falls causing injuries
• getting out of bed and performing activities without being aware (sleep-driving, sleepwalking, making or eating food, talking on the phone)
• hallucinations (e.g., seeing or hearing things that aren't there)
• memory problems (more common for seniors)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• withdrawal effects (e.g., abdominal cramps, vomiting, sweating, tremor, seizures)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• thoughts of self-harm or suicide

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol and other medications that cause drowsiness: Avoid taking eszopiclone after consuming alcohol or other medications that cause drowsiness (e.g., antidepressants, narcotic pain relievers, anxiety medications). Combining these drugs increases the risk of severe side effects such as breathing difficulty and performing activities while not being aware or awake, and may be life threatening. Alcohol should not be consumed if you are taking eszopiclone.

Anxiety or restlessness: Some people have experienced an increase in daytime anxiety or restlessness while taking eszopiclone.

Bad taste in mouth: Eszopiclone may cause you to have a coated tongue, bad breath, or a bitter taste in your mouth. These effects often occur when this medication is being used.

Behaviour changes: This medication may cause agitated or aggressive behaviour. If you experience these symptoms or any other behaviour change while taking this medication, contact your doctor immediately.

Family members or caregivers of people who are taking this medication should contact the person's doctor immediately if they notice unusual behaviour changes.

Confusion: This medication can affect your brain's ability to process information (e.g., effects on concentration, attention, and vigilance). The risk of confusion is greater for seniors and people with brain damage.

Dependence and misuse: Physical dependence, psychological dependence, and abuse have occurred with the use of medications to help with sleep. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while taking this medication.

Depression: Sleep medications can contribute to the symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Drowsiness/reduced alertness: Eszopiclone can cause excessive drowsiness and decreased mental alertness. Do not operate heavy machinery or drive after taking this medication. Some people experience confusion or reduced alertness the day after taking eszopiclone. These effects may be increased if a full night's sleep is not possible. Wait at least 12 hours after taking this medication before driving or engaging in other activities that require mental alertness.

Kidney function: The kidneys are partially responsible for removing this medication from your body. Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function:  Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Memory disturbance: Although rare, amnesia has been reported following normal doses of medications like eszopiclone.

Performing activities while not fully awake: People taking eszopiclone may perform activities such as sleepwalking, driving, preparing and eating food, and making phone calls while not fully awake and unaware of their actions. The next morning, they may not remember what happened. This may be more likely to occur if you also use alcohol or other medications that cause drowsiness. If you discover this has happened to you, contact your doctor immediately.

If you or someone in your family has a history of sleepwalking, or other conditions that affect sleep or cause you to wake up frequently, you may be at an increased risk of experiencing complex sleep-related behaviours.

Withdrawal: Eszopiclone can become habit-forming. Withdrawal symptoms similar to those occurring with related substances, including alcohol, have been observed after stopping the medication suddenly (after having taken it regularly over a period of time). These symptoms include:

• abdominal cramps
• agitation
• confusion
• diarrhea
• extreme anxiety
• headache
• increased appetite
• irritability
• memory impairment
• muscle pain
• nervousness
• restlessness
• sleep problems such as rebound insomnia
• tension
• tremors
• vomiting

If you have been using eszopiclone regularly, talk to your doctor about the best way to decrease your use of the medication to reduce withdrawal effects, before stopping it completely.

Pregnancy: The safety of using this medication during pregnancy has not been established. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are breast-feeding and taking eszopiclone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of eszopiclone have not been established for use by children and adolescents under 18 years of age.

Seniors: People over 65 years of age are more likely to experience side effects of eszopiclone related to higher doses, such as drowsiness, dizziness, or impaired coordination. Using doses that are too high may result in accidents such as falls.  Lower doses of eszopiclone are recommended for seniors.

There may be an interaction between eszopiclone and any of the following:

• alcohol
• antihistamines (e.g., azelastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine, rupatadine)
• antipsychotics (e.g., aripiprazole, cariprazine, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• apalutamide
• aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• brimonidine
• buprenorphine
• butorphanol
• calcium channel blockers (e.g., diltiazem, verapamil)
• cannabis
• chloral hydrate
• clonidine
• cobicistat
• daridorexant
• dimenhydrinate
• diphenoxylate
• dronedarone
• efavirenz
• entacapone
• enzalutamide
• esketamine
• flibanserin
• flunarizine
• general anesthetics (medications used to put people to sleep before surgery)
• grapefruit juice
• guanfacine
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• kava kava
• lemborexant
• lenacapavir
• letermovir
• lumacaftor and ivacaftor
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• melatonin
• mifepristone
• minocycline
• mirtazapine
• mitotane
• muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone, tapentadol, tramadol)
• nirmatrelvir and ritonavir
• perampanel
• pizotifen
• pomalidomide
• pramipexole
• pregabalin
• protein kinase inhibitors (e.g., crizotinib, idelalisib, imatinib, nilotinib)
• rifampin
• ropinirole
• rotigotine
• seizure medications (e.g., clobazam, levetiracetam, phenobarbital, phenytoin, primidone, rufinamide, topiramate, valproic acid)
• sodium oxybate
• tetrabenazine
• thalidomide
• tizanidine
• trazodone
• tricyclic antidepressants (e.g., clomipramine, desipramine, imipramine)
• valerian
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.