4. Bottom Line

Eszopiclone induces and helps maintain sleep; however, it has been associated with unusual behaviors such as sleep-driving or food making and consumption while asleep. In some people, effects persist until the next day, making driving or other hazardous tasks dangerous.

5. Tips

• Always take the lowest effective dose. 1mg is generally recommended as a starting dose. Dosage may be increased to 2mg or 3mg (maximum of 2mg in elderly people, those with liver disease or taking certain medications) but be aware this increases the risk of next day impairment of driving and other activities that require alertness. Higher dosages also increase the risk of dependence and addiction.
• Do not take with or immediately after a meal. Take immediately before bed as eszopiclone works very quickly. This will help decrease the risk of falling and other side effects.
• Do not drive after taking eszopiclone. You may still feel the effects of eszopiclone after you wake up in the morning, so do not drive or perform unsafe tasks until you are fully awake.
• Do not take eszopiclone if you have drunk alcohol that evening. Do not drink any alcohol after taking eszopiclone.
• Do not take more than the recommended dose or take for longer than prescribed without checking with your doctor.
• Be aware that some people have performed certain activities such as sleep-driving, making and eating food, telephone conversations, and having sex while they were not fully awake after taking eszopiclone. Talk to your doctor if such an event happens to you.
• Eszopiclone can be addictive and you can become dependant on it if you take too much for too long. If your sleep does not improve within 7 to 10 days or worsens, talk with your doctor.
• Do not take eszopiclone if you have to get up earlier than seven to eight hours after going to bed. Do not take eszopiclone after midnight if you plan to awaken before 9 am.
• Talk to your doctor about the possibility of an underlying reason for your insomnia, such as anxiety or depression. Tell your doctor immediately if you experience any worsening of mood symptoms such as depression or suicidal thoughts.
• Do not use eszopiclone at the same time as other sedatives. Talk to your doctor or pharmacist before taking any other medications, including those brought over the counter, with eszopiclone.

6. Response and Effectiveness

• The peak effects of eszopiclone are reached within approximately one hour after oral administration. Effects of eszopiclone may be reduced if taken with a high-fat or heavy meal; therefore, it is best taken away from food.

7. Interactions

Medicines that interact with eszopiclone may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with eszopiclone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with eszopiclone include:

• anti-anxiety medications, such as diazepam and oxazepam
• anticonvulsants such as valproate
• antidepressants, such as amitriptyline, imipramine, nortriptyline
• antihistamines that cause sedation, such as diphenhydramine
• azelastine
• barbiturates
• buprenorphine
• chlormethiazole
• duloxetine
• medications that induce or inhibit CYP3A4, such as carbamazepine, phenytoin, clarithromycin, itraconazole, ritonavir, or verapamil
• monoamine oxidase inhibitors, such as selegiline, isocarboxazid, or phenelzine
• opioid analgesics such as codeine, oxycodone, and morphine
• oral contraceptives
• melatonin
• muscle relaxants such as cyclobenzaprine
• probenecid
• scopolamine
• some medications used to treat mental illness, such as clozapine and thioridazine
• theophylline
• other medications that cause sedation, such as zolpidem.