Sleep-wake disorders:

Indications for LUNESTA:

Insomnia (decreased sleep latency and improved sleep maintenance).


Use lowest effective dose. ≥18yrs: Initially 1mg immediately before bedtime [take only if able to get full night's sleep (7–8hrs) before becoming active again]; may increase to 2–3mg if needed; max 3mg/dose. Elderly, debilitated, concomitant CYP3A4 inhibitors (see Interactions), or severe hepatic impairment: max 2mg/dose. Effect delayed if taken with heavy/high-fat meals.


<18yrs: not established.


Monitor for CNS depressant effects and next-day impairment. Evaluate for co-morbid diagnoses (eg, physical and/or psychiatric disorders) prior to treatment. Reevaluate if insomnia fails to remit after 7–10 days of use. Depression. Suicidal tendencies. Abnormal thinking and behavioral changes. Compromised respiratory function. Conditions that affect metabolism or hemodynamic response. Drug or alcohol abuse. Severe hepatic impairment. Avoid abrupt cessation. Write ℞ for smallest practical amount. Elderly (higher risk of falls). Debilitated. Pregnancy. Nursing mothers.

Pharmacologic Class:

Pyrrolopyrazine hypnotic.


Concomitant other sedative-hypnotics at bedtime or middle of the night: not recommended. Potentiates CNS depression with alcohol, other CNS depressants; adjust dose. Potentiated by CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, troleandomycin, ritonavir, nelfinavir); reduce eszopiclone dose. May be antagonized by CYP3A4 inducers (eg, rifampicin).

Adverse Reactions:

Unpleasant taste, headache, somnolence, dizziness, dry mouth, infection, rash, anxiety, hallucinations, pain; complex behaviors (eg, sleep-driving; consider discontinuing if occurs); rare: anaphylaxis, angioedema, others (see full labeling).

Generic Availability:


How Supplied:

Tabs 1mg—30; 2mg, 3mg—30, 100

Pricing for LUNESTA

3mg tablet (Qty: 30)
Appx. price $17