PharmaceuticalSedativeZ-drugHypnotic

Eszopiclone

Also known as Lunesta · S-zopiclone

Written by enwyReviewed 15 Jul 20261 sources0 comments

Eszopiclone is the active (S)-enantiomer of zopiclone, licensed (as Lunesta) for insomnia. It reduces sleep latency and improves sleep maintenance and is one of the Z-drugs studied for somewhat longer-term use. It shares the class risks of dependence and complex sleep behaviours.

01 Overview

Eszopiclone is the single active enantiomer of zopiclone and is marketed in the United States as Lunesta. Clinical trials support its use for both sleep-onset and sleep-maintenance insomnia, and it has been studied over longer treatment periods than most hypnotics.

It acts at the GABA-A benzodiazepine site. Like other Z-drugs it can cause dependence, next-day impairment and complex sleep behaviours such as sleep-driving with amnesia. An unpleasant taste is a frequently reported effect.

02 Mechanism

Positive allosteric modulator at the GABA-A benzodiazepine receptor site (active S-enantiomer of zopiclone), enhancing inhibitory neurotransmission to promote sleep.

03 Dosing

Tier	Dose	Route	Notes
Therapeutic (adult)	1–3 mg/day	Oral	At bedtime; start at 1 mg, elderly typically 1-2 mg.

04 Effects

Effect	Magnitude	Evidence
Reduced sleep latencyFalls asleep faster, shown in controlled trials.		Clinical
Improved sleep maintenanceFewer awakenings and longer sleep, including in longer-term studies.		Clinical
SedationCNS depression that can persist into the morning.		Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Dependence and rebound insomniaTolerance and dependence with continued use; rebound insomnia on stopping.	Moderate	Common with prolonged use	Clinical
Complex sleep behavioursSleep-driving, sleep-walking and related behaviours with amnesia, prompting an FDA boxed warning for the Z-drug class.	Severe	Rare	Observational
Next-day impairmentResidual drowsiness impairing driving and coordination.	Moderate	Common	Clinical
Additive respiratory depressionDangerous with opioids or alcohol.	Life-threatening	High risk in combination	Clinical

06 Legal status

United States

Schedule IV controlled substance

as of Jan 2026

United Kingdom

Prescription-only

as of Jan 2026

07 References

Eszopiclone (Lunesta) FDA prescribing informationUS FDA

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.