Non-benzodiazepine hypnotic (Z-drug; cyclopyrrolone S-isomer of zopiclone)
Eszopiclone
Brand names: Lunesta (US)
Adult dose
Dose: Not licensed in UK; US dose 1–3mg at bedtime (elderly 1mg)
Route: Oral
Frequency: OD nocte; short-term use
Clinical pearls
- Not currently licensed in UK — listed in BNF as appendix reference only; UK preferred Z-drug is zopiclone
- NICE CKS Insomnia: CBT-I first; Z-drugs limited to 4 weeks
- DVLA: residual sedation impairs driving
Contraindications
- Severe hepatic impairment
- Severe respiratory disease
- Sleep apnoea
- Myasthenia gravis
- Hypersensitivity
- Pregnancy/breastfeeding
Side effects
- Unpleasant taste
- Dry mouth
- Headache
- Daytime drowsiness
- Parasomnias
- Tolerance/dependence
- Memory impairment
Interactions
- Alcohol/CNS depressants
- CYP3A4 inhibitors/inducers
- Opioids (respiratory depression)
Monitoring
- Duration of use
- Daytime function
- Falls risk
Reference: BNF; NICE CKS Insomnia; DVLA guidance; https://bnf.nice.org.uk/drugs/eszopiclone/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Vancomycin Dosing Calculator · Drug Dosing
- Phenytoin Correction for Albumin / Renal Failure · Drug Dosing
- Local Anaesthetic Maximum Dose Calculator · Drug Dosing
- Tisdale Risk Score for QT Prolongation · Arrhythmia
- Bazett Corrected QT Interval (QTc) Calculator · Arrhythmia
- DAPT Score for Dual Antiplatelet Therapy Duration · Antiplatelet Therapy
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF