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Understanding Lunesta Side Effects

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Lunesta is the brand name of a generic medication called eszopiclone. It is a prescription medication that is used to treat insomnia. Lunesta is a sedative-hypnotic medication. As with many medications, Lunesta can cause side effects, some of which can be serious. 

This medication guide will help you understand Lunesta's side effects, the risks associated with its use, the maximum dosage of this medicine, and how to take it safely.

Is Lunesta a good sleeping pill?

Lunesta (eszopiclone) is an effective sleeping pill. The exact mechanism of Lunesta is unclear, but it is believed that it can make you feel relaxed and sleepy by raising GABA levels in the nervous system. Studies have shown that Lunesta both decreases sleep latency (the time taken to fall asleep) and improves sleep maintenance (the ability to stay asleep). 

Lunesta is generally well-tolerated. However, there are some serious adverse effects you should watch out for. People have reported unusual thoughts and behavioral changes while taking Lunesta. This medication can also worsen suicidal thoughts and depression. 

Before initiating insomnia treatment with Lunesta, to make sure it is safe for you, you should let your doctor know if you have the following conditions:

  • A breathing disorder
  • Liver disease
  • Mental illnesses such as depression or suicidal thoughts
  • Drug or alcohol addiction

Complex sleep behavior is another side effect you should be aware of. These behaviors include sleepwalking, sleep driving, and sleep eating. Though rare, these behaviors can cause serious injury or even death.

What is the maximum dose of Lunesta?

The maximum dose of Lunesta in adults is 3 mg once daily, immediately before bedtime. The recommended starting dose is 1 mg; the dose can be raised to 2 mg or 3 mg if needed.

In older adults, frail individuals, and patients with severe hepatic impairment (liver disease or liver damage), the maximum dose of Lunesta is 2 mg daily. The typical maintenance dose for these patient populations is 1 mg to 2 mg orally once a day immediately before bedtime.

Lunesta use is approved for adults only. The safety and efficacy of this drug have not been established in children. High doses of Lunesta can result in reduced alertness and cognitive impairment the next day. 

How to take Lunesta?

You should take Lunesta right before bedtime since Lunesta is effective within an hour of taking it. Don’t take this medicine during your waking hours or if you don’t have enough time for a full night’s sleep (7-8 hours).  

Do not take Lunesta after a heavy meal. This can make the drug less effective and take longer to kick in. 

While on Lunesta, especially at higher doses, you may feel dizziness, drowsiness or extra sleepiness the morning after. Therefore, you should be extremely cautious while driving or performing other potentially hazardous activities that require complete mental alertness; especially in the beginning when you don’t know how your body will react to this medication. 

The sedating effect of Lunesta is typically stronger in elderly patients, frail individuals, and those with liver impairment. People in these populations need to use extra caution to prevent a fall, which can lead to accidental injury and disability.

Lunesta is a schedule IV controlled substance. You should tell your doctor if you have a history of alcohol or drug abuse since Lunesta can be habit-forming. Lunesta abuse can lead to serious side effects. As a schedule IV controlled substance, Lunesta has a low potential for abuse and a low risk for dependence. However, Lunesta addiction and physical dependence can occur. You should reach out to seek help if you or someone you love are dealing with a substance use disorder.

Do not drink alcohol while on Lunesta, as it can worsen certain side effects, such as sedation and impaired coordination during the next day, which can lead to serious injury.  

Lunesta is usually taken at bedtime to treat insomnia; therefore, most people don’t frequently miss it. In case of a missed dose, take it as soon as you remember. However, do not take Lunesta if there are less than 7-8 hours left before you must wake up.

Is it OK to take Lunesta every night?

Lunesta is for the short-term treatment of insomnia. It is usually prescribed for 7-10 days. Tell your doctor if your sleep difficulties do not improve during the 7 to 10 days of treatment with Lunesta or if they get worse during treatment. Your insomnia may be due to some other underlying medical condition that needs to be diagnosed and treated. Also, tell your doctor if you notice any unusual thoughts or behaviors while on Lunesta. 

Note that many people experience rebound insomnia (worse sleep problems compared to before) after they stop taking Lunesta. Let your doctor know if you experience worsened sleep problems after stopping Lunesta. 

What are the side effects of Lunesta?

Stop taking the medication and let your doctor know right away if you experience the following side effects:

  • Signs of allergic reaction, such as hives, difficulty breathing, nausea, vomiting, and swelling of face, lips, tongue, or throat.
  • Worsening depression or suicidal thoughts.
  • Memory problems or memory impairment, confusion, or hallucinations
  • Complex sleep behaviors such as sleepwalking, sleep driving, or any other activities that you engage in while not fully awake and don’t have any memory of afterward.

Some common side effects of Lunesta are listed below:

  • Dizziness, day-time drowsiness, or “hangover” feeling
  • Headache
  • Dry mouth, unusual or unpleasant taste in your mouth

Other side effects of Lunesta are rash, nausea, sore throat, fever, cough, and other cold or flu symptoms like runny nose and body aches.

There have been reports of the following side effects of Lunesta:

  • Mouth ulceration, ear pain
  • Increased appetite
  • Leg cramps, abnormal gait
  • Skin discoloration
  • Difficulty concentrating, emotional lability
  • Rectal hemorrhage, vaginal hemorrhage, or uterine hemorrhage 
  • Breast enlargement, breast pain, breast engorgement

Some of the above side effects are rare but dangerous. Let your doctor know if you experience any of these signs and symptoms. This is not a comprehensive list of Lunesta side effects. Talk to your doctor or pharmacist if you experience a side effect that is not listed above.

What are the long-term effects of taking Lunesta?

Long-term use of this medicine can lead to problems with cognitive functions. Examples of some serious side effects include memory loss, worsened depression, suicidal thoughts, anxiety, hallucinations, and paranoia.

What are the risks of taking Lunesta?

Allergic Reaction

Rarely, taking Lunesta can lead to a severe allergic reaction called anaphylaxis, presenting as difficulty breathing, hives, and swelling of the throat, tongue, or lips. This type of allergic reaction requires emergency medical treatment. Before starting Lunesta, tell your doctor if you have ever had an allergic reaction to eszopiclone or any other medicines. Seek emergency medical help if you develop signs and symptoms of a severe allergic reaction.

Withdrawal Symptoms

Stopping Lunesta suddenly can lead to withdrawal effects like nausea, vomiting, stomach cramps, anxiety, unusual dreams, shakiness, sweating, and seizures in rare cases. Do not stop taking Lunesta without talking to your doctor first. Your doctor will tell you how to reduce the dose gradually. 

Drug Interactions

Lunesta can interact with other drugs and cause severe side effects, potentially leading to serious health complications. Before taking Lunesta, you should talk to your doctor if you are taking any medications that can make you drowsy or slow your breathing since this drug combination can be very dangerous; examples include opioid pain medications, muscle relaxants, and anxiety medications.  

Rifampin and ketoconazole can affect the levels of Lunesta in your body; let your doctor know if you are taking these medications. Other drugs to watch out for are itraconazole, clarithromycin, nefazodone, troleandomycin, ritonavir, and nelfinavir. 

To avoid unpleasant adverse effects, you should inform your doctor or pharmacist about all the medications you are taking, including prescription medications, over-the-counter products, herbal supplements, and vitamins.

Special populations

The side effects of Lunesta are stronger in elderly patients (65 years and older), frail individuals with serious health problems, and those with severe liver disease. Lunesta should be used with caution in those groups of people. Dose adjustment and close monitoring are required to ensure safety. 

What does Lunesta do to the brain?

Lunesta is a sedative-hypnotic that works as a central nervous system depressant. Lunesta’s exact mechanism of action is unclear except for the fact that this medication may increase GABA levels in the nervous system. This reaction, in turn, leads to the calm, relaxed feeling that helps you fall asleep. By slowing down brain activity, Lunesta can cause impaired coordination, dizziness, and lightheadedness. Lunesta can also cause short-term memory problems if taken during waking hours or not having a full night’s sleep (7-8 hours) after taking this medication.


  1. https://www.mayoclinic.org/drugs-supplements/eszopiclone-oral-route/side-effects/drg-20063743?p=1
  2. https://medlineplus.gov/druginfo/meds/a605009.html
  3. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021476s030lbl.pdf
  4. https://americanaddictioncenters.org/lunesta-treatment/side-effects