Lunesta is the brand name version of eszopiclone, a commonly prescribed medication for insomnia. While this medication is generally well-tolerated, some people will experience side effects. Common side effects include a bitter taste in the mouth, headaches, and some residual sleepiness the next day. More serious Lunesta side effects like swelling, hives, breathing problems, and sleep-walking are also possible, but are less common. [1][2]
- Lunesta is the brand name version of a medication called eszopiclone, which is commonly prescribed for the treatment of insomnia.
- Side effects like dry mouth, bitter taste in the mouth, headache, nausea, and residual daytime sleepiness are relatively common and may be addressed by adjusting the dose.
- Less commonly, more serious side effects like allergic reactions, sleepwalking, psychosis, and increased suicidal ideation are possible, and should be discussed immediately with a doctor or prescriber.
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Most common side effects of Lunesta
Lunesta is one of the most commonly prescribed medications for insomnia, and is preferred by many prescribers because of its low incidence of side effects. Most of the time, side effects of Lunesta are relatively mild in nature and do not pose a serious risk to health or safety. [2]Â
Some of the most common side effects of Lunesta include: [1][2]Â
- A bitter or unpleasant taste in the mouth
- Dry mouth
- Nausea or vomiting
- Headaches
- Dizziness or drowsiness
- Unusual dreams
- Somnolence (daytime sleepiness)
Next-day impairment
Lunesta is preferred by many prescribers because it has fewer residual effects than many competitors on the market. Still, there are some reports of sleepiness, poor coordination, lack of alertness, and memory problems the day after taking this medication. Next-day impairment appears to be highest in people who are taking high doses of this medication. For this reason, the FDA issued a warning and adjusted the recommended starting dose from 2-3 mg to 1 mg for this medication in 2014. [3]
Specifically, the FDA reported that there is research suggesting that people taking 3 mg of Lunesta at bedtime sometimes experienced difficulty remaining awake, alert, and coordinated the next day. These residual effects often went unnoticed by people taking the medication, but were significant enough to affect driving, coordination, memory, and alertness. Next-day impairment may be highest in older adults, who metabolize the medication more slowly. [3][4]
Serious side effects & warnings
A small number of people who take Lunesta experience serious side effects, and some may require emergency medical attention. Drug allergies to Lunesta are uncommon, but can occur. Signs that can indicate a severe, life-threatening allergy or response to this medication include: [1]
- Hives or rash
- Severe itching
- Swelling of the face, eyes, lips, tongue, throat, hands, feet, or legs
- Trouble swallowing
- Throat closing
- Horseness of voice
Other serious, but uncommon, Lunesta side effects include: [1][2]Â
- Sleep-walking
- Hallucinations or delusions
- Increased suicidal ideation or severe depression
Complex sleep behaviors & safety
Some people who take Lunesta experience strange sleep behaviors, which can pose a serious risk and safety concern. For instance, there have been reports of people getting up out of bed, getting in the car to drive, making phone calls, or preparing food without having any memory the next day. [3]
These blackout experiences are similar to sleepwalking and can include a number of strange behaviors that occur when the effects of the medication are still highly active. This can pose a safety risk because the effects of the medication can actively impair a person’s cognitive functioning, memory, and physical coordination.Â
Dependence, tolerance, & withdrawal risks
Lunesta is a schedule IV controlled substance, which means it has a potential for abuse and dependence. There have not been significant reports of the medication being abused or taken for recreational purposes. When taken as prescribed, studies have shown that it carries a low risk for tolerance, even when used long-term. Because of this, most people report that the drug remains effective, and no dose increases are needed. [2]Â
This medication works by binding to GABA and selective benzodiazepine receptors in the brain that affect a person’s anxiety, alertness, coordination, and memory. When taking this medication long-term, it may be necessary to taper off slowly. Stopping the medication suddenly may result in unwanted withdrawal symptoms, especially at higher doses. [1][2]Â
Tapering and managing withdrawals
After taking Lunesta for long periods of time, it is usually recommended to work with a prescriber to taper off the medication gradually, rather than suddenly stopping. Stopping the medication suddenly after long-term use may induce temporary symptoms of withdrawal, including: [1]
- Anxiety
- Insomnia
- Unusual dreams
- Stomach or muscle cramps
- Nausea or vomiting
- Shakiness
- Sweating
- Seizures (rare but serious withdrawal symptom)
Interactions & high risk combinations
It’s always important to talk with your prescriber about any medications you are taking, including disclosing use of supplements, vitamins, recreational drugs, or alcohol. Drug interactions are complex and may increase the chances of experiencing serious side effects.Â
Some of the known drug interactions and contraindications of Lunesta include: [1]
- Alcohol or other CNS depressants
- CYP3A4 inhibitors
- Grapefruit juice
Caution for special populations
Certain populations may be more likely to develop serious side effects when taking Lunesta. This medication is metabolized more slowly by older adults age 65+, who are often recommended to start at lower dosages of around 1 mg. Because this medication is metabolized by the liver, people who have pre-existing liver problems should consult with a doctor before starting this medication. [1][4]
It is not known whether this medication is safe for pregnant or breastfeeding women, so speak with your doctor if you become pregnant, are breastfeeding, or plan to become pregnant after starting this medication. [1]
Some research indicates that this medication can increase depressive symptoms and suicidality in people who have an existing diagnosis of depression. There is also an increased risk of depressed people using this medication to attempt suicide via an overdose. [2]Â
Overdose signs and what to do
It is possible to overdose on Lunesta, but all reported cases have been intentional in nature. The medication is safe when taken within normal prescribed doses. Taking higher than prescribed doses can lead to serious side effects, which may be life-threatening in nature and require immediate medical attention. If you or a loved one has overdosed on Lunesta, go to your nearest emergency room to be evaluated.
Some of the possible signs of Lunesta overdose include: [1]
- Extreme drowsiness, dizziness, and lightheadedness.
- Poor coordination, speech, and motor impairment.
- Loss of consciousness or coma.
- Slowed or labored breathing.
- Irregular breathing or heart rate.
- Pale or bluish skin or nails.
Long term use and alternatives
Lunesta is one of the most commonly prescribed insomnia medications, and is preferred by many prescribers because it is considered safe for long-term use. Because Lunesta has a lower rate of serious side effects, cognitive impairment, and next-day residual effects, there is a low rate of people stopping the medication because of adverse effects. [1][2]Â
People who do not tolerate Lunesta well can consult with their doctor or prescriber to discuss alternatives. Other sleep medications like Zolpidem, Zaleplon, or Trazodone are also commonly prescribed for insomnia, and may be more effective for some people. Natural alternatives like supplementing with melatonin or making lifestyle changes to improve sleep hygiene are also effective for some people who struggle with insomnia.
Managing side effects: tips and when to see a doctor
When starting any new medication, it’s important to work closely with your doctor or prescriber to monitor the efficacy and address any concerning side effects. This can occur in a regularly scheduled follow-up appointment, but it’s important to schedule a sooner appointment if you notice serious side effects.Â
Some of the potential serious side effects to monitor and talk with your doctor about include: [1][2]Â
- Rash, hives, or swelling that may indicate an allergic reaction.
- Trouble or difficulty swallowing or breathing.
- Increased depressive symptoms or suicidal thoughts.
- Hallucinations, delusions, or unwanted intrusive thoughts and urges.
- Sleepwalking or strange sleep behaviors.
- Impaired daytime memory, concentration, or cognitive functioning.
- Excessive daytime sleepiness or residual next-day effects.
- Abnormal liver functioning or liver enzyme results.
