Eszopiclone
| Clinical data | |
|---|---|
| Trade names | Lunesta, Eszop, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a605009 |
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| Routes of administration | By mouth |
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| Pharmacokinetic data | |
| Protein binding | 52–59% |
| Metabolism | Liver oxidation and demethylation (CYP3A4 and CYP2E1-mediated) |
| Elimination half-life | 6 hours |
| Excretion | Kidney |
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| ECHA InfoCard | 100.149.304 |
| Chemical and physical data | |
| Formula | C17H17ClN6O3 |
| Molar mass | 388.81 g·mol−1 |
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Eszopiclone, sold under the brand name Lunesta among others, is a nonbenzodiazepine medication used in the treatment of short-term and long-term insomnia. It holds the distinction of being one of the few FDA-approved hypnotic medications with a controlled substance designation that does not have restrictions on its length of use. [2][3] Evidence supports benefits up to six months, with some studies suggesting similar efficacy after 12 months.[4][3][5] It is taken by mouth.[2][4]
Eszopiclone's primary mechanism of action involves enhancing the natural effect of GABA receptors by acting as a Positive Allosteric Modulator on GABA-A expressing neurons. This increases the frequency of the chloride channel opening when GABA is present. This is a distinguishing feature, as Eszopiclone will not force sleep or act as a tranquilizer but instead encourages a positive sleep-wake routine.
Common side effects include headache, dry mouth, nausea, and dizziness.[4] Severe side effects may include suicidal thoughts, hallucinations, and angioedema.[4] Rapid decreasing of the dose may result in withdrawal.[4] Eszopiclone is classified as a nonbenzodiazepine or Z-drug and a sedative and hypnotic of the cyclopyrrolone group.[6] It is the S-stereoisomer of zopiclone.[4][7]
Approved for medical use in the United States in 2004,[2] eszopiclone is available as a generic medication.[4] In 2020, it was the 232nd most commonly prescribed medication in the United States, with more than 1 million prescriptions.[8][9] Eszopiclone is not sold in the European Union; as of 2009, the European Medicines Agency (EMA) ruled that it was too similar to zopiclone to be considered a new active substance.[10][11][12]
- ^ Anvisa (2023-03-31). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 2023-04-04). Archived from the original on 2023-08-03. Retrieved 2023-08-16.
- ^ a b c d "Lunesta- eszopiclone tablet, coated". DailyMed. 24 May 2023. Retrieved 7 July 2023.
- ^ a b Cite error: The named reference
TB2012was invoked but never defined (see the help page). - ^ a b c d e f g "Eszopiclone Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 6 April 2019.
- ^ Rösner S, Englbrecht C, Wehrle R, Hajak G, Soyka M (October 2018). "Eszopiclone for insomnia". The Cochrane Database of Systematic Reviews. 2018 (10): CD010703. doi:10.1002/14651858.CD010703.pub2. PMC 6492503. PMID 30303519.
- ^ Cite error: The named reference
Davis2017was invoked but never defined (see the help page). - ^ Rösner S, Englbrecht C, Wehrle R, Hajak G, Soyka M (October 2018). "Eszopiclone for insomnia". The Cochrane Database of Systematic Reviews. 2018 (10): CD010703. doi:10.1002/14651858.CD010703.pub2. PMC 6492503. PMID 30303519.
- ^ "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
- ^ "Eszopiclone - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
- ^ "Lunivia: Withdrawn application". European Medicines Agency. 17 September 2018. Retrieved 19 February 2023.
- ^ Edwards J (13 June 2009). "End of Sepracor-GSK Deal Raises Question in Lunesta Patent Fight". www.cbsnews.com. Retrieved 7 April 2019.
- ^ "Sepracor Pharmaceuticals Ltd withdraws its marketing authorisation application for Lunivia (eszopiclone)". European Medicines Agency. 15 June 2009. Archived from the original on 3 August 2012. Retrieved 7 April 2019.