Usual Adult Dose for Insomnia

Initial dose: 1 mg orally once a day immediately before bedtime
Maintenance dose: 1 to 3 mg orally once a day immediately before bedtime
Maximum dose: 3 mg/day

Comments:

• The lowest effective dose should be used.
• Patients should be monitored for cognitive and/or motor impairments, especially if this drug is used repeatedly.
• Patients should be reevaluated if insomnia persists after 7 to 10 days of treatment.

Usual Geriatric Dose for Insomnia

Initial dose: 1 mg orally once a day immediately before bedtime
Maintenance dose: 1 to 2 mg orally once a day immediately before bedtime
Maximum dose: 2 mg/day

Comments:

• The lowest effective dose should be used.
• Patients should be monitored for cognitive and/or motor impairments, especially if this drug is used repeatedly.
• Patients should be reevaluated if insomnia persists after 7 to 10 days of treatment.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Mild to moderate liver dysfunction: No adjustment recommended; use with caution.
Severe liver dysfunction: Up to 2 mg orally once a day immediately prior to bedtime

• Maximum dose: 2 mg/day

Dose Adjustments

CONCOMITANT USE WITH CENTRAL NERVOUS SYSTEM (CNS) DEPRESSANTS: Dose adjustment may be required; however, no specific guidelines have been suggested. Caution is recommended.

DEBILITATED PATIENTS AND/OR THOSE TAKING POTENT CYP450 3A4 INHIBITORS: Up to 2 mg orally once a day immediately prior to bedtime

• Maximum dose: 2 mg/day

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or to any of the ingredients
• Patients who have previously experienced an episode of complex sleep behaviors after taking this drug

• Complex sleep behaviors including sleepwalking, sleep-driving, and engaging in other activities while not fully awake may occur following the use of this drug.
• Some of these events may result in serious injuries, including death.

• Discontinue this drug immediately is a patient experiences a complex sleep behavior.

Dialysis

Data not available

Other Comments

Administration advice:

• Doses should be administered immediately before bedtime.
• The effects of eszopiclone on sleep onset may be reduced if it is taken with or immediately after a high-fat/heavy meal.

• This drug decreased sleep latency and improved sleep maintenance when administered at bedtime in clinical trials.
• Taking a sedative/hypnotic while still up and about may result in short-term memory impairment, hallucinations, impaired coordination, dizziness, and lightheadedness.
• The risk of next day impairment of driving and other activities that require full alertness is increased following use of 2 mg or 3 mg doses.
• Withdrawal effects may occur if the dose is rapidly reduced or treatment discontinued.

• NERVOUS SYSTEM: Changes in cognitive function, including complex behaviors
• PSYCHIATRIC: New/worsening depression

• Patients should be instructed to immediately report "sleep driving," other complex behaviors, and any new/worsening signs/symptoms of depression.
• Inform patients that this drug may cause somnolence and/or transient amnesia, and they should remain in bed and avoid driving or operating machinery for a full 7 to 8 hours after administration of this drug.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Frequently asked questions

• Is “Ambien-Tweeting” a Thing?