Indications for LUNESTA:
Insomnia (decreased sleep latency and improved sleep maintenance).
Use lowest effective dose. Effects delayed if taken with or after a heavy/high-fat meal. ≥18yrs: initially 1mg immediately before bedtime (with at least 7–8hrs remaining before planned time of awakening); may increase to 2–3mg if needed; max 3mg/dose. Elderly, debilitated, concomitant CYP3A4 inhibitors, or severe hepatic impairment: max 2mg/dose.
<18yrs: not established.
Prior history of complex sleep behaviors with Lunesta.
Complex sleep behaviors.
Risk of complex sleep behaviors (eg, sleep-walking, sleep-driving, engaging in other activities while not fully awake); discontinue immediately if occur. Monitor for CNS depressant effects and next-day impairment. Evaluate for co-morbid diagnoses (eg, physical and/or psychiatric disorders) prior to treatment. Reevaluate if insomnia fails to remit after 7–10 days of use. Depression. Suicidal tendencies. Evaluate any new onset of behavioral changes. Compromised respiratory function. Conditions that affect metabolism or hemodynamic response. Drug or alcohol abuse. Hepatic impairment. Avoid abrupt cessation. Write ℞ for smallest practical amount. Elderly (higher risk of falls). Debilitated. Pregnancy. Nursing mothers.
Concomitant other sedative-hypnotics at bedtime or middle of the night: not recommended. Potentiates CNS depression with alcohol, other CNS depressants; adjust dose. Potentiated by CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, troleandomycin, ritonavir, nelfinavir); see Adults. May be antagonized by CYP3A4 inducers (eg, rifampicin).
Unpleasant taste, headache, somnolence, dizziness, dry mouth, infection, rash, anxiety, hallucinations; abnormal thinking and behavioral changes; rare: anaphylaxis, angioedema (do not rechallenge).
Generic Drug Availability:
Tabs 1mg—30; 2mg, 3mg—30, 100