Prescription non-benzodiazepine sedative-hypnotic (Schedule IV controlled substance) approved for insomnia. The S-isomer of zopiclone, it is one of the few prescription sleep aids approved for long-term use (no restriction on duration). Improves both sleep onset and sleep maintenance. Associated with an unpleasant metallic taste as a common side effect. Dosage must be determined by your prescribing physician.
History of complex sleep behaviors after eszopiclone use9,3
The bottom line
Evidence rating strong. Most-documented uses: improved sleep onset, improved sleep maintenance, approved for long-term use. 10 sources indexed (2014–2025), with 1 interaction record on file.
The science
How it works, mechanistically.
Core mechanism
Binds to GABA-A receptors at or near the benzodiazepine binding site. While not as alpha-1 selective as zolpidem, it preferentially modulates GABA-A receptor subtypes involved in sleep initiation and maintenance. Its interaction with alpha-2 and alpha-3 subunits may contribute to anxiolytic and sleep-maintaining effects.6
Class
Sedative-Hypnotic (Non-Benzodiazepine)
Absorption
Best on an empty stomach
Dosing
Dosing & protocol.
Common range
1–3 mg at bedtime (as prescribed by your physician)
Recommended form
Tablet
Take immediately before bedtime on an empty stomach. Taking with or after a heavy, high-fat meal delays absorption. Allow at least 7–8 hours before planned awakening.2
Alcohol can add to eszopiclone's hypnotic and psychomotor-impairing effects. The combination can cause excessive sedation, impaired coordination, confusion, falls, and complex sleep behaviors. Older adults and people taking other sedatives are at higher risk.
Recommendation: Do not drink alcohol when taking eszopiclone. Skip eszopiclone rather than combining it with alcohol unless your prescriber gives different individualized instructions. Do not drive or perform hazardous tasks if both were used.
Li RY, Zhu DL, Chen KY. Efficacy and safety of eszopiclone combined with drug therapy in the treatment of insomnia after stroke: A network meta-analysis and systematic review. PloS one. 2024
Zhou M, Tang J, Li S et al.. Orexin dual receptor antagonists, zolpidem, zopiclone, eszopiclone, and cognitive research: A comprehensive dose-response meta-analysis. Frontiers in human neuroscience. 2022
Liang L, Huang Y, Xu R et al.. Eszopiclone for the treatment of primary insomnia: a systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials. Sleep medicine. 2019
Stranks EK, Crowe SF. The acute cognitive effects of zopiclone, zolpidem, zaleplon, and eszopiclone: a systematic review and meta-analysis. Journal of clinical and experimental neuropsychology. 2014
Schmickl CN, Orr JE, Alex RM et al.. Combination Drug Therapy with Acetazolamide, Eszopiclone ± Venlafaxine for Obstructive Sleep Apnea (RESCUE-Combo): A Randomized, Double-Blind, Placebo-controlled Clinical Trial. Annals of the American Thoracic Society. 2025
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