Eszopiclone Side Effects and Safety Concerns

Introduction to Eszopiclone Side Effects

Unpleasant or bitter/metallic taste is the hallmark side effect of eszopiclone, occurring in approximately 7-26% of patients compared to 0.5-5.6% with placebo 1
This taste disturbance is dose-related, with higher incidence at the 3 mg dose 1
While bothersome, this side effect is generally not serious enough to preclude use in appropriate patients 1

Eszopiclone is associated with mild to moderate adverse effects in observational studies, which is more favorable than zolpidem's profile of serious adverse effects (amnesia, vertigo, confusion, diplopia) 2, 3
Increased infection incidence has been reported with eszopiclone in pooled RCT data 2, 3
In older patients, sedative-hypnotics including eszopiclone show increased risks of:
- 5-fold increase in memory loss, confusion, and disorientation 2, 3
- 3-fold increase in dizziness, loss of balance, or falls 2, 3
- 4-fold increase in residual morning sedation 2, 3

Patients may still feel drowsy the next day and should not drive or perform dangerous activities until fully awake 3, 4
The FDA warns that drugs taken at bedtime remain at levels high enough to interfere with morning driving 3, 4
Dose reduction is advised in women and older/debilitated adults 3, 4