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Sleep Aids and Hypnotics

Lunesta with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Lunesta (Eszopiclone). Most antibiotics do not interfere meaningfully with Eszopiclone at 1mg, 2mg, 3mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Sleep Aids and Hypnotics agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Eszopiclone at 1mg, 2mg, 3mg.

Practical guidance

According to the prescribing information for Eszopiclone, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Lunesta is co-administered. Adjusted 1mg, 2mg, 3mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Lunesta during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Eszopiclone is metabolised and may need a temporary 1mg, 2mg, 3mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Lunesta regimen.

Will antibiotics make Lunesta stop working?

Most antibiotics do not affect Lunesta efficacy. Rifampicin and a few others can lower Eszopiclone levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Lunesta

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.