Lunesta with the birth control pill
Many women of reproductive age take a combined or progestogen-only oral contraceptive while also using a chronic medication such as Lunesta (Eszopiclone). The combination is generally fine at 1mg, 2mg, 3mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Lunesta can affect contraceptive efficacy
Combined and progestogen-only contraceptives are metabolised through CYP3A4. Strong CYP3A4 inducers (some antiepileptics, rifampicin, St John's Wort) lower contraceptive plasma levels and reduce efficacy. Whether Eszopiclone acts on CYP3A4 determines whether Lunesta affects contraception. Most agents in Sleep Aids and Hypnotics have no clinically meaningful effect on the pill at 1mg, 2mg, 3mg.
Practical guidance
According to the prescribing information for Eszopiclone, women on hormonal contraception should review Lunesta with the prescribing pharmacist or doctor. Where an interaction is documented, additional barrier contraception or switching to a non-oral method (IUD, implant) for the duration of Lunesta therapy is the standard mitigation.
Frequently asked questions
Will Lunesta make my pill less effective? ▾
Most Sleep Aids and Hypnotics medications at 1mg, 2mg, 3mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Eszopiclone states whether the interaction is meaningful.
Do I need a backup contraceptive on Lunesta? ▾
Backup contraception is needed only when there is a documented interaction between Lunesta and the contraceptive method. For most users at 1mg, 2mg, 3mg, no backup is required. The pharmacist confirms whether Eszopiclone interacts with hormonal contraception.
More on Lunesta
- With alcoholLunesta and alcohol — is it safe to drink?
- With foodShould Lunesta be taken with food?
- Side effectsLunesta side effects: common, rare and warning signs
- Dosage guideLunesta dosage guide: how much to take and when
- OnsetHow fast does Lunesta start working?
- DurationHow long does Lunesta last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.