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Non-benzodiazepine hypnotic (Z-drug)

Eszopiclone 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 Eszopiclone (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 Eszopiclone 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 Eszopiclone affects contraception. Most agents in Non-benzodiazepine hypnotic (Z-drug) 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 Eszopiclone 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 Eszopiclone therapy is the standard mitigation.

Frequently asked questions

Will Eszopiclone make my pill less effective?

Most Non-benzodiazepine hypnotic (Z-drug) 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 Eszopiclone?

Backup contraception is needed only when there is a documented interaction between Eszopiclone and the contraceptive method. For most users at 1mg, 2mg, 3mg, no backup is required. The pharmacist confirms whether Eszopiclone interacts with hormonal contraception.

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