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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
You might be experiencing trouble sleeping for any number of reasons. You might be stressed with a new job or another change in your living situation. If you’re experiencing insomnia, a healthcare provider might recommend a prescription sleep aid like Lunesta or Ambien. But which one works better?
The answer is it depends. These medications are part of the same class of drugs called sedative-hypnotics. Both Lunesta and Ambien are believed to work by interacting with GABA receptors in the brain to produce a sense of calm. While they may have similar effects, they have differences in formulation and how long they last for.
Continue reading to learn more about the differences between Lunesta and Ambien.
What are the main differences between Lunesta vs. Ambien
Lunesta and Ambien contain different active ingredients
Although both drugs work in similar ways, Lunesta and Ambien contain different ingredients. Lunesta is a brand-name medication that contains eszopiclone while Ambien is a brand-name medication that contains zolpidem tartrate.
Lunesta lasts longer than Ambien
Lunesta generally lasts longer than regular Ambien. It has a longer half-life of six hours compared to a half-life of around 2.5 hours with Ambien. People may be able to fall asleep and stay asleep longer with Lunesta than with Ambien.
Lunesta reaches peak levels in the blood around one hour after taking it while Ambien reaches peak levels in the blood around 1.5 hours after administration. Therefore, Lunesta may start producing maximum sedative effects faster than Ambien.
Lunesta and Ambien are available in different strengths and formulations
Lunesta is available as a tablet in strengths of 1 mg, 2 mg, and 3 mg. Ambien is available as an immediate-release tablet in strengths of 5 mg and 10 mg.
Ambien CR is an extended-release version of Ambien that is available as a 6.25 mg and 12.5 mg tablet. Ambien CR releases the active ingredient over a longer period of time than regular Ambien to help you stay asleep longer.
| Main differences between Lunesta and Ambien | ||
|---|---|---|
| Lunesta | Ambien | |
| Drug class | Sedative-hypnotic | Sedative-hypnotic |
| Brand/generic status | Brand and generic version available | Brand and generic version available |
| What is the generic name? | Eszopiclone | Zolpidem tartrate |
| What form(s) does the drug come in? | Tablet | Tablet Extended-release tablet |
| What is the standard dosage? | Recommended initial dose of 1 mg before bedtime Maximum dosage of 3 mg once daily Dosage may differ for the elderly and people with liver problems |
Recommended initial dose of 5 or 10 mg before bedtime Maximum dosage of 10 mg once daily Dosage may differ for the elderly and people with liver problems |
| How long is the typical treatment? | Short-term or long-term | Short-term or long-term |
| Who typically uses the medication? | Adults | Adults |
Conditions treated by Lunesta and Ambien
Lunesta and Ambien are approved by the Food and Drug Administration (FDA) to treat insomnia. Although they are generally recommended to be used for short-term or temporary insomnia, they may also be used to treat long-term or chronic insomnia. Lunesta and Ambien can help a person fall asleep faster and stay asleep longer.
| Condition | Lunesta | Ambien |
| Insomnia | Yes | Yes |
Is Lunesta or Ambien more effective?
Lunesta may be considered more potent than Ambien as it has a longer half-life and thus, its effects may last longer. However, clinical studies have shown that Lunesta and Ambien are similarly effective prescription drugs for treating insomnia.
Double-blind, clinical trials have found that Lunesta and Ambien are comparable in efficacy. Based on Insomnia Severity Index scores after four weeks of treatment, people taking Lunesta or Ambien experienced similar improvements in total sleep time.
Some studies have shown that Ambien decreases the time it takes to fall asleep (sleep latency) more than Lunesta. However, the effects on sleep latency may be influenced by dosage. When given in larger doses in clinical trials, Ambien and Lunesta provide similar effects on improving sleep latency.
The most effective medication is the one that works best for you depending on your overall health condition. Consult a healthcare provider for medical advice on the best treatment option. Other factors, such as cost and insurance coverage, could also influence which medication is better for you.
Coverage and cost comparison of Lunesta vs. Ambien
Lunesta is a brand-name medication that may be covered by some insurance plans. Most Medicare and insurance plans cover the cost of the generic version, eszopiclone. The average cash price of Lunesta is $586 for a standard supply. Using a discount card for Lunesta could help reduce the cash price of Lunesta.
Ambien is also a brand-name medication that may be covered by some insurance plans. A generic version of Ambien, zolpidem, is available on the market and is generally covered by Medicare and insurance plans. The cash price of Ambien is $724 on average for a prescription. An Ambien discount card may help lower the cash price of Ambien.
| Lunesta | Ambien | |
| Typically covered by insurance? | Yes, the generic version is usually covered | Yes, the generic version is usually covered |
| Typically covered by Medicare Part D? | Yes, the generic version is usually covered | Yes, the generic version is usually covered |
| Quantity | 30, 3 mg tablets | 30, 10 mg tablets |
| Typical Medicare copay | $1–$5 | $0–$2 |
| SingleCare cost | $9+ | $10+ |
Common side effects of Lunesta vs. Ambien
The most common side effects of Lunesta are dry mouth, an unpleasant taste in the mouth, drowsiness, dizziness, headache, and symptoms of the common cold.
The most common side effects of Ambien are drowsiness, dizziness, diarrhea, grogginess, and a drugged feeling.
Serious side effects may include mental and behavioral changes, as well as allergic reactions. Consult a healthcare provider if you experience any side effects while taking Lunesta or Ambien.
A comparison of the common side effects of Lunesta and Ambien can be found below.
| Lunesta 2 mg | Ambien ≤ 10 mg | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Drowsiness | Yes | 10% | Yes | 8% |
| Dizziness | Yes | 5% | Yes | 5% |
| Headache | Yes | 21% | Yes | 7% |
| Symptoms of the common cold | Yes | 3% | Yes | 2% |
| Diarrhea | Yes | 2% | Yes | 3% |
| Grogginess | No | – | Yes | 3% |
| Constipation | No | – | Yes | 2% |
| Abnormal dreams | Yes | 1% | Yes | 1% |
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Lunesta), DailyMed (Ambien)
Drug interactions of Lunesta vs. Ambien
Lunesta and Ambien are processed in the liver by the CYP3A4 enzyme. Drugs that act as CYP3A4 inhibitors can block the CYP3A4 enzyme and increase blood levels of Lunesta or Ambien. Increased blood levels could increase the risk of side effects. Examples of CYP3A4 inhibitors include certain antifungals like ketoconazole and macrolide antibiotics like clarithromycin.
Drugs that act as CYP3A4 inducers do the opposite of CYP3A4 inhibitors. These drugs can speed up the processing of Lunesta or Ambien and decrease their overall blood levels. Lunesta and Ambien may not work as well when taken with CYP3A4 inducers like rifampin or St. John’s wort.
Lunesta and Ambien work by slowing down activity in the central nervous system (CNS). Other drugs, such as opioids, benzodiazepines, muscle relaxants, and tricyclic antidepressants, can have similar CNS depressant effects. Combining these types of drugs with Lunesta or Ambien may increase the risk of drowsiness and dizziness.
| Drug | Drug Class | Lunesta | Ambien |
| Ketoconazole Itraconazole |
Antifungal | Yes | Yes |
| Clarithromycin Erythromycin |
Macrolide antibiotics | Yes | Yes |
| Rifampin | Rifamycin antibiotic | Yes | Yes |
| St. John’s wort | Herbal supplement | Yes | Yes |
| Alcohol | Alcohol | Yes | Yes |
| Codeine Hydrocodone Hydromorphone Oxycodone Fentanyl |
Opioid pain relievers | Yes | Yes |
| Lorazepam Diazepam Clonazepam Alprazolam |
Benzodiazepines | Yes | Yes |
| Carisoprodol Cyclobenzaprine Metaxalone |
Muscle relaxants | Yes | Yes |
| Fluoxetine Sertraline Citalopram Paroxetine |
SSRI antidepressants | Yes | Yes |
| Venlafaxine Desvenlafaxine Duloxetine |
SNRI antidepressants | Yes | Yes |
| Imipramine Desipramine Amitriptyline Nortriptyline |
Tricyclic antidepressants | Yes | Yes |
This may not be a complete list of all possible drug interactions. Consult a healthcare provider with all medications you may be taking.
Warnings of Lunesta and Ambien
Lunesta and Ambien can cause serious side effects that may result in injury or death. In rare cases, these drugs can cause complex sleep behaviors, such as sleepwalking or sleep-driving. They can also cause memory loss of these events. Discontinue Lunesta or Ambien and seek help from a healthcare provider if you experience complex sleep behaviors.
Lunesta and Ambien can cause significant drowsiness and other CNS depressant effects that can lead to impairment the next day. These drugs should be used with caution especially when driving or operating machinery the next day.
In rare cases, Lunesta and Ambien may cause worsening depression and suicidal thinking. These drugs may also cause abnormal thinking or behaviors, including agitation and hallucinations.
Abruptly lowering the dose or stopping the use of Lunesta or Ambien can lead to withdrawal symptoms, such as lightheadedness, fatigue, nausea, and stomach cramps. The risk of withdrawal symptoms may be higher with long-term use of Lunesta or Ambien. These medications should only be discontinued under the guidance of a healthcare provider.
The elderly and people with liver problems should use caution when taking Lunesta or Ambien. The recommended dose may be reduced to decrease the risk of side effects.
Consult with a healthcare provider for other possible warnings associated with Lunesta or Ambien.
Frequently asked questions about Lunesta vs. Ambien
What is Lunesta?
Lunesta is a brand-name sleep medication used to treat insomnia. The generic name of Lunesta is eszopiclone, and it is available as a 1 mg, 2 mg, or 3 mg tablet. The usual starting dose is 1 mg before bedtime.
What is Ambien?
Ambien is a brand-name prescription drug used to treat insomnia. It is available as a generic drug called zolpidem. Ambien is usually taken as a 5 mg or 10 mg tablet before bedtime. It is also available in an extended-release form called Ambien CR.
Are Lunesta and Ambien the same?
Lunesta and Ambien are sleep medications used to treat insomnia. However, they contain different active ingredients and come in different formulations. Lunesta contains eszopiclone while Ambien contains zolpidem. Lunesta is available as a regular oral tablet while Ambien is available as a regular and extended-release oral tablet.
Is Lunesta or Ambien better?
Lunesta and Ambien are both effective for treating sleep problems. Lunesta has a longer half-life and may last longer than Ambien. Lunesta may also start producing maximum effects faster than Ambien. However, some studies show that Ambien may help put you to sleep faster depending on the dosage prescribed.
The best medication will be determined based on your overall condition. Other sleep medications may be recommended instead of Lunesta or Ambien, such as Sonata (zaleplon) or over-the-counter melatonin.
Can I use Lunesta or Ambien while pregnant?
Some healthcare providers may prescribe Lunesta or Ambien to women who are pregnant. However, there is not enough data to show that Lunesta or Ambien is safe to use during pregnancy. Animal studies have shown Lunesta may cause toxicity in an unborn baby. Reports have also found that Ambien can cause respiratory depression and sedation in infants when taken in the third trimester. Talk to a healthcare provider before using Lunesta or Ambien while pregnant.
Can I use Lunesta or Ambien with alcohol?
Alcohol can slow down the central nervous system and cause side effects like drowsiness and dizziness. Drinking alcohol with Lunesta or Ambien can increase the risk of drowsiness and dizziness.
Is Lunesta less habit-forming than Ambien?
Both Lunesta and Ambien are Schedule IV medications that carry a risk of abuse, misuse, and dependence. They can both be habit-forming, especially with long-term use. Lunesta and Ambien should only be taken as prescribed by a healthcare provider.
What happens if you take Lunesta and stay awake?
If you take Lunesta and stay awake, you may experience dizziness, impaired coordination, hallucinations, or short-term memory loss. The effects of Lunesta may still be present if you don’t get a full seven to eight hours of sleep. You could experience decreased alertness and confusion if you take Lunesta without getting enough sleep.
Does Lunesta help with anxiety?
It’s important to note that Lunesta can cause anxiety as a side effect. However, chronic insomnia may be linked to anxiety and depression. Lunesta is sometimes used to treat insomnia and sleep disorders associated with anxiety.
