Prescription And Medication

Difference between Lunesta and Ambien

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Ambien and Lunesta are two prescription medications that are used in individuals who suffer from insomnia.  Both medications are heavily marketed and have become popular among people in the United States. 

Despite the fact that both medications are non-benzodiazepene hypnotics prescribed for similar indications, namely difficulty falling asleep and/or staying asleep, significant differences exist between Lunesta and Ambien.

Ambien is the brand name for the prescription medication known generically as Zolpidem.  Ambien is used for the short term treatment of difficulty falling asleep.  Individuals should be aware of the difference between Ambien and Ambien CR.  The extended release version of Ambien, known as Ambien CR, is the only form of Ambien used for difficulty falling asleep as well as difficulty staying asleep through out the night.

Lunesta, on the other hand, is the brand name for the prescription medication known generically as Eszoplicone.  While non-CR Ambien is indicated only for difficulty falling asleep, Lunesta is used for both difficulty falling asleep and difficulty staying asleep.

Ambien is used sublingually, meaning that it is placed under the tongue to dissolve, or is taken as a tablet.   Lunesta is not available as a sublingual preparation.  Both Ambien and Lunesta begin acting almost immediately, so individuals should take Ambien or Lunesta  just before bed. 

Both Ambien and Lunesta are rapidly absorbed but the absorption can be slowed if taken with or after full meals or excessively fatty meals.  These medications are best taken on an empty stomach for the most rapid onset of sleep. 

The dose of Ambien does not have to be adjusted for altered renal (kidney) function.  However, Ambien should be used with caution in individuals with liver failure.

As with Ambien, the dose of Lunesta does not have to be adjusted for altered renal or liver function.  However, the pharmacokinetic metabolism of Lunesta is more likely to be altered by certain medications that are also metabolized in the liver.  Physicians should be aware of the potential for drug interactions.

Neither Ambien nor Lunesta are benzodiazepenes.  However, both medications do have the potential for abuse, though this potential is believed to be lower than the abuse potential of benzodiazepenes such as Lorazepam and Ativan.

Perhaps the most significant difference between Ambien and Lunesta is in the development of tolerance to the medication.  Studies have shown that individuals who have taken Lunesta for up to 6 months do not develop tolerance to this medication.  Tolerance is defined as the need for increased doses of a medication in order to achieve a desired effect.

Ambien (Zolipidem) decreases an aspect of sleep known as sleep latency.  Ambien should not be prescribed in quantities that exceed the amount needed for a 1 month supply.  Lunesta (Eszoplicone), as well, should not be prescribed in amounts this great.  This is because a long-term requirement for insomnia medications implies a psychological and/or medical cause for insomnia that should be addressed.

Source:  Lexi-Comp Online. Accessed Mar 25, 2010.

More about this author: Nicole Evans M.D.

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