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Lunesta vs Rozerem
Introduction
For individuals struggling with insomnia or other sleep-related disorders, specific medications that modify the activities of certain brain compounds associated with sleep can be beneficial in managing symptoms. Lunesta and Rozerem are two such drugs often prescribed for these conditions. Each one impacts different substances within the brain, but both have effects on improving sleep quality.
Lunesta (eszopiclone) is a sedative-hypnotic agent that works mainly by slowing down activity in the brain to allow sleep. It's commonly used for short-term treatment of difficulties with falling asleep or staying asleep during the night.
On the other hand, Rozerem (ramelteon) is unique as it acts specifically on melatonin receptors in the brain. It helps regulate your body's internal clock, thus promoting natural onset of sleep rather than inducing artificial drowsiness.
Lunesta vs Rozerem Side By Side
Attribute | Lunesta | Rozerem |
---|---|---|
Brand Name | Lunesta | Rozerem |
Contraindications | Should not be taken with strong inhibitors of certain liver enzymes (like fluvoxamine) or with alcohol. | Should not be taken with strong inhibitors of certain liver enzymes or with alcohol. |
Cost | Brand-name: Around $400 for 30 tablets (3 mg). Generic: Between $0.50 and $15 per day. | Brand-name: About $350 for 30 capsules (8 mg). No generic available in most markets. |
Generic Name | Eszopiclone | Ramelteon |
Most Serious Side Effect | Memory issues, engaging in activities such as driving without full awareness ('sleep-driving'), unusual sensations, severe allergic reactions. | Allergic reactions, changes in behavior such as aggression, abnormal thoughts or hallucinations, unusual mood swings. |
Severe Drug Interactions | Strong inhibitors of certain liver enzymes, alcohol. | Strong inhibitors of certain liver enzymes, alcohol. |
Typical Dose | 1–3 mg/night | 8 mg/day before bedtime |
What is Lunesta?
Eszopiclone (the generic name for Lunesta) was a significant development in the class of drugs known as sedative-hypnotics designed to treat insomnia. It got its approval from the FDA in 2004. Lunesta works by increasing levels of GABA, an inhibitory neurotransmitter in the brain, producing a calming effect that helps people fall asleep more quickly and stay asleep longer. On the other hand, Ramelteon (Rozerem's generic name), approved by FDA in 2005, is unique among sleep medications because it mimics melatonin, a natural hormone our bodies produce to regulate sleep-wake cycles. Unlike Lunesta which affects GABA receptors throughout the brain, Rozerem selectively targets melatonin receptors located specifically in part of your brain that controls circadian rhythms - thus resulting potentially fewer side effects than traditional hypnotic medication like Lunesta.
What conditions is Lunesta approved to treat?
Lunesta is approved for the treatment of various sleep disorders:
- Insomnia, characterized by difficulty falling asleep or staying asleep
- Sleep maintenance insomnia (difficulty staying asleep throughout the night)
- Sleep initiation insomnia (trouble falling asleep at the beginning of the night)
How does Lunesta help with these illnesses?
Lunesta aids in managing insomnia by enhancing the effects of a neurotransmitter, gamma-aminobutyric acid (GABA), in the brain. It achieves this by increasing GABA's affinity for its receptor sites, which allows it to have a greater effect when released. GABA is an inhibitory neurotransmitter that reduces neuronal excitability, and it plays a fundamental role in sleep regulation as well as anxiety and muscle relaxation among other things. Insomnia sufferers often have disrupted or less effective GABA activity, leading to difficulty initiating or maintaining sleep. Therefore, by amplifying the action of GABA through Lunesta intake can help patients manage their condition and achieve more restful sleep.
What is Rozerem?
Rozerem is a brand name for ramelteon, which is a melatonin receptor agonist. This means it increases the levels of melatonin in the body by binding to its receptors and stimulating action similar to natural melatonin. It was first approved by the FDA in 2005 as an innovative approach to treating insomnia. Unlike traditional hypnotics or benzodiazepines like Lunesta (eszopiclone), Rozerem does not work by slowing brain activity; instead, it specifically targets sleep-wake cycles, making it less likely to cause side effects such as next-day drowsiness or dependency issues often associated with other sleep aids. Because of its unique mechanism of action on melatonin receptors rather than GABA receptors - common targets of most sedative drugs - Rozerem has shown less potential for abuse and withdrawal symptoms upon discontinuation compared to other prescription sleep medications like Lunesta.
What conditions is Rozerem approved to treat?
Rozerem has been approved by the FDA for treating insomnia in adults. Specifically, it is designed to help with:
- Difficulty falling asleep
- Maintaining sleep throughout the night This unique medication works differently than other sleeping pills by targeting melatonin receptors in the brain, which can help regulate your body's sleep-wake cycle rather than inducing drowsiness.
How does Rozerem help with these illnesses?
Melatonin is a hormone that plays key roles in regulating the body's sleep-wake cycle, controlling when we feel tired and when we feel awake. Low levels of melatonin can lead to insomnia and other sleep disorders. Rozerem works by mimicking the effects of melatonin, thereby helping to regulate the body's internal clock. Its action on melatonin receptors helps promote sleepiness and maintain a normal sleep cycle. Unlike Lunesta, which primarily acts as a sedative-hypnotic medication, Rozerem does not significantly affect GABA receptors — neurotransmitters associated with feelings of relaxation — instead targeting circadian rhythms directly. As such, it may be prescribed for those who have difficulty falling asleep or maintaining regular sleeping schedules due to jet lag or shift work.
How effective are both Lunesta and Rozerem?
Both eszopiclone (Lunesta) and ramelteon (Rozerem) are popular pharmaceutical options for treating sleep disorders such as insomnia, with each offering unique mechanisms of action that cater to different patient needs. Lunesta was approved by the FDA in 2004, just a year prior to Rozerem's approval.
Eszopiclone belongs to the class of drugs known as nonbenzodiazepine hypnotics and acts on GABA receptors, promoting sleep onset and maintenance. A double-blind clinical trial conducted in 2006 found that patients receiving Lunesta experienced significant improvements in their sleep latency (the time it takes to fall asleep) compared to those taking placebo. However, some individuals may experience side effects from Lunesta like unpleasant taste or dry mouth.
Ramelteon works differently; it is a melatonin receptor agonist which mimics the body's natural hormone involved in regulating circadian rhythm. This makes Rozerem particularly effective at helping people who have trouble falling asleep due its ability to reset the body’s internal clock. A 2005 study showed Rozerem had similar efficacy rates with fewer next-day residual effects than seen with other types of hypnotic medications.
A review carried out in 2012 concluded that both these drugs were effective treatments for chronic insomnia. Ramelteon is considered safer for long-term use because it doesn’t lead to dependence or withdrawal symptoms unlike many other sleeping aids including eszopiclone.
On balance, deciding between Lunesta and Rozerem often comes down individual patient factors such as their specific difficulties related to sleep initiation or maintenance and any history of substance abuse.
At what dose is Lunesta typically prescribed?
Oral dosages of Lunesta range from 1–3 mg/night, with studies indicating that a dose as low as 1mg/night is effective for most people in treating insomnia. Elderly or debilitated patients may start at the 1 mg dosage to ensure safety and tolerability. Dosage can be increased after a week if there is no response; however, it's important not to exceed the maximum recommended dosage of 3 mg per night. On the other hand, Rozerem has a standard oral dosage of 8 mg before bedtime; it does not need adjustment based on age or condition severity. Both medicines should only be taken under medical supervision.
At what dose is Rozerem typically prescribed?
Rozerem treatment is typically initiated at a dosage of 8 mg/day, taken right before bedtime. The timing is crucial as Rozerem works by mimicking the sleep-promoting effects of melatonin in your body and should be taken close to your intended sleeping time. It's important not to exceed this dose unless advised otherwise by your physician. This medication can be taken for extended periods without the risk of dependence or tolerance, unlike other sleep medications. However, if after several weeks there seems to be little or no response to treatment at the initial dosage, consultation with a healthcare provider would be prudent for further evaluation and possible adjustment of medication regimen.
What are the most common side effects for Lunesta?
Common side effects of Lunesta and Rozerem include:
- Drowsiness or sleepiness
- Dizziness
- Unusual, unpleasant taste in the mouth (more common with Lunesta)
- Headache
- Anxiety or nervousness
- Dry mouth
- Nausea, stomach upset or pain
- Diarrhea or constipation
-Sinusitis symptoms like stuffy nose, sneezing, sore throat
-Unusual dreams
-Less frequently reported side effects can include decreased sexual desire, menstrual changes for women
Immediately seek medical attention if you experience any severe reactions such as memory loss, mood changes (e.g., agitation), unusual behavior/thoughts of suicide.
Are there any potential serious side effects for Lunesta?
While both Lunesta and Rozerem are used for treating insomnia, it's crucial to be aware of the potential side effects. For instance:
- An allergic reaction to either drug may manifest in symptoms such as difficulty breathing; swelling of your face, lips, tongue, or throat; hives; or a severe skin reaction (fever, sore throat burning eyes, skin pain) followed by a red or purple skin rash that spreads and causes blistering and peeling.
- Changes in behavior or mood: you might experience anxiety, agitation, aggression, confusion or hallucinations. There could also be thoughts about suicide or self-harm.
- Memory issues: Some people have reported engaging in activities such as driving vehicles while not fully awake ("sleep-driving"). Others have prepared meals or made phone calls with no memory of these actions later on.
- Unusual sensations: Such feelings can include pins-and-needles tingling in the hands and feet. You might also notice changes in taste perception.
If you experience any unusual side effects after taking Lunesta or Rozerem – especially if they cause concern – seek medical help immediately.
What are the most common side effects for Rozerem?
Rozerem, a sleep aid, can have several side effects that potential users should be aware of:
- Dry mouth or changes in taste
- Dizziness or lightheadedness
- Daytime drowsiness
- Nausea or upset stomach
- Headache
- Unusual dreams These side effects are generally mild and tend to decrease over time as your body adjusts to the medication. However, if they persist, it is essential to contact your healthcare provider. It's also important to note that Rozerem may cause serious allergic reactions in some people, although this is rare.
Are there any potential serious side effects for Rozerem?
While Rozerem is generally well-tolerated, it can cause some serious side effects in rare cases. Be sure to seek medical attention immediately if you experience any of the following symptoms:
- Signs of an allergic reaction including hives, itching, difficulty breathing or swallowing
- Swelling of the face, throat or tongue
- Changes in behavior such as aggression, abnormal thoughts or hallucinations
- Unusual mood swings leading to depression and/or suicidal thoughts
- A marked change in your sleep pattern that may include trouble falling asleep or staying asleep
- Menstrual period changes (for women)
- Decreased sexual desire.
It's also worth noting that while less severe side effects like dizziness, tiredness and nausea are more common with Rozerem use. Always consult your doctor if these persist for a prolonged period.
Contraindications for Lunesta and Rozerem?
Both Lunesta and Rozerem, like most other sleep aids, may worsen symptoms of insomnia in some people. If you notice your sleeping problems worsening or an increase in abnormal thinking or behavioral changes, please seek immediate medical attention.
Neither Lunesta nor Rozerem should be taken if you are taking or have been taking strong inhibitors of certain liver enzymes (like fluvoxamine). Always tell your physician which medications you are taking; these enzyme inhibitors will require a period to clear from the system to prevent dangerous interactions with Lunesta and Rozerem. It's also important to inform your doctor about any alcohol consumption as this can interfere with how these drugs work and potentially lead to serious side effects.
How much do Lunesta and Rozerem cost?
For the brand-name versions of these drugs:
- The price of 30 tablets of Lunesta (3 mg) averages around $400, which works out to approximately $13.33/day.
- The price for 30 capsules of Rozerem (8 mg) is about $350, working out to nearly $11.67/day.
This means that if you're in the standard dosage range for both medications, brand-name Rozerem may be slightly less expensive on a per-day treatment basis. However, it's important to remember that cost should not be your primary consideration when determining which sleep aid is right for you.
In terms of generic alternatives:
- Eszopiclone (the generic version of Lunesta) comes in packs from 7 up to 100 tablets and can cost between $0.50 and $15 per day depending on your dose and pack size.
- Ramelteon (the generic version of Rozerem), however, currently has no available generics in most markets due to patent protections.
So while Lunesta may seem more expensive initially as a branded product, its availability as a cheaper generic version makes this drug potentially more affordable overall than Rozerem whose patent protection keeps prices consistently higher without offering lower-cost alternatives.
Popularity of Lunesta and Rozerem
Eszopiclone, under the brand name Lunesta, was prescribed to approximately 2.6 million people in the USA in 2020. As a non-benzodiazepine hypnotic agent, it accounted for nearly one fifth of prescriptions within its class. Its prevalence as an insomnia treatment has been generally steady over the last several years.
Ramelteon, sold under the brand name Rozerem, was prescribed significantly less than eszopiclone at roughly 400 thousand prescriptions in 2020. Ramelteon is unique among sleep aids as it acts on melatonin receptors to induce sleepiness rather than acting via GABAergic pathways like most other drugs in this category. Although its prescription volume is considerably lower than that of eszopiclone, ramelteon's use has been gradually increasing since its introduction into the market.
Conclusion
Both Lunesta (eszopiclone) and Rozerem (ramelteon) have established reputations for use in patients suffering from insomnia, with numerous clinical trials indicating that they are significantly more effective than placebo treatments. Both drugs can be used together under certain circumstances, but this should always be done under the careful supervision of a healthcare provider due to their differing mechanisms of action.
Lunesta acts primarily on gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain, promoting sleep induction and maintenance. On the other hand, Rozerem works by mimicking melatonin's activity at MT1 and MT2 receptors in the suprachiasmatic nucleus of the brain, aiding in sleep onset rather than maintaining it. Therefore, these two medications may be prescribed under different scenarios: Lunesta is often chosen as a first-line treatment for both trouble falling asleep and staying asleep while Rozerem would usually be considered for people having difficulty initiating sleep or those who wish to avoid potential dependence issues associated with some sleeping pills.
Both medications are available as generic drugs which offers significant cost savings especially for patients paying out-of-pocket. The effects may not be noticeable immediately upon starting either medication; an adjustment period might be necessary.
The side effect profiles between these two drugs vary; both are generally well-tolerated though Lunesta has been linked to unpleasant taste sensations and next-day drowsiness more frequently than Rozerem. With any new medication regimen, it's important for individuals to monitor their responses closely – especially when initiating therapy – and seek immediate medical assistance if adverse reactions occur or existing symptoms worsen.
Refrences
- Mets, M. (2010, November). Critical appraisal of ramelteon in the treatment of insomnia. Nature and Science of Sleep. Informa UK Limited.http://doi.org/10.2147/nss.s6846
- Simpson, D., & Curran, M. P. (2008). Ramelteon. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868130-00011
- Srinivasan, V., Spence, D. W., Pandi-Perumal, S. R., Trakht, I., & Cardinali, D. P. (2008, January). Jet lag: Therapeutic use of melatonin and possible application of melatonin analogs. Travel Medicine and Infectious Disease. Elsevier BV.http://doi.org/10.1016/j.tmaid.2007.12.002