Last reviewed by Miljan Krcobic on August 28th, 2018.
What is Ambien? What is Ambien used for?
Ambien is a Brand name for a medicine that contains sedative called zolpidem as an active ingredient. It is used for the treatment of insomnia and other conditions where major problem is falling or staying asleep. Zolpidem works by slowing brain activity and therefore enable to falling asleep. It is available in 5 mg and 10 mg tablets for oral use.
This drug is approved for the short-term management of insomnia characterized with initiation of sleep issues. Ambien is not used as anticonvulsant or muscle relaxant because doses needed for these effects are 10-20 times higher compared to the dose needed to cause sedation and sleep. New finding showed that Ambien can dramatically improve health conditions of patients who have brain injuries.
Other common Brand names on the market containing zolpidem are:
- Nimadorm and Hypnogen.
FDA approved Ambien in 1992. It is originally manufactured by Sanofi-Aventis.
What is Lunesta? What is Lunesta used for?
Lunesta is a Brand name for a medicine containing sedative substance eszopiclone as an active ingredient. Chemically Eszopiclone is the active stereoisomer of another sedative called zopiclone, and belongs to the class of drugs known as cyclopyrrones. Lunesta works by affecting chemicals in CNS that are unbalanced in patients with sleep problems.
This sedative causes relaxation of the body and helps you to easy falling and staying asleep. Thus it is used for the treatment of insomnia. Unlike almost all other hypnotic sedative drugs which are approved only for the short-term relief of insomnia for the maximum of 6-8 weeks,
Lunesta is approved by the Food and Drug Administration for long-term use. Lunesta is available in the form of tablet in doses of: 1 mg, 2 mg and 3 mg. FDA approved Lunesta in 2004 and is manufactured by Sunovion Pharmaceuticals, Inc.
Difference in mechanism of action between Ambien and Lunesta
Zolpidem, the active ingredient of Ambien, is a nonbenzodiazepine short-acting hypnotic drug that enhances effects of GABA neurotransmitter, which is the strongest inhibitory neurotransmitter in the CNS. Zolpidem binds to places of benzodiazepine receptors which are located on the GABA-alpha subunits linked with chloride channel macromolecular complex.
Opposite from classic benzodiazepines with non-selectively interaction of all three subtypes of GABA –alpha receptors, zolpidem selectively and predominantly binds to the GABA – alpha-1 receptor. Zolpidem works very quickly, within 15 minutes, and has a short half-life time of approximately 2-3 hours.
Eszopiclone, the active ingredient of Lunesta is a non-benzodiazepine hypnotic drug unrelated to the benzodiazepines, barbiturates, or other drugs with known hypnotic properties. Chemically it is pyrrolopyrazine derivative from the cyclopyrrolone class. Eszopiclone interacts with the gamma-aminobutyric acid-benzodiazepine (GABABZ subunit) receptor complex.
Modulation of GABABZ subunit receptor chloride channel macromolecular complex is hypothesized to be responsible for some of the pharmacological properties of benzodiazepines, which include anxiolytic, sedative, and muscle relaxant effects in animal models. Eszopiclone also binds selectively to the alpha subunit of the GABA A omega-1 receptor in the brain.
Difference between Ambien and Lunesta
Both drugs are classified as non-benzodiazpine sedative drugs that are used for the treatment of insomnia. The main difference between these two medicines is that Lunesta is approved for long term treatment of insomnia, while Ambien is approved only for a short-term of 6-8 weeks, like all other benzodiazepines, barbiturates and other narcotics. Both drugs begin to work fast, within the 15 minutes after administration.
Chemically these drugs are different. Zolpidem belongs to the class of chemical compounds known as phenylimidazoles, polycyclic aromatic compounds containing a benzene ring linked to an imidazole ring through a CC or CN bond.
Eszopiclone belongs to the class of organic compounds known as cyclopyrrolones. This compound belongs to a family of pyridin-2-ylpyrrole based chemicals. The pyrrole is usually fused to a benzene, pyrimidine, or dithiin.
While there aren’t many relevant and multicental studies that directly compare Ambien and Lunesta, there are no known advantages of one over the other so it can be said that Ambien has comparable efficacy Lunesta.
Ambien has a shorter half-life time of 2.6 hours compared to Lunesta’s half-life time of about 6 hours. Both drugs are primarily eliminated through the urine.
Before taking Ambien patients should mention their doctor if they have or have ever had some kidney or liver disease, and any mental or mood problems such as depression or thoughts of suicide. Doctors also need to know if patient has some lung or breathing problems, such as chronic obstructive pulmonary disease and sleep apnea, or the presence of myasthenia gravis.
Before taking Lunesta, patients need to mention if they had any history of intoxication with drugs that depress CNS or breathing, such as CNS or respiratory depressants as well as alcohol or sedatives. They also need to tell their doctor if they have or have ever had some liver disease or lung diseases, such as chronic obstructive pulmonary disease or sleep apnea.
Common side effects of both medicines are lightheadedness and dizziness and also sleepiness during the day.
If you take high doses of these drugs for more than 10 days, a physical dependency may be developed. That means that regular dose will not be as effective as it once was. Patients who had abused some substance in the past are always at greater risk of developing a dependency from one of these drugs. Stopping suddenly use of these drugs can lead to withdrawal symptoms.
Ambien vs Lunesta side effects
Ambien possible side effects Lunesta possible side effects
Dizziness (5-12%) Headache (13-21%)
Headache (7-19%) Unpleasant taste (17-34% in non-elderly)
Drowsiness (6-15%) Abnormal dreams (elderly)
Allergy (4%) Accidental injury (elderly)
Hallucinations (4%) Diarrhea
Myalgia (4%) Dizziness
Sinusitis (4%) Dry mouth
Memory disorder (3%) Dyspepsia
Visual disturbance (3%) Nervousness
Pharyngitis (3%) Neuralgia
Lightheadedness (2%) Pain
Palpitation (2%) Pruritus
Rash (2%) Rash (in non-elderly)
Constipation (2%) Somnolence
Depression (2%) Unpleasant taste (elderly)
Drowsiness (2%) Agitation
Asthenia (1%) Alopecia
Diarrhea (1%) Angioedema
Dry mouth (1%) Asthma
Flu-like symptoms (1%) Anorexia
Can you take Lunesta and Ambien together?
These drugs should never be taken together as their effects will become additive and they may increase the risk of serious side effects to happen. Using Ambien together with Lunesta may increase side effects such as dizziness, confusion, drowsiness and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.
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