Alternatives to Eszopiclone If You Can't Fill Your Prescription

If you've been prescribed Eszopiclone (brand name Lunesta) but can't find it in stock, can't afford it, or need to switch for medical reasons, you have options. Several other FDA-approved medications treat insomnia effectively, and your doctor can help you find the right one.

In this article, we'll explain what Eszopiclone is, how it works, and walk through four real alternatives that your prescriber might consider.

What Is Eszopiclone?

Eszopiclone is a prescription sleep medication in the non-benzodiazepine sedative-hypnotic class. It's FDA-approved for treating insomnia — both difficulty falling asleep and trouble staying asleep through the night. Eszopiclone is one of the few sleep medications approved for long-term use, which is why many patients and doctors prefer it.

It's available as a generic (since 2019) in 1 mg, 2 mg, and 3 mg tablets. The brand-name version, Lunesta, is manufactured by Sunovion Pharmaceuticals. Eszopiclone is classified as a Schedule IV controlled substance by the DEA.

How Does Eszopiclone Work?

Eszopiclone works by enhancing the activity of GABA (gamma-aminobutyric acid), a neurotransmitter that reduces brain activity. Specifically, it acts as a positive allosteric modulator at GABA-A receptors, which helps calm the nervous system and promote sleep.

This is similar to how benzodiazepines work, but Eszopiclone has a more targeted mechanism with a generally lower risk of dependence. It typically takes effect within 30 minutes and helps you both fall asleep and stay asleep.

Alternative 1: Zolpidem (Ambien)

Zolpidem is probably the most well-known prescription sleep medication in the United States. Like Eszopiclone, it's a non-benzodiazepine sedative-hypnotic that works on GABA receptors.

• Available forms: Immediate-release (Ambien), extended-release (Ambien CR), sublingual (Edluar, Intermezzo)
• Strengths: 5 mg, 6.25 mg, 10 mg, 12.5 mg depending on formulation
• Best for: Patients who primarily have trouble falling asleep. The extended-release version also helps with staying asleep.
• Key difference from Eszopiclone: Zolpidem IR is typically intended for short-term use (a few weeks), while Eszopiclone is approved for longer-term treatment.
• Cost: Generic Zolpidem is widely available and inexpensive — often under $10 for a 30-day supply with a coupon.
• Schedule: Schedule IV controlled substance

Zolpidem is a solid first-line alternative and is one of the most commonly prescribed sleep medications in the country.

Alternative 2: Suvorexant (Belsomra)

Suvorexant works through a completely different mechanism than Eszopiclone. Instead of enhancing GABA, it blocks orexin receptors — the brain chemicals that keep you awake. This is called a dual orexin receptor antagonist (DORA).

• Available forms: Oral tablet
• Strengths: 5 mg, 10 mg, 15 mg, 20 mg
• Best for: Patients who struggle with both falling asleep and staying asleep, and who want a non-GABA-based option.
• Key difference from Eszopiclone: Different mechanism of action. May have a lower risk of complex sleep behaviors. Less likely to cause the unpleasant metallic taste that Eszopiclone is known for.
• Cost: No generic available yet. Cash price can be $400+ per month, but manufacturer coupons and insurance may reduce this.
• Schedule: Schedule IV controlled substance

Alternative 3: Lemborexant (Dayvigo)

Lemborexant is another dual orexin receptor antagonist (DORA), similar to Suvorexant but newer. It was FDA-approved in 2019.

• Available forms: Oral tablet
• Strengths: 5 mg, 10 mg
• Best for: Patients looking for a newer option that's effective for both sleep onset and sleep maintenance.
• Key difference from Eszopiclone: Works on orexin receptors rather than GABA. Clinical studies show it's effective for long-term use. May cause less next-day drowsiness at lower doses.
• Cost: Brand-only; cash price around $400+ per month. Insurance coverage varies.
• Schedule: Schedule IV controlled substance

Alternative 4: Ramelteon (Rozerem)

Ramelteon is unique among prescription sleep medications because it's not a controlled substance. It works by targeting melatonin receptors (MT1 and MT2) in the brain, which regulate your sleep-wake cycle.

• Available forms: Oral tablet
• Strengths: 8 mg
• Best for: Patients who have difficulty falling asleep (not sleep maintenance). Also a good option for patients with a history of substance abuse, since it has no abuse potential.
• Key difference from Eszopiclone: Non-controlled, no abuse potential, but less effective for staying asleep through the night. Works specifically on the circadian rhythm rather than broadly sedating the brain.
• Cost: Generic available; typically $15–$40 per month with a coupon.
• Schedule: Not a controlled substance

How to Choose the Right Alternative

The best alternative depends on your specific situation:

• If cost is the main issue: Generic Zolpidem or Ramelteon are the most affordable options.
• If you need long-term treatment: Lemborexant and Suvorexant are both approved for longer use, similar to Eszopiclone.
• If you want to avoid controlled substances: Ramelteon is the only non-controlled option listed here.
• If you mainly need help staying asleep: Suvorexant, Lemborexant, or Zolpidem ER may work better than Zolpidem IR.

Always discuss alternatives with your doctor before making a switch. They can consider your full medical history, other medications, and insurance coverage to find the best fit.

Final Thoughts

Not being able to fill your Eszopiclone prescription is stressful, but you're not without options. Whether it's a temporary availability issue or a longer-term switch, there are several effective insomnia treatments available in 2026.

If you're trying to find Eszopiclone before switching, Medfinder can help you locate it in stock near you. And if cost is a barrier, check out our guide on saving money on Eszopiclone.