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Drug Safety-related Labeling Changes (SrLC)

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LUNESTA (NDA-021476)

(ESZOPICLONE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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08/18/2019 (SUPPL-38)

Approved Drug Label (PDF)

Boxed Warning

Newly added section:

WARNING: COMPLEX SLEEP BEHAVIORS

Complex sleep behaviors including sleep-walking, sleep-driving, and engaging in other activities while not fully awake may occur following use of LUNESTA. Some of these events may result in serious injuries, including death. Discontinue LUNESTA immediately if a patient experiences a complex sleep behavior.

4 Contraindications

Addition of the following:

  • LUNESTA is contraindicated in patients who have experienced complex sleep behaviors after taking LUNESTA

5 Warnings and Precautions

Newly added subsection:

5.1 Complex Sleep Behaviors

Complex sleep behaviors including sleep-walking, sleep-driving, and engaging in other activities while not fully awake may occur following the first or any subsequent use of LUNESTA. Patients can be seriously injured or injure others during complex sleep behaviors. Such injuries may result in a fatal outcome. Other complex sleep behaviors (e.g., preparing and eating food, making phone calls, or having sex) have also been reported. Patients usually do not remember these events. Post-marketing reports have shown that complex sleep behaviors may occur with LUNESTA alone at recommended dosages, with or without the concomitant use of alcohol or other CNS depressants. Discontinue LUNESTA immediately if a patient experiences a complex sleep behavior.

Additions and/or revisions underlined:

5.8 Special Populations

Use in Patients with Depression

Newly added information:

In primarily depressed patients treated with sedative-hypnotics, worsening of depression, including suicidal thoughts and actions (including completed suicides), have been reported in association with the use of sedative/hypnotics.

6 Adverse Reactions

Addition of the following:

The following are described in more detail in the Warnings and Precautions section of the label:

  • Complex Sleep Behaviors

  • CNS Depressant Effects and Next-Day Impairment

  • Need to Evaluate for Comorbid Diagnoses

  • Severe Anaphylactic and Anaphylactoid Reactions

  • Abnormal Thinking and Behavioral Changes

  • Withdrawal Effects

  • Timing of Drug Administration

  • Special Populations

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/or revisions underlined:

LUNESTA may cause serious side effects, including:

  • Complex sleep behaviors that have caused serious injury and death. After taking LUNESTA, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing (complex sleep behaviors). The next morning, you may not remember that you did anything during the night. These activities may occur with LUNESTA whether or not you drink alcohol or take other medicines that make you sleepy.

Reported activities and behaviors include:

  • doing activities when you are asleep like:
    • making and eating food

    • talking on the phone

    • having sex

    • driving a car (“sleep-driving”)

    • sleep walking

Stop taking LUNESTA and call your healthcare provider right away if you find out that you have done any of the above activities after taking LUNESTA.

The morning after you take LUNESTA your ability to drive safely and think clearly may be decreased. You also may experience sleepiness during the day.

Do not take LUNESTA if you:

  • have ever experienced a complex sleep behavior (such as driving a car, making and eating food, talking on the phone or having sex while not fully awake) after taking LUNESTA.

Who should not take LUNESTA?

  • Do not take LUNESTA if you have ever had a complex sleep behavior happen after taking LUNESTA.

What are the possible side effects of LUNESTA? Possible serious side effects of LUNESTA include:

  • abnormal thoughts and behavior Addition of ‘acting strangely’

PATIENT COUNSELING INFORMATION

Newly added information:

Complex Sleep Behaviors

Instruct patients and their families that LUNESTA may cause complex sleep behaviors, including sleep-walking, sleep-driving, preparing and eating food, making phone calls, or having sex while not being fully awake. Serious injuries and death have occurred during complex sleep behavior episodes. Tell patients to discontinue LUNESTA and notify their healthcare provider immediately if they develop any of these symptoms.

02/06/2019 (SUPPL-37)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 CNS Depressant Effects and Next-Day Impairment

(additions underlined)

Because Lunesta can cause drowsiness and a decreased level of consciousness, patients, particularly the elderly, are at higher risk of falls.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT COUNSELING INFORMATION

(additions underlined)

 

CNS Depressant Effects and Next-Day Impairment

Tell patients that LUNESTA can cause next-day impairment even when used as prescribed, and that this risk is increased if dosing instructions are not carefully followed. Caution patients taking the 3 mg dose against driving and other activities requiring complete mental alertness the day after use. Inform patients that impairment can be present despite feeling fully awake. Advise patients that increased drowsiness and decreased consciousness may increase the risk of falls in some patients.


11/07/2018 (SUPPL-36)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.1 Pregnancy

8.2 Lactation

PLLR conversion. Extensive additions and/or revisions in the 2 subsections. Please refer to label for complete information.