Indications
Zopiclone is a sleeping medicine used for the short-term treatment of insomnia (difficulty falling asleep, waking during the night or waking too early) when it is severe, disabling or causing great distress.
How It Works
Zopiclone belongs to a group of medicines sometimes called “Z-drugs”. It boosts the action of GABA, the brain’s main calming chemical messenger, at the same receptor site targeted by benzodiazepines. This slows brain activity, helping you fall asleep faster and stay asleep longer. It starts working within about an hour.
Dosage and Administration
Usual adult dose: 7.5 mg taken once, just before going to bed. Older adults and people with liver, kidney or breathing problems usually start with 3.75 mg. Do not take more than 7.5 mg in one night, and do not take it unless you can have 7 to 8 hours of sleep. Treatment should be as short as possible, usually a few days and not more than 4 weeks including the time to reduce the dose. Not for children and young people under 18.
Interactions
- Opioid pain medicines (such as Tramadol, Codeine, Morphine): together they can cause severe drowsiness, slow breathing, coma and death; use only if the doctor says so.
- Alcohol, other sleeping pills, benzodiazepines, sedating antihistamines, antipsychotics and antidepressants increase drowsiness.
- Erythromycin, Clarithromycin, Ketoconazole, Itraconazole and Ritonavir raise Zopiclone levels; Rifampicin, Carbamazepine and Phenytoin lower them.
Contraindications
- Allergy to Zopiclone.
- Myasthenia gravis.
- Severe breathing problems (respiratory failure) or severe sleep apnoea.
- Severe liver disease.
- Previous complex sleep behaviours (such as sleepwalking or sleep driving) after taking Zopiclone.
Side Effects
Common: bitter or metallic taste in the mouth, dry mouth and drowsiness the next day. Less common: dizziness, headache, nausea, tiredness, nightmares, memory loss for events after taking the dose, confusion, irritability and depression.
Get urgent medical help for swelling of the face or throat, difficulty breathing, very slow or shallow breathing, extreme drowsiness, hallucinations, aggressive behaviour, thoughts of self-harm, or doing things while not fully awake (such as sleep walking, eating or driving) that you do not remember.
Pregnancy and Lactation
Avoid in pregnancy unless the doctor considers it essential; use late in pregnancy can cause floppiness, low temperature and breathing problems in the newborn. It passes into breast milk, so it is not recommended while breastfeeding.
Precautions and Warnings
- Can cause dependence and withdrawal; do not stop suddenly after regular use. Avoid if you have a history of alcohol or drug misuse.
- Next-day drowsiness can impair driving; do not drive or use machines for at least 12 hours after taking it, or longer if still drowsy.
- Use with care in older adults (risk of falls), depression, and liver, kidney or lung disease.
- Rebound insomnia can occur when stopping.
Overdose
Overdose causes deep sleep, confusion, poor coordination, slow breathing and coma, especially if mixed with alcohol or other sedatives. Seek emergency medical help immediately.
Therapeutic Class
Hypnotic (sleeping medicine), cyclopyrrolone (non-benzodiazepine “Z-drug”).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.