Patient Information Leaflet: Zopiclone
Introduction Zopiclone is a prescription medication used primarily for the short-term treatment of insomnia. As a hypnotic, it helps individuals fall asleep faster and stay asleep longer. It is generally prescribed for a maximum of four weeks to prevent dependency and tolerance.
Indications and Dosage Zopiclone is recommended for short-term use in treating insomnia, with the dosage varying based on the patient’s age and health condition:
- Adults: 7.5 mg taken orally at bedtime for up to 4 weeks.
- Elderly Patients: Initially, 3.75 mg at bedtime, which may be increased to 7.5 mg if necessary.
- Patients with Chronic Pulmonary Insufficiency: A starting dose of 3.75 mg, with potential adjustment to 7.5 mg as needed.
Contraindications Zopiclone should not be used in individuals with the following conditions:
- Severe respiratory failure
- Myasthenia gravis
- Marked neuromuscular respiratory weakness
- Severe sleep apnea syndrome
Cautions and Special Considerations Zopiclone should be used cautiously in patients with:
- A history of depression
- Alcohol or drug dependence
- Chronic pulmonary insufficiency (increased risk of respiratory depression)
- Psychiatric disorders
- Muscle weakness
Special Considerations for Elderly Patients Elderly individuals are at a higher risk of excessive daytime drowsiness, falls, and coordination issues (ataxia). Regular medication reviews are necessary to ensure safety and efficacy.
Drug Interactions Zopiclone may interact with other medications, including:
- Central nervous system depressants (e.g., alcohol, opioids, benzodiazepines)
- Certain antidepressants and antipsychotics
- Some antibiotics and antifungal medications
Always inform your doctor or pharmacist about all medications, including over-the-counter drugs and herbal supplements.
Side Effects While Zopiclone is generally well-tolerated, it may cause side effects, categorized as follows:
Common or Very Common:
- Dry mouth
- Bitter taste
Uncommon:
- Dizziness
- Fatigue
- Nausea
- Headache
- Sleep disturbances
Rare or Very Rare:
- Hallucinations
- Confusion
- Respiratory issues
- Falls
- Memory impairment
Unknown Frequency:
- Cognitive impairment
- Speech disorders
- Drug dependence
- Withdrawal symptoms
Use During Pregnancy and Breastfeeding Zopiclone is not recommended during pregnancy due to the risk of neonatal withdrawal symptoms. If taken in late pregnancy, it may cause:
- Neonatal hypothermia
- Hypotonia (reduced muscle tone)
- Respiratory depression
Additionally, Zopiclone is present in breast milk, and its use is not advised while breastfeeding.
Use in Patients with Liver and Kidney Impairment
- Mild to Moderate Hepatic Impairment: A reduced dose of 3.75 mg is recommended.
- Severe Hepatic Impairment: Zopiclone should be avoided due to the risk of accumulation and toxicity.
- Renal Impairment: A lower starting dose of 3.75 mg is suggested to prevent excessive drug accumulation.
Patient and Carer Advice
- Driving and Skilled Tasks: Zopiclone may cause drowsiness that persists into the next day, affecting activities such as driving. Alcohol can amplify these effects.
- Follow-Up: Regular follow-ups with a healthcare provider are recommended to assess effectiveness and any potential side effects.
Availability and Prescription Guidelines Zopiclone is available in tablet form (3.75 mg and 7.5 mg). Special-order manufacturers may provide oral suspension or solution for those with swallowing difficulties.
Since Zopiclone is a controlled medication, its prescription is subject to national regulations, which may limit long-term use due to the risk of dependence and withdrawal symptoms.
Related Medications Other drugs in the same class as Zopiclone include:
- Eszopiclone
- Zaleplon
These medications may offer alternative options for insomnia treatment.
Conclusion Zopiclone is an effective short-term treatment for insomnia, but it should be used cautiously, especially in elderly patients and those with existing health conditions. Always follow your healthcare provider’s guidance and report any concerning side effects or symptoms. If you have any questions about Zopiclone, consult your doctor or pharmacist for professional advice.
