Zopiclone

Zopiclone [1 tablet 10 cents]
ADMINISTRATION ROUTES:
PO, NG
BRAND NAMES:
Imovane, Zimovane, Apo-Zopiclone
ICU INDICATIONS:
Insomnia
PRESENTATION AND ADMINISTRATION:
PO / NG:
Zopiclone 7.5mg tablet
DOSAGE:
3.75-7.5mg nocte
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
No dose adjustment is required
DOSAGE IN PAEDIATRICS:
0.1-0.4mg/kg nocte
CLINICAL PHARMACOLOGY:
Zopiclone is a short-acting hypnotic with a pharmacological profile similar to that of the
benzodiazepenes. It has hypnotic, sedative, anxiolytic, anti-convulsant & muscle-
relaxant properties. It has negligible residual effects the following morning without
rebound insomnia on cessation of treatment. It is rapidly & well absorbed after oral
administration with an elimination half-life of 5 hours, prolonged to 7 hours in the elderly.
It is not removed effectively by haemodialysis due to a large volume of distribution.
CONTRAINDICATIONS:
1. Hypersensitivity to Zopiclone
2. Myasthenia gravis
3. Severe sleep apnoea syndrome
4. Severe hepatic insufficiency
5. Respiratory failure
WARNINGS
Risk of dependence if treatment duration is longer than 4 weeks; this is increased in
patients with a history of drug abuse, alcoholism or personality disorders.
Risk of rebound & withdrawal after abrupt discontinuation after prolonged treatment.
Gradual dose decrement is recommended, especially so in patients with a history of
seizures
Anterograde amnesia may occur especially in the elderly or with disruption of sleep.
This effect is dose-related. The risk of confusion is also higher in the elderly & in
patients with cerebral impairment.
Zopiclone
419
PRECAUTIONS
General
Additive effect with concomitant use of other central depressant drugs.
Laboratory Tests
No tests are required in addition to routine ICU blood tests
Drug/Laboratory Test Interactions
None known
IMPORTANT DRUG INTERACTIONS FOR THE ICU
Activity may be enhanced when co-administered with drugs that inhibit hepatic enzymes
(particularly cytochrome P450) such as cimetidine or erythromycin.
ADVERSE REACTIONS
Nervous system:
Drowsiness, inco-ordination, headaches, fatigue
Cardiovascular:
Arrhythmias (especially in elderly patients)
Digestive:
Dry mouth, heartburn, constipation, diarrhoea, nausea, vomiting
Skin:
Urticaria, tingling Version 30/08/2010