Zopiclone

Zopiclone

[1 tablet 10 cents]

ADMINISTRATION ROUTES:

  • PO, NG

BRAND NAMES:

  • Imovane, Zimovane, Apo-Zopiclone

ICU INDICATIONS:

  1. 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.

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

Critical Care Drug Manual

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