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:
- Hypersensitivity to Zopiclone
- Myasthenia gravis
- Severe sleep apnoea syndrome
- Severe hepatic insufficiency
- 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
About Mike Cadogan
