Published: 6 June 2014

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Zopiclone and next-day impairment

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Prescriber Update 35(2)
6 June 2014

Key Messages

  • Patients taking zopiclone should be warned that their ability to drive or operate dangerous machinery may be impaired the next day.
  • Effects on driving performance may be significantly impaired for at least 11 hours after taking the medicine.
  • Zopiclone is intended for occasional use in adults at a dose of 7.5 mg orally shortly before bedtime. It should not be used for more than four weeks.
  • The initial dose should be reduced in older people.

 

Zopiclone is used for the treatment of short-term and chronic insomnia in adults. This includes difficulties with falling asleep (initial insomnia) and night time awakening (middle insomnia).

Patients taking zopiclone should be warned that their ability to drive or operate dangerous machinery may be impaired the next day. Importantly the patient may not be aware that they are impaired, especially if they feel they have had a good night’s sleep.

A recent article concluded that zopiclone 7.5 mg caused a significant impairment of driving performance for at least 11 hours after administration. These effects did not differ between males and females and did not increase with age1.

Concomitant intake of even small amounts of alcohol is also known to increase the risk of zopiclone adversely affecting a patient’s driving ability2.

In the last 10 years, the Centre of Adverse Reactions Monitoring (CARM) has received 15 reports of psychomotor impairment experienced within 24 hours of taking zopiclone. The reported reactions include impaired concentration, somnolence (sleepiness), headache and hangover.

In adults, the usual dose is 7.5 mg shortly before bedtime for a maximum of 2–4 weeks2,3. Due to poorer metabolism, the dose for older people is reduced to an initial dose of 3.75 mg2,3 ­— taking a full dose will increase the risk of next-day impairment. To reduce the risk of next-day impairment, this dose should not be exceeded.

Prescribers are also reminded that zopiclone should only be used as a short term treatment (should not exceed four weeks).

References

  1. Leufkens TR, Vermeeren A. 2014. Zopiclone's residual effects on actual driving performance in a standardized test: a pooled analysis of age and sex effects in 4 placebo-controlled studies. Clinical Therapeutics 36(1): 141-150.
  2. Sanofi-Aventis New Zealand Limited. 2011. Imovane Data Sheet. 31 May 2011. URL: www.medsafe.govt.nz/profs/datasheet/i/Imovanetab.pdf (accessed 24 April 2014).
  3. Apotex NZ Ltd. 2011. Apo-Zopiclone Data Sheet. 13 May 2011. URL: www.medsafe.govt.nz/profs/datasheet/a/Apozopiclonetab.pdf (accessed 24 April 2014).
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