Sleep medications: Zopiclone (Somnosan, Imovane, Lipovan, Ximovan, Datolan)

Zopiclone is the generic name of a prescription sleep aid developed by Sepracor and introduced in 1988. Zopiclone helps you get to sleep faster and sleep with fewer interuptions. It is available in about 85 countries worldwide and marketed under various names including Somnosan, Imovane, Lipovan, Ximovan and Datolan. But it was never approved in the US.

What is the recommended dose?

Adults, 7.5 mg just before retiring for the night. Geriatrics, patients with impaired liver function or chronic respiratory insufficiency: 3.75 mg at bedtime, depending on acceptability and efficacy. Use for more than 2-3 consecutive weeks requires re-evaluation of the patient.

How does it work?

In the simplest terms, insomnia is the result of your brain’s “awake chemicals” being more active than its “sleep chemicals.” Awake chemicals include adrenaline and noradrenaline - all the things that get you revved up. As for sleep chemicals, the most important is an amino acid called Gamma-Aminobutyric Acid (GABA). GABA slows down brain activity so that your mind and body can relax, enabling you to fall asleep and stay asleep. At bedtime, good sleepers are able to naturally lower their levels of “awake chemicals” and raise their levels of GABA, which allows them to sleep without a problem. Unfortunately, if you have insomnia, you aren’t able to make this chemical shift as easily. The main issue is that your GABA doesn’t work efficiently. So the “awake chemicals” overpower the brain, making it extremely difficult to get quality sleep.

How can zopiclone help?

Just one zopiclone tablet nightly helps your body work more like that of a good sleeper. It enhances GABA activity, helping you to fall asleep quickly, stay asleep through the night with fewer interruptions, and wake up feeling refreshed.

What is the correct dose?

The dose should be individualized. The recommended starting dose for most non-elderly adults is 2 mg immediately before bedtime. Dosing can be initiated at or raised to 3 mg if clinically indicated, since 3 mg is more effective for sleep maintenance. The recommended starting dose for elderly patients whose primary complaint is difficulty falling asleep is 1 mg immediately before bedtime. In these patients, the dose may be increased to 2 mg if clinically indicated. For elderly patients whose primary complaint is difficulty staying asleep, the recommended dose is 2 mg immediately before bedtime.

What happens if I miss a dose?

Since generic Imovane is usually taken only if you need it to help you sleep, missing a dose will not cause any problems. Take the missed dose only if you can be sure that you will get 8 full hours of sleep after the dose. If you do not sleep 8 full hours, you may experience carryover effects after you wake up.

What happens if I overdose?

Seek emergency medical attention. Symptoms of a zopiclone overdose may include sleepiness, confusion, dizziness, difficult or slow breathing, and unconsciousness.

What should I avoid while taking zopiclone?

Use caution when driving, operating machinery, or performing other hazardous activities. Zopiclone will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. The dose should be taken just before bedtime. You may experience some carryover effects the next day. Do not drink alcohol while taking zopiclone. Avoid other sedatives, sleeping pills, and tranquilizers, including over-the-counter preparations. They should not be used while you are taking zopiclone unless your doctor directs otherwise. Taking this sleep aid with or immediately after a heavy, high-fat meal results in slower absorption and reduces the effect on sleep latency.

What about alcohol?

Alcohol will increase drowsiness and may increase dizziness, which could be dangerous.

What about zopiclone side effects?

Headache, dry mouth, nausea, vomiting, dyspepsia, anxiety, confusion, depression, dizziness, hallucinations, decreased libido, nervousness, respiratory infection, rash, unpleasant taste, dysmenorrhea, gynecomastia.

What other precautions should I know about?

A problem that may occur when any sleep medicine is stopped is known as “rebound insomnia.” This means that a person may have more trouble sleeping the first few nights after the medicine is stopped than before starting the medicine. If you should experience rebound insomnia, do not get discouraged. This problem usually goes away on its own after 1 or 2 nights. zopiclone may be habit forming. Stopping this medication suddenly can cause withdrawal effects if you have taken it continuously for several weeks.

Zopiclone is not recommended during pregnancy. It is secreted in human milk, and its concentration may reach 50% of the plasma levels. Therefore, the administration of zopiclone to nursing mothers is not recommended.

Patients with a history of substance or alcohol abuse, impaired renal or hepatic functions, severe pulmonary insufficiency, a history of seizures, depression, elderly and/or debilitated patients should only take this medication under the strictist medical supervision.