Zopiclone is used to treat short-term sleep problems. Find out how to take it safely and possible side effects. Zopiclone is also called Imovane.
|Type of medicine
- Sleeping tablet
- Belongs to a group of medicines known as hypnotics (medicines to help you sleep)
- Zopiclone Actavis®
What is zopiclone?
Zopiclone is used to treat short-term sleep problems or insomnia. It helps if you have difficulty falling off to sleep, wake too early or lie awake for long periods at night. It works on chemicals in your brain to make you relaxed and sleepy.
Zopiclone should only be used for a short time (10 days or less). This is because your body gets used to it quickly and after this time it's unlikely to have the same effect. Your body can also become dependent on it.
You should only use zopiclone if other non-medication treatments aren't working, and it's best to continue to use relaxation techniques while you are taking zopiclone. Read more about insomnia, sleep and tips to improve your sleeping habits.
In New Zealand zopiclone is available as tablets (7.5 mg).
- The usual dose of zopiclone is 1 tablet at bedtime.
- A lower dose (half a tablet) is recommended in older adults (over 65 years of age). Taking a lower dose reduces the risk of excessive sleepiness, which can lead to falls and other side effects.
- Your doctor will prescribe a short course, usually for 10 days or less.
- Always take your zopiclone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
How to take zopiclone
- You do not need to take zopiclone every night.
- Only use zopiclone if you have to. Try to fall asleep first using sleep hygiene techniques and then use zopiclone only if you remain awake.
- Swallow the whole tablet, do not crush or chew it. You can take zopiclone with or without food.
- Do not take zopiclone if you wake up from your sleep during the night.
Precautions – before starting zopiclone
- Do you have liver or kidney problems?
- Do you have breathing problems such as asthma, COPD or sleep apnoea?
- Are you pregnant or breastfeeding?
- Do you have dementia?
- Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines.
If so, it’s important that you tell your doctor or pharmacist before you start zopiclone. Sometimes a medicine isn’t suitable for a person with certain conditions or it can only be used with extra care.
Precautions – while you are taking zopiclone
Extra care is needed when taking zopiclone because it can cause sleepiness and affect your concentration the next day. Drowsiness can last for at least 11 hours after taking your dose.
||Avoid alcohol while you are taking zopiclone, especially when you first start treatment.
- Drinking alcohol while taking zopiclone causes severe drowsiness and impaired concentration.
- If you do drink alcohol, drink only small amounts and see how you feel.
|Taking other medicines
- Taking some other medication (such as antihistamines, antidepressants, painkillers) or herbal products with zopiclone may make sleepiness and concentration worse.
- Check with your pharmacist if you are taking other medicines or herbal products.
||Zopiclone is likely to affect your concentration and ability to drive.
- The effects of zopiclone can last into the following day — effects on driving performance may be significantly impaired for at least 11 hours after taking the medicine.
- Do not drive until you know how the medication affects you, especially when you first start treatment.
- Read more on zopiclone and next-day impairment.
|Risk of falls
||Zopiclone can increase your risk of falls because of its affect on concentration and sleepiness, and it can also cause muscle weakness.
|Stopping zopiclone suddenly
- If you have been using zopiclone for longer than a few weeks, do not stop taking it suddenly. It is best to reduce the dose slowly.
- Suddenly stopping can cause withdrawal symptoms such as anxiety and restlessness, and more sleep problems if you have been taking it for more than 2 weeks.
Like all medicines, zopiclone can cause side effects, although not everyone gets them.
This is more likely to happen if you have been taking zopiclone for more than a few weeks. Some people are more likely to develop dependence than others and seem to be very sensitive to the cravings. You may be at greater risk if you have mental health problems, such as depression, or a history of substance abuse, including alcohol and recreational drugs.
To reduce your risk of dependence, use zopiclone on only 2 or 3 nights each week, rather than every night. Only use zopiclone if you have to – try to fall asleep first using sleep hygiene techniques and then use zopiclone only if you remain awake.
||What should I do?
- Feeling sleepy
- Dizzy or tired the next day
- Be careful when driving or using tools until you know how this medicine affects you.
- These effects put you at risk of falls and injuries especially if you are elderly. Tell your doctor if you are concerned.
- Do not drink alcohol.
- A different taste in your mouth
- Dry mouth
- These are quite common when you first start taking zopiclone and usually go away with time.
- Tell your doctor if troublesome.
- Unusual changes in mood or behaviour
- Tell your doctor immediately or ring HealthLine.
Medsafe Consumer Information Sheets Imovane®
- Zopiclone New Zealand Formulary
- Hypnotics New Zealand Formulary
- Zopiclone – indicated for short-term use only June 2019
- Zopiclone and next-day impairment Medsafe 2014
Information for health professionals
This section will be of most interest to clinicians (eg, nurses, doctors, pharmacists and specialists).
Zopiclone is New Zealand’s most frequently prescribed hypnotic medicine
- Zopiclone is the most frequently prescribed hypnotic medicine, and one of the highest prescribed medicines in New Zealand overall.
- Dispensing of zopiclone starts to increase from around age 30 years.
- Many patients dispensed zopiclone receive large numbers of tablets, including younger patients – 20% of patients receive enough tablets for approximately 1 every second night or more. Of this group, one-quarter are aged 55 years or under
- Non-pharmacological approaches are the preferred first-line treatment for insomnia.
- Hypnotic medicines, including zopiclone and benzodiazepines, can provide short-term benefit but are associated with a range of adverse effects including falls, motor vehicle accidents and a possible link with dementia.
Read more: Zopiclone is New Zealand’s most frequently prescribed hypnotic medicine BPAC, NZ, 2018
The pharmacological approach for improving sleep
- Medicines for improving sleep should always be used in conjunction with non-pharmacological approaches.
- Patients with particularly severe symptoms or acute trouble sleeping, such as during bereavement, may benefit from being prescribed a medicine to assist their sleep at the same time as they begin non-pharmacological treatment.
- If medicines are prescribed, they should be used for a short period of time only and an “exit strategy” agreed on from the beginning.
- Benzodiazepines, zopiclone, melatonin (approved for patients aged 55 years and over) or tricyclic antidepressants may be appropriate pharmacological options for short-term use in selected patients, depending on individual circumstances.
Read more: The ideal pharmacological approach for improving sleep BPAC, NZ, 2017
For the treatment of insomnia, benzodiazepines and zopiclone are not preferred treatment options, because:
- cognitive-behavioural approaches (eg, sleep hygiene) have high levels of efficacy, are supported by a good evidence base and achieve better outcomes in the long term
- benzodiazepines are known to alter sleep architecture, with a reduced amount of time spent in slow-wave sleep, reducing overall sleep quality compared to the equivalent duration of sleep achieved by cognitive-behavioural approaches.
Read more: Overuse of benzodiazepines – still an issue? BPAC, NZ, 2015
Medsafe prescriber updates
|Zopiclone and next-day impairment (2014)
- 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 4 weeks.
- The initial dose should be reduced in older people.
- Read more: Zopiclone and next-day impairment
|Hypnotics and anxiolytics — a wake-up call (2010)
- Before considering pharmacological treatment for insomnia, other possible causes should be excluded.
- If pharmacological treatment is initiated, a short-acting benzodiazepine or other hypnotic such as zopiclone can be used in the short term.
- Patients should be given the lowest effective dose for the shortest possible time; regular review should include careful consideration of the need for ongoing treatment.
- Patients should also be informed about some of the less well-known effects, such as sleep walking and other dissociative behaviours, eg, sleep eating.
- Patients who are treated long term with benzodiazepines and other hypnotics for insomnia should be encouraged to gradually withdraw treatment. Slowly tapering the dose over a number of months may help to reduce the withdrawal effects such as agitation, anxiety and insomnia.
- Read more: Hypnotics and anxiolytics — a wake-up call