An A-Z Guide to Zopiclone

Zopiclone is a popular sleep aid that may be used to help someone get a good night's rest. But, as with any medication, it's important to know its details. Our guide provides an A-Z look into Zopiclone. In this article, we'll explain each part, making sure you understand fully and use the medicine safely and confidently.

A - Administration

Zopiclone is typically administered in tablet form. A patient usually takes it orally (by mouth) with a glass of water. It's recommended to take Zopiclone just before bed, as it acts relatively quickly to induce sleep. It's essential to follow the prescribed dose and not to take more than the advised amount. 

B - Benefits

Zopiclone is a medication primarily used to treat insomnia. When used correctly, it offers several benefits, including:

• Improved sleep onset

• Improved sleep quality

• Reduced amount of night awakenings

• General relief from insomnia

• Improved daytime function

C - Central Nervous System

The central nervous system (CNS) is one of the primary components of our nervous system, comprising the brain and spinal cord. Its principal role is to process and transmit information, control most functions of the body and mind, and coordinate activity among all body parts. Zopiclone belongs to a group of medicines called 'non-benzodiazepines' which have sedative effects. It works by slowing down the activity of the CNS. This depressant action helps induce sleep and maintain it throughout the night.

D - Drowsiness

Yes, Zopiclone does cause drowsiness. In fact, this is the primary intended effect of the medication, as it is prescribed to help people with difficulties in sleeping. Drowsiness and sedation are the main therapeutic effects of Zopiclone, aiding in the initiation and maintenance of sleep. 

However, the drowsiness can also be viewed as a side effect, especially if it persists into the next day. Some people might experience what's called a "hangover effect" the day after taking Zopiclone, which includes residual drowsiness and reduced alertness. This can affect tasks that require concentration, such as driving or operating machinery.

E - Efficacy

"Efficacy" refers to the ability of something, often a drug or treatment, to produce a desired or intended result. For Zopiclone, its efficacy relates to its ability to treat insomnia. The efficacy of Zopiclone has been established in various clinical trials over the years. Zopiclone is effective in reducing the time it takes for individuals to fall asleep. It can also extend the duration of sleep, ensuring that individuals get a longer, more restful night.

F - Fast Acting

Zopiclone is considered a fast-acting medication. After oral administration, Zopiclone is rapidly absorbed, with its sedative effects usually beginning within about 30 minutes to 1 hour. This quick onset of action is one of the reasons it's recommended to take Zopiclone immediately before bedtime or when you're ready to sleep.

G - General Dosage

The dosage of Zopiclone can vary depending on the individual's specific needs and circumstances, but the general dosages are as follows:

• Adults: The usual dose for adults (including the elderly) is 7.5 mg taken just before bedtime. However, for some elderly individuals or those with liver or kidney problems, a lower dose of 3.75 mg might be recommended initially.

• Children and Adolescents: Zopiclone is not generally recommended for children and adolescents under 18 years of age, as its safety and efficacy in this age group have not been firmly established.

H - Hypnotics

Hypnotics are a class of drugs primarily used to induce and maintain sleep. They work by depressing the central nervous system (CNS) to promote sedation and drowsiness. Because of their sedative effects, hypnotics are commonly prescribed for insomnia and other sleep disorders. Zopiclone is a hypnotic. 

I - Insomnia

Insomnia is a common sleep disorder characterised by persistent difficulty in falling asleep, staying asleep, or both. It can result in reduced sleep quality and quantity, leading to daytime fatigue, impaired concentration, and other negative impacts on well-being and daily functioning. Symptoms of insomnia can include:

• Difficulty falling asleep at night.

• Waking up during the night and having trouble going back to sleep.

• Waking up too early in the morning.

• Feeling tired upon waking.

• Daytime tiredness, fatigue, or sleepiness.

• Irritability, mood disturbances, or difficulty concentrating.

• Ongoing worries about sleep.

J - Joint Interactions

Zopiclone can potentially interact with several medications. It's always essential to inform healthcare professionals about all medications you're taking, including over-the-counter drugs, herbal supplements, and prescription medications, to avoid possible interactions. Here are some types of medications and substances that may interact with Zopiclone:

• Other CNS Depressants (e.g., Benzodiazepines, certain antipsychotics, Barbiturates)

• Opioids (e.g. codeine, morphine, fentanyl)

• Antidepressants (e.g., tricyclic antidepressants, certain SSRIs)

• Sedative Antihistamines (e.g., diphenhydramine)

• Alcohol

• Antifungal Medications (e.g., ketoconazole, itraconazole)

• Certain Antibiotics (e.g., clarithromycin, erythromycin)

• HIV Protease Inhibitors (e.g., ritonavir)

• Medications for Epilepsy (e.g., phenytoin, carbamazepine)

• Herbal Products (e.g., St. John's Wort)

K - Kidney Function

The kidneys play a role in the elimination of Zopiclone from the body. A significant proportion of the drug is excreted in the urine, either as the unchanged drug or as its metabolites. Individuals with reduced kidney function may have a decreased ability to excrete Zopiclone, which can result in increased levels of the drug in the bloodstream. This might lead to heightened effects and a greater risk of side effects.

L - Liver Metabolism

The liver is the primary site for the metabolism of Zopiclone. Once ingested, Zopiclone undergoes extensive metabolism in the liver through various enzymatic pathways. In individuals with liver impairment, the metabolism of Zopiclone may be reduced. This can result in increased blood levels of the drug, potentially leading to heightened effects and an increased risk of side effects, much like individuals with impaired kidney function.

M - Monitoring

Monitoring Zopiclone involves keeping track of its therapeutic effects, potential side effects, and any signs of misuse or dependence. Patients taking Zopiclone should have regular reviews with their GP or prescribing doctor, especially when starting the medication, to assess its effectiveness and check for any adverse effects. Patients may be asked to maintain a sleep diary to track their sleep patterns, sleep quality, and how long it takes them to fall asleep. This can help assess the drug's effectiveness.

N - Non-Benzodiazepines

Non-benzodiazepines, often referred to as "Z-drugs" due to the common presence of the letter 'Z' in their names, are a class of psychoactive drugs that are used primarily for the treatment of insomnia. They act on the same receptors in the brain as benzodiazepines but have a different chemical structure. Their mechanism of action is similar, in that they enhance the activity of the neurotransmitter gamma-aminobutyric acid (GABA) which inhibits brain activity, leading to sedative effects.

O - Oral Administration

Oral administration refers to the way that you take a medication, into the mouth and then swallow. Zopiclone is commonly formulated as a tablet designed for oral administration. Zopiclone tablets are intended to be swallowed whole with water. This means the primary route of introducing Zopiclone into the body is via the oral route. Oral administration is one of the most straightforward and convenient methods of taking medication. This ease of use can improve patient compliance, ensuring that the medication is taken as prescribed.

P - Prescription-only Medication

Prescription-only medications (POM) are medicines that can only be obtained with a prescription issued by a qualified healthcare professional, such as a general practitioner (GP) or a specialist. These medications are not available for general sale over the counter (OTC) at pharmacies or other retail outlets.

Q - Quality of Sleep

Zopiclone is primarily used to treat insomnia, and its effects on sleep quality are well known (Grönblad et al, 1993). Zopiclone can reduce the time it takes to fall asleep, known as sleep onset latency. This is beneficial for individuals who find it difficult to initiate sleep. Sleep is categorised into different stages, including REM (rapid-eye movement) sleep and various stages of non-REM sleep. Zopiclone can influence the proportions of these stages and thus the quality of overall sleep. 

R - Recommended Precautions

If you're taking Zopiclone, there are several precautions to consider for safe and effective use:

• Avoid alcohol.

• Be cautious of drowsiness; avoid driving or tasks requiring concentration.

• Use typically for short-term periods (2-4 weeks).

• Monitor dosage for elderly patients.

• Inform doctors of all other medications and supplements taken.

• Adjust dosages for impaired liver or kidney function.

• Discuss potential effects on mental health.

• Consider risks if pregnant or breastfeeding.

• Be aware of potential sleep-related behaviours (e.g., sleepwalking).

• Watch for signs of allergic reactions.

• Regularly review use to monitor tolerance and dependence.

• Don't suddenly stop the medication; consult a doctor for tapering.

S - Sleeping Tablets

Sleeping tablets, commonly referred to as sleep aids or hypnotics, are medications prescribed to treat insomnia and other sleep disorders. Their primary purpose is to help individuals fall asleep faster, stay asleep longer, or improve the overall quality of sleep.

T - Tablets

Zopiclone is formulated as a tablet primarily for precision, stability, and convenience. Tablets ensure a consistent and accurate dose of the medication, offer protection to the active ingredient from environmental factors and are straightforward for patients to handle and consume. The oral administration of Zopiclone tablets allows for systematic absorption in the body, leading to its therapeutic effects on the central nervous system. The familiarity and ease of swallowing tablets also encourage patient adherence to the prescribed treatment.

U - Usage

Zopiclone is used to treat short-term insomnia and should be taken as directed by a healthcare professional. To use Zopiclone correctly:

• Take the prescribed dose, typically 7.5 mg for adults, before bedtime.

• Swallow the tablet whole with water.

• Ensure a 7-8 hour sleep window after taking.

• Use for short durations, usually 2-4 weeks.

• Avoid alcohol while on the medication.

• Do not drive or operate machinery until you know its effects.

V - Valium

Valium is the brand name for the drug "diazepam." It belongs to a class of medications known as benzodiazepines. Valium (diazepam) and Zopiclone are both central nervous system (CNS) depressants, but they belong to different classes of medications and serve distinct primary purposes. While Valium and Zopiclone have similarities, especially in their effects on the CNS, they are distinct drugs with specific therapeutic uses.

W - Withdrawal Symptoms

When you stop using Zopiclone you may experience withdrawal symptoms because your body has become dependent on the medication (Sikdar, 1998). This is especially true if you stop using it abruptly after you have used it for a long time. Some withdrawal symptoms associated with Zopiclone include:

• Sleep disturbances including insomnia, nightmares and vivid dreams

• Anxiety or panic attacks

• Tremors or shakiness

• Headaches

• Nausea or stomach cramps

• Cravings

• Seizures (this is rare)

X - Xanax

Xanax is the brand name for the medication alprazolam (Ait-Daoud et al, 2018). Like Zopiclone, both Xanax and Zopiclone are central nervous system depressants, but they belong to different medication classes and are primarily used for different purposes. Xanax is a benzodiazepine medication, whereas Zopiclone is a non-benzodiazepine medication. Xanax, whilst it can be used for insomnia, is primarily used to help treat anxiety and panic attacks. 

Y - Your Sleep Patterns

The term sleep patterns, also known as sleep cycles or sleep architecture, refers to the structure of your sleep. An average sleep cycle has a number of different stages. These stages include:

• Non-REM (rapid-eye movement) sleep: This part includes a number of different stages such as light sleep, deeper sleep and deep, restorative sleep.

• REM (rapid-eye movement) sleep: This is characterised by rapid eye movements, increased brain activity and vivid dreams. 

In relation to Zopiclone, the medication shortens the amount of time it takes you to get to sleep. It can also increase the total length of sleep, particularly non-REM sleep (Billiard et al, 1989). Zopiclone might increase the time you are in the deep sleep stages of non-REM sleep which are crucial for rest and recovery.

Z - Zimovane

Zimovane is a branded version of Zopiclone. Essentially, Zimovane and Zopiclone are the same medication. If you are prescribed Zimovane, it’s important to know that you are essentially being prescribed Zopiclone. This means you may be able to save money on your medication by purchasing generic Zopiclone as opposed to branded Zimovane.

Zopiclone is available to order online from EU Meds upon successful completion of our free online consultation. This comes with free standard delivery to an address of your choice.

Medically Reviewed by:
Dr. Irfan Siddique MBBS
GMC reference no: 7694522
LinkedIn

Sources

• EUMeds: Zopiclone

• EUMeds: Zimovane

• EUMeds: Xanax (Alprazolam)

• EUMeds: Codeine

• PubMed: Zopiclone for insomnia

• PubMed: Clinical pharmacokinetics of zopiclone

• NCBI: The effects of zopiclone on sleep

• Springer: Efficacy of zopiclone in insomnia

• Yashoda Hospitals: FAQs about Zopiclone