Zopiclone

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Zopiclone from the group of Z-substances is one of the most important drugs for those who have trouble falling asleep and staying asleep. It has a comparatively specific effect and is generally considered to be well tolerated. However, like all sleeping pills, zopiclone should only be used for as short a period of time as possible. Otherwise, a dependency can develop. Here you can read everything you need to know about zopiclone.

This is how zopiclone works

Zopiclone is a drug from the group of so-called Z-substances. It has a sedating (calming) effect and helps you fall asleep.

The human nervous system has various messenger substances (neurotransmitters) that can have an activating or inhibiting effect. Normally they are in a balanced equilibrium and enable the change between waking and sleeping states.

One of these messenger substances, GABA (gammaaminobutyric acid), has an inhibitory effect on the nervous system as soon as it binds to its docking points (receptors). Zopiclone increases the effect of the messenger substance GABA, which results in sedation. This makes it easier to fall asleep and stay asleep.

Z-substances such as zopiclone preferentially bind to the alpha-1 subunit of the GABA receptor, which is why other effects (anti-anxiety effect, relaxation of the muscles, anti-epileptic effect) take a back seat.

Uptake, breakdown and excretion

About 80 percent of zopiclone is absorbed from the intestine into the blood after ingestion through the mouth (oral intake). The maximum effect occurs relatively quickly and lasts five to ten hours. Zopiclone is then partially converted in the liver and then excreted primarily through the kidneys.

When is zopiclone used?

The sleeping pill zopiclone is used for the short-term treatment of problems falling asleep and staying asleep in adults.

This is how zopiclone is used

The active ingredient is taken in the form of tablets. The zopiclone dosage is generally 7.5 milligrams per day (adults). Elderly patients and patients with impaired kidney or liver function receive a lower dose.

The tablets are swallowed with sufficient liquid immediately before going to bed - for a maximum of four weeks. Because the active ingredient can be addictive, especially after prolonged use and at high doses.

In addition, when you stop taking it, you should not suddenly stop taking the sleep aid, otherwise withdrawal symptoms may occur. Instead, one should gradually reduce the dosage over a period of about a week ("tapering off").

Treatment for sleep problems should not rely solely on medication. You should also try to find out the reason for the difficulty falling asleep and staying asleep and, if possible, to eliminate it. Zopiclone can only counteract symptoms (disturbed sleep), but not the cause.

What are the side effects of zopiclone?

Often (that is, in around ten percent of those treated), a bitter metallic taste in the mouth, dry oral mucosa and limited ability to coordinate occur after taking the sleeping pill. Occasionally, zopiclone also causes side effects such as headache, dizziness, anxiety, nausea and confusion.

Withdrawal symptoms such as muscle pain, headache, anxiety, tremors, nightmares, confusion, and mild irritability may occur when the patient is stopped suddenly. Elderly patients in particular are at risk of falling if they take sleeping pills for a long time.

What should be considered when taking zopiclone?

Contraindications

Zopiclone is contraindicated in the following cases:

pathological muscle weakness (myasthenia gravis)
severe shortness of breath
severe liver dysfunction
Hypersensitivity to the active substance or other components of the tablets
Breastfeeding

Interactions

When taken at the same time, zopiclone increases the effect of other centrally acting drugs such as pain relievers, anti-depressants and anti-epileptic drugs, antihistamines and drugs that relax muscles (muscle relaxants).

Avoid alcohol during treatment with zopiclone - it can worsen side effects and increase the risk of addiction.

Drugs that inhibit the breakdown of zopiclone increase the sedative effect. These drugs include, for example, erythromycin and clarithromycin (antibiotics), cimetidine (for heartburn and gastrointestinal ulcers), ketoconazole and itraconazole (for fungal infections) and ritonavir (for HIV).

In contrast, drugs that promote degradation reduce the effect of zopiclone. This applies, for example, to rifampicin (antibiotic), carbamazepine, phenytoin and phenobarbital (for epilepsy and seizures) and St. John's wort (herbal antidepressant).

If the simultaneous use of such active ingredients cannot be avoided, the dose must be adjusted accordingly by the attending physician.

Driving and using machines

Taking zopiclone in the evening means that the main effect is limited to the night. Nevertheless, the ability to react can also be impaired during the day.

Anyone who uses zopiclone should therefore refrain from actively participating in road traffic and operating dangerous machines. This is especially true when consuming alcohol at the same time.

Age restrictions

Children and adolescents under the age of 18 who suffer from difficulty falling asleep or staying asleep must not be treated with zopiclone.

pregnancy and breast feeding period

Experience in the short-term use of zopiclone during pregnancy is relatively high. Experts do not suspect any long-term effects for the newborn. However, in the first few days after birth (especially when using sleeping pills in the last trimester of pregnancy), the newborn may experience adjustment disorders.

Tried and tested active ingredients such as diphenhydramine or promethazine are available as alternative sleeping pills. In addition, experts always recommend non-drug methods such as relaxation exercises for sleep disorders.

Zopiclone only passes into breast milk to a very small extent. Nevertheless, the sleeping pill should not be used during breastfeeding.

Overdose

Symptoms of poisoning with the active ingredient zopiclone are drowsiness, sleepiness and muscle weakness up to loss of consciousness and breathing problems. A zopiclone overdose is generally not life-threatening. However, if the active ingredient is combined with other centrally acting drugs or alcohol, it can lead to a life-threatening increase in effectiveness.

How to get drugs with zopiclone

Zopiclone requires a prescription in Germany, Austria and Switzerland and is therefore only available with a prescription from a doctor in the pharmacy.

No preparations with the active ingredient zopiclone are currently sold in Austria.