Imovane (Zopiclone)

Zopiclone is a hypnotic agent used to manage sleep disorders.

• Insomnia: helps initiate and maintain sleep in adults.
• Primary insomnia: provides short‑term relief of difficulty falling asleep.
• Adjustment insomnia: aids sleep during periods of stress or environmental change.

• Zopiclone acts as a positive allosteric modulator at the GABA‑A receptor complex, binding to a distinct site and enhancing the inhibitory effect of GABA. This increased chloride influx hyperpolarizes neuronal membranes, leading to reduced neuronal excitability and a sedative‑hypnotic effect that facilitates sleep onset and maintenance.

Zopiclone may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Drowsiness or excessive sleepiness.
• Dry mouth.
• Bitter or metallic taste.
• Headache.
• Dizziness.
• Nausea or abdominal discomfort.

Serious or Rare Side Effects

• Complex sleep behaviors such as sleep‑walking or driving while asleep.
• Allergic reactions including rash, swelling, or anaphylaxis.
• Mood changes, depression, or suicidal thoughts.
• Memory impairment or amnesia.
• Respiratory depression, especially when combined with other depressants.
• Severe hypotension or cardiac arrhythmias.

When prescribing Zopiclone, several safety considerations should be observed.

• Pregnancy: Category C; use only if potential benefit justifies the potential risk to the fetus.
• Elderly patients: increased sensitivity; start with the lowest effective dose and monitor closely.
• Driving and operating machinery: avoid until the individual knows how the drug affects them.
• Alcohol: avoid concurrent consumption as it may enhance sedative effects.
• Renal or hepatic impairment: dose adjustment may be necessary based on clinical assessment.
• Store at ambient temperature below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Zopiclone can interact with other medicines, affecting its sedative effect or plasma concentration.

Major Interactions (Avoid)

• CNS depressants (e.g., benzodiazepines, opioids): additive sedation and respiratory depression.
• Alcohol: potentiates central nervous system depression.
• Macrolide antibiotics (erythromycin, clarithromycin): may increase Zopiclone plasma levels.

Moderate Interactions (Monitor Closely)

• Selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine): may raise Zopiclone concentrations.
• Cimetidine: can reduce hepatic clearance, leading to higher exposure.
• Carbamazepine: may decrease Zopiclone effectiveness by inducing metabolism.