Imovane (Zopiclone)

Zopiclone is a hypnotic agent used to manage sleep disorders.

• Insomnia: short‑term treatment to improve sleep onset and maintenance in adults.
• Transient insomnia: helps patients achieve adequate sleep during brief periods of sleep disturbance.
• Primary insomnia: facilitates restoration of normal sleep patterns in individuals with chronic difficulty sleeping.

• Zopiclone binds to the benzodiazepine site of the GABA‑A receptor complex as a positive allosteric modulator, enhancing the inhibitory effect of GABA. This increases chloride ion flow into neurons, leading to hyperpolarization and a reduction in neuronal excitability, which produces sedative‑hypnotic effects that promote sleep.

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

Common Side Effects

• Drowsiness: feeling unusually sleepy during the day.
• Dry mouth: reduced salivation causing discomfort.
• Bitter or metallic taste: unpleasant oral sensation.
• Headache: mild to moderate cranial pain.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Gastrointestinal upset: nausea, abdominal discomfort, or dyspepsia.

Serious or Rare Side Effects

• Allergic reactions: rash, itching, swelling, or anaphylaxis.
• Complex sleep behaviors: sleepwalking, sleep‑driving, or other activities performed while not fully awake.
• Memory impairment: difficulty recalling events that occurred after dosing.
• Mood changes: depression, anxiety, or suicidal thoughts.
• Respiratory depression: slowed breathing, especially when combined with other depressants.
• Dependence or withdrawal: symptoms upon abrupt discontinuation after prolonged use.

Before prescribing Zopiclone, clinicians should consider several safety measures.

• Assess duration of insomnia: limit use to short‑term periods to reduce dependence risk.
• Use lowest effective dose: start with the minimal dose that provides therapeutic benefit.
• Avoid alcohol: concurrent consumption can potentiate sedative effects.
• Caution in hepatic impairment: liver dysfunction may increase drug exposure.
• Monitor for dependence: watch for signs of tolerance or withdrawal.
• Store below 25°C: keep in the original pack, protect from moisture.

Zopiclone can interact with other substances that affect the central nervous system or its metabolism.

Major Interactions (Avoid)

• Alcohol: additive CNS depression leading to excessive sedation.
• Other CNS depressants (e.g., opioids, barbiturates): heightened risk of respiratory depression.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): increased plasma concentrations of Zopiclone.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, carbamazepine): reduced efficacy due to lower drug levels.
• Antidepressants (e.g., SSRIs, SNRIs): potential for enhanced sedation.
• Antihistamines: may increase drowsiness.
• Grapefruit juice: can modestly raise Zopiclone exposure.
• Antihypertensives: possible additive hypotensive effect.