Imovane (Zopiclone)

Zopiclone is a non‑benzodiazepine hypnotic that acts on the central nervous system to improve sleep quality.

• Primary insomnia: improves sleep onset and maintenance in adults with chronic difficulty sleeping.
• Sleep onset insomnia: shortens the time needed to fall asleep after bedtime.
• Sleep maintenance insomnia: reduces the number of nocturnal awakenings and prolongs total sleep time.
• Transient insomnia due to jet lag: helps adjust sleep pattern during travel.
• Insomnia associated with psychiatric conditions: supports sleep while other treatments address the underlying disorder.

• Zopiclone binds to the benzodiazepine site of the GABA_A receptor complex as a positive allosteric modulator, enhancing GABA‑mediated chloride influx. This hyperpolarises neuronal membranes, depresses central nervous system activity, and facilitates the initiation and maintenance of sleep.

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

Common Side Effects

• Bitter taste: unpleasant metallic sensation in the mouth.
• Drowsiness: feeling of sleepiness during daytime.
• Dry mouth: reduced salivation leading to thirst.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Complex sleep behaviours: activities such as sleepwalking or sleep‑driving performed while not fully awake.
• Allergic reactions: rash, swelling, or anaphylaxis requiring immediate medical attention.
• Depression or mood changes: emergence of low mood, anxiety, or suicidal thoughts.
• Memory impairment or amnesia: difficulty recalling events after waking.

Before prescribing Zopiclone, clinicians should evaluate several safety considerations to minimise risks.

• Assess sleep hygiene: evaluate non‑pharmacologic measures before initiating therapy.
• Avoid alcohol: concurrent consumption may intensify sedation and respiratory depression.
• Elderly patients: use the lowest effective dose and monitor for falls or confusion.
• Short‑term use: limit treatment to two weeks or less to reduce dependence potential.
• Pregnancy and lactation: discuss potential risks with the prescriber and consider alternatives.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Alcohol: additive central nervous system depression leading to profound sedation.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): increase Zopiclone levels and risk of toxicity.
• Opioids: combined use may cause enhanced respiratory depression and profound sedation.

Moderate Interactions (Monitor Closely)

• Other CNS depressants (e.g., antihistamines, muscle relaxants): may increase overall sedation.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine): reduce Zopiclone effectiveness by lowering plasma concentrations.
• Certain antidepressants (e.g., fluoxetine, sertraline): possible pharmacodynamic interaction affecting sleep architecture.