Zopiclone (Imovane®)

Zopiclone (Imovane® and generic forms) belongs to a group of medications called “hypnotics” or “sedatives.”

What is this medication used for?

Zopiclone is commonly referred to as a “sleeping pill.” It is approved by Health Canada for short-term relief of sleeping difficulties (insomnia) in adults.

Like many other medications prescribed for children and adolescents, Health Canada has not approved zopiclone for use by children or adolescents. When potential benefits outweigh risks, zopiclone may be prescribed “off-label” for treatment of sleep disorders (insomnia). Learn more about off-label medication use:http://bit.ly/KMH-off-label-use

Tell your doctor or pharmacist if you:

Have allergies or bad reactions to a medication
Take (or plan to take) other prescription or non- prescription medications, including natural medicines. Some medications interact with zopiclone. Your doctor may adjust medication doses or monitor for side effects
Have a history of lung disease or breathing problems, kidney or liver disease, sleep apnea or myasthenia gravis
Have a history of depression, any other psychiatric condition, thoughts of self-harm or complex sleep- related behaviors (sleepwalking or sleeptalking)
Miss a menstrual period, are pregnant, breast-feeding or planning a pregnancy
Use alcohol or drugs. Taking zopiclone together with certain substances may cause a bad reaction. Learn more at www.DrugCocktails.ca

When will the medication start to work?

Zopiclone is usually prescribed to be taken on an ‘as needed’ basis, but it is sometimes taken regularly. You should start to feel drowsy within 30-60 minutes of taking zopiclone.

Talk with your doctor if you feel that zopiclone has not been helpful or if side effects are too bothersome. Your doctor may recommend switching you to a different medication.

Is this medication addictive?

The use of zopiclone may lead to physical and psychological dependence (such as unable to sleep without medication) or abuse (taking more than prescribed). However, zopiclone appears to have a lower risk of dependence and rebound insomnia than other sleeping pills.

As the zopiclone dosage and duration of treatment increases, the risk of dependence or abuse becomes higher. If you have been taking zopiclone for a long period of time and suddenly stop, you make experience worsened sleep problems (rebound insomnia) or feelings of anxiety. Your doctor will explain how to safely lower the dose gradually to prevent uncomfortable withdrawal effects as your body adjusts to being without it.

How do I take this medication?

When used regularly, zopiclone should be taken once daily at bedtime. Usually, you will start with a low dose and may slowly increase this dose over several days or weeks, based on how you tolerate it. It is important to follow the dosing schedule as given by your doctor. Your doctor will determine the dose of zopiclone that works best for you based on your symptoms and your response to this medication. Do not take more than the recommended dosage before talking to your doctor.

Zopiclone is available in tablets that are taken by mouth. If necessary, tablets may be broken in half, but they should not be crushed or chewed.

Possible common or serious side effects:

Side effects may be more common when first starting a medication or after a dose increase. Talk to your doctor, nurse or pharmacist if any side effect concerns you.

Blurred vision, dry mouth or unpleasant taste
Nausea, vomiting, stomach ache or constipation
Dizziness, poor coordination or headache
Agitation, irritability, vivid dreams or nightmares
Memory problems or morning drowsiness
Trouble sleeping or increased anxiety after you stop taking zopiclone

Contact your doctor immediately if you experience:

Mood or behavioral changes or aggression
Hallucinations (hearing or seeing things that are not there)
Thoughts of hurting yourself, suicide, increased hostility or worsening symptoms
Getting out of bed without being fully awake and taking part in activities you are not aware of and do not remember (complex sleep-related behaviors)
Irregular heartbeat
Muscle spasms or stiff muscles

What precautions should my doctor and I be aware of when taking this medication?

Before starting Zopiclone, try making small changes to sleep habits to see if you have a need for medication. For example, good sleep habits include:
- avoiding caffeine and other substances that can disrupt sleep (alcohol, nicotine, cannabis)
- sticking to a regular sleep/wake schedule (avoid sleeping in or taking naps)
- powering down devices early in the evening and avoiding stimulating activities, large meals or exposure to bright lights before bedtime
- keeping the bedroom only for sleep, free of distractions
Many medications may interact with zopiclone, including other sleep-aides, anti-anxiety medications, antidepressants, mood stabilizers, antibiotics and several others. If you are (or begin) taking any other prescription, over-the-counter medication, natural health product or supplement, check with your doctor or pharmacist to see if they are safe to use.
While taking this medication, if you feel dizzy, drowsy or slowed down in the morning, do not drive a car or operate heavy machinery. Alcohol could make this worse. Try to avoid alcohol while taking zopiclone.

What special instructions should I follow while using this medication?

Keep all appointments with your doctor.
Tell your doctor about your sleep pattern. Your doctor will monitor your sleep disorder and response to this medication.
Do not allow anyone else to use your medication.

What should I do if I forget to take a dose of this medication?

If you take zopiclone regularly and forget to take it, skip the missed dose and take your next dose at its regularly scheduled time the next day. DO NOT double your next dose to try to ‘catch up’.

How do I store this medication?

Keep this medication in the original container, stored at room temperature away from moisture and heat and protected from light. Keep this medication out of reach and sight of children.

How does this medication work?

Zopiclone affects actions of the brain chemical GABA. By enhancing the action of GABA, zopiclone helps you fall asleep faster and increases total sleep duration as well as sleep quality.

How well does the medication work in children and adolescents?

Zopiclone may improve sleep by shortening the time it takes you to fall asleep, decreasing the number of times you wake up during the night, and increasing your total sleep duration. A closely related medication (eszopiclone) has been studied in children and adolescents with ADHD and has been shown to be no better than placebo(an inactive pill). Zopiclone is sometimes prescribed when other treatments are ineffective or not well-tolerated. Studies show that with regular use over time, zopiclone may become less effective for sleep.

How long should I take the medication for?

Zopiclone is usually taken only on ‘as needed’ basis when you have sleep difficulties. Generally, its use should be limited to 7-10 consecutive days at a time, whenever possible. However, some patients may need to take zopiclone regularly for a longer period of time. Your doctor will discuss the benefits and risks of taking zopiclone with you. At this time, you can also discuss how long you might need to take this medication.

If you take zopiclone regularly, do not increase, decrease, or stop taking this medication without discussing it with your doctor. If you stop taking zopiclone suddenly, it is possible that you will experienced worsened sleep.