Here in England (I cannot speak for the rest of Great Britan) they have curious way of dispensing medicine.
If the amount prescribed is not a full box they will either put the correct amount in a medicine bottle or they will put it in a box unmarked save for the name and instructions.
This is a problem for me since I like to read the leaflet that comes with them in order to figure out the side effects for example.
This is especially important when using psychotropic drugs or medicine that affects the nervous system.
So I present this writeup in hope that if take this drug and do not receive a leaflet you know the score.
Brand Name (USA, Canada and Australia): Imovane
Molecular Composition: C17H17CIN6O3
Molecular weight: 388.8
The tablets as distributed currently contain 7.5mg of the active ingredient. It also contains lactose monohydrate, hypromellose, titanium dioxide, wheat starch, calcium dihydrogen phosphate, and sodium carboxymethyl amylopection.
Pharmacology.
Zopiclone is a short acting
hypnotic agent. It belongs to a novel chemical class that is unrelated to other hypnotic agents. Having said this, it
similar in its pharmacological profile to
benzodiazepines.
In tests carried out over in man, the drug reduced
sleep latency, increased the duration of sleep and
reduced nocturnal awakenings.
It delayed the onset of REM sleep, but over the course
did not reduced the total duration of the
REM sleep incurred.
To explain, the duration of
Stage 1 sleep was
shortened and the time that the study spent in Stage 2 was
lengthend. In some cases stage 3 and 4 sleeps where also increased but the majority of cases no change was observed. This non-change is where the difference from benzodiazepines lies. In benzodiazepines the slow wave sleep is decreased and
REM sleep is
prolonged.
Physical and metabolic results (Pharmokinetiks)
Zopiclone is rapidly absorbed, the maxim time of total plasma concentration recorded is 1.75 hours (105 minutes). It's peak distribution in the blood and tissue is 0.5 hours (30 minutes). The areas it shows maximum absorption are in the kidneys, liver, small intestines and stomach. The liver is the main point of metabolism in this case.
After twenty fours hours the considerable residue of the drug in the patients blood was 8%.
The elimination starts 45minutes after the dosage; the process is mainly hepatic metabolism. Other methods of excretion and elimination are largely dependent on the subject and they're for inconsiderable.
Elderly patients the elimination process is prolonged. Studies show that elimination process start almost seven hours after administration.
In recipients with mild to moderate hepatic insufficiency the elimination is prolonged to nearly twelve hours and peak plasma times are raised to nearly four hours.
If the patient suffers from renal insufficiency,also mild to moderate, the pharmokinetiks of Zopiclone are not altered.
As mentioned above this drug is used as a short term hypnotic. It is prescribed to treat short term insomnia (short term being between two and four weeks).
People with following ailments and symptoms should perhaps search for an alternative remedy;
Warnings
As with all hypnotics patients should not operate dangerous machinery or motor vehicles until the treatment has been proven not to cause drowsiness.
Abilities at a mental and physical level may be impaired the day after use.
Tolerance for alcohol and other depressants is reduced, and these substances should be reduced or eliminated where possible whilst on the Zopiclone treatment.
Dependence and withdrawal
Risks of withdrawal symptoms have been seen when abruptly terminating a long treatment with this drug.
It is recommended that after a prolonged period of usage the dosage should be reduced gradually.
The risk of dependency increases with the dosage and duration of treatment and in patients with a history of alcohol and drug abuse. Even in patients that drink only occasionally the risk of dependence is substantially higher.
Precautions
Precautions should be taken with patients suffering from severe renal and hepatic insufficiency, thyroid or hormonal disorders and in the cases where the patient suffers a serve and chronic respiratory disorder.
In patients with depression (even latent), psychosis and schizophrenia caution is advised and risk of suicide may be increased.
If the patient suffers from epilepsy treatment should not be withdrawn abruptly since the risk of a seizure is very high.
Temporary amnesia or memory fails is a high possibility especially when sleep is interrupted or the subject does not retire to bed once taken the tablet.
Adverse reactions and side effects
The most common side effect of Zopiclone is a bitter taste in the mouth.
Less common reactions include,
Reactions observed on the nervous system are as follows,
Overdosage
To date no serious effects have been seen in patients with overdose.
The minor effects are drowsiness and lethargy.
Following an overdose a stomach wash (gastric lavage) should be performed and vitals monitored.
As an antidote Flumazenil may be useful.