From the Guidelines
The recommended dose of zopiclone for treating insomnia in Canada is typically 7.5 mg taken orally once daily at bedtime for adults, with a lower starting dose of 3.75 mg recommended for elderly patients or those with hepatic or renal impairment.
Key Considerations
- Zopiclone should be used for short-term treatment of insomnia, generally for 2-4 weeks including a gradual tapering period, as prolonged use can lead to tolerance and dependence 1.
- The medication works by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain, which helps reduce brain activity and induce sleep.
- Patients should take zopiclone immediately before bedtime and ensure they have 7-8 hours available for sleep to avoid residual daytime drowsiness.
- Common side effects include a bitter metallic taste, dry mouth, and morning drowsiness.
- Zopiclone should not be combined with alcohol or other central nervous system depressants, as this can dangerously increase sedation.
Important Safety Information
- A systematic review found that nonbenzodiazepine BZRAs, including zopiclone, improved sleep efficiency and other important outcomes compared with placebo, but the U.S. Food and Drug Administration recently released a safety announcement on the risk for serious injuries caused by sleep behaviors associated with these agents 1.
- To minimize the incidence of adverse events, zopiclone should be administered at the lowest effective dose and for the shortest possible duration, and all patients offered this agent should be counseled on the potential risks.
From the Research
Zopiclone Doses Available in Canada
- The recommended dose of zopiclone for treating insomnia is not explicitly stated in the provided studies as being specific to Canada, but general dosing information can be inferred from the studies on zopiclone and related nonbenzodiazepine hypnotics 2, 3, 4, 5.
- Zopiclone is indicated for short-term use and should not be prescribed for more than 4 weeks 4.
- The typical dosage of zopiclone is 7.5 mg/day, which has demonstrated efficacy equivalent to or greater than that of several benzodiazepines 3, 4, 5.
Dosage Considerations
- The dosage of zopiclone may need to be adjusted based on individual patient response and tolerance 2, 3, 4, 5.
- Zopiclone has a relatively low propensity to cause residual clinical effects, such as difficulty waking or reduced morning concentration 3, 5.
- Rebound insomnia can occur after withdrawal of zopiclone, but it does not appear to be common based on short-term studies 5.
Comparison to Other Hypnotics
- Zopiclone has been compared to other nonbenzodiazepine hypnotics, such as eszopiclone, and benzodiazepines, such as flurazepam and temazepam 2, 3, 4, 5.
- Zopiclone has a favorable adverse-effect profile and is considered a viable alternative to benzodiazepines for the short-term treatment of insomnia 2, 4, 5.