Zaleplon (Oral)

Zaleplon is a sedative medication, used to help short-term insomnia sufferers get restful sleep. As a hypnotic, Zaleplon acts on brain certain centers, to relax central nervous system activity and prepare the patient for sleep.

Overview

Zaleplon is a non-benzodiazepine hypnotic, also regularly referred to as a sedative. It affects chemicals in the brain that may be unbalanced in people with neurotic related sleep problems or insomnia. Zaleplon is used to treat short-term insomnia but it is not recommended for long-term use, as it has characteristics that can cause complications.

This medicine causes relaxation in brain activity and the central nervous system, to help the patient fall asleep and reach the initial periods of deep sleep. Due to its relatively short one hour peak absorption and one hour half life, Zaleplon should be used as a catalyst to sleep, rather than as a full night sedative. The benefit to such a brief period of effectiveness is that the patient is able to wake up after a full night of rest with less of the side effects of other medications that last longer.

The adverse effects associated with Zaleplon have been shown to be more rapidly resolved and lesser in magnitude than those associated with benzodiazepines and other drugs used to treat sleep loss. Non-benzodiazepines like Zaleplon do not affect sleep architecture in the same way as benzodiazepines do. The result is that a patient taking Zaleplon is more likely to go through the natural stages of sleep, into the final REM (Rapid Eye Movement) stages, whereas REM sleep was found to be less likely in patients taking benzodiazepines. Zaleplon also has less of the addictive characteristics of other benzodiazepine sleep aid medications.

Conditions Treated

  • Insomnia
  • Short-term sleep disruption
  • Neurotic induced sleep disruption
  • Anxiety related sleep disruption

Type Of Medicine

  • Nonbenzodiazepine hypnotic, Pyrazolopyrimdine class.

Side effects

  1. Just after taking

The patient may feel some dizziness, drowsiness, headache or nausea shortly after taking Zaleplon. It is also possible that, if the patient fails to get to sleep after taking Zaleplon, that they may experience some short-term memory loss. These effects are more pronounced within the first two hours of taking the medication and this is why it is highly recommended that Zaleplon be taken in the moments before sleep is attempted. A physician may recommend that the patient takes Zaleplon around 10 to 15 minutes before going to bed, or 20 minutes after going to bed, if the patient has failed to get to sleep. Peak absorption usually takes around one hour and has a half-life of around 1 hour. The drug may last for a total of up to four to five hours before the effects fully subside.

  1. Less common side effects

Some patients experience concerning side effects after taking Zaleplon. Although these instances are not common, it is important to be aware of these and to understand in advance any symptoms that the patient may experience and what to do should they occur. These include:

  • Abdominal pains or menstrual pains
  • Burning, tingling or prickly sensations
  • Constipation
  • Coughing
  • Difficulty concentrating
  • Dryness of mouth
  • Eye pain, blurred vision or itchy eyes
  • Fever
  • Heartburn, indigestions or increased stomach acid
  • Joint stiffness
  • Mental depression
  • Nervousness or anxiety
  • Nosebleeds
  • Sensitive hearing
  • Severe headaches
  • Short-term memory loss
  • Shortness of breath
  • Skin rash
  • Tight chest
  • Trembling or shaking
  • Wheezing

If the patient experiences any of the above side effects to a severe level, then seek medical assistance.

  1. Sleepwalking

On rare occasions, patients have been prone to sleepwalking after taking Zaleplon and due to the effects of the drug, had little to no memory of doing so. Taking Zaleplon while under the influence of alcohol will increase the chances of this effect. Under no circumstances should Zaleplon be mixed with alcohol or any other drug, unless the patient has consulted with a pharmacist, or it has been prescribed by a medical professional.

  1. Supervision

It is recommended that the first dose of Zaleplon is taken under supervision, where possible. This can help to prevent the patient from sleepwalking, which could cause risk or harm to the patient or others. There are known cases of Zaleplon patients attempting to drive vehicles, operate machinery and becoming involved in sexual activity during incidents of sleepwalking. Having someone present who is aware of the patient's medication, within the vicinity for the first two hours of the initial dose, can help prevent the patient from undertaking any dangerous activities. The most likely cause of sleepwalking or unconscious action after taking Zaleplon is taking an overdose.

  1. Hallucinations

Zaleplon has been known to cause hallucinations through a variety of methods, in some rare cases. The patient could experience auditory, visual or other hallucinations. It is possible if failure to get to sleep occurs that the patient may see, hear, smell or feel things that are not really there, under the effect of the drug. If any symptoms like the above occur, it is likely they will pass as the effect of the drug wears off, however, the patient should contact a medical professional for advice immediately.

  1. Medical study evidence

Adverse effects from Zaleplon are of relatively short duration, milder, and resolve more quickly when compared with those of the previously recommended benzodiazepine hypnotics. Between 1998 and 2004, Texas poison control centers recorded adverse effects reported from patients using Zaleplon. The most frequently recorded adverse effects for Zaleplon were drowsiness, slurred speech, ataxia, tachycardia, hallucinations, dizziness, confusion, and vomiting. In the few scientific studies featuring Zaleplon, most of the side effects were found to be psychological. For example, researchers found that 30% to 35% said they developed headaches from both Zaleplon and placebos and 7% reported dizziness from both Zaleplon and placebos. It is important to understand that severe side effects are rare.

  1. Emergency

If the patient becomes concerned about the side effects of Zaleplon or believes someone may be at risk, then call 911 or the Poison Control Centre (1-800-222-1222).

Dosage

As with any drug, only take Zaleplon as prescribed by a physician, pharmacist or medical professional. Follow their instructions closely and disclose all relevant information regarding medical conditions and other medications to receive the correct medical advice. It is important that the medication is not taken more than 10 minutes prior to going to bed, to reduce side effects.

Healthy Adults

For cases of insomnia in healthy adults, an initial dose of 10mg is normally recommended, either 10 minutes before going to bed, or after failing to get to sleep within 20 minutes of going to bed. The maximum dose for healthy adults is 20mg per night.

Older Patients

In geriatrics and elderly patients, an initial dose of 5mg is more commonly prescribed, with a maximum dose of 10mg per night. This is to help prevent instability in motor activity in the elderly who are more susceptible and reduce injuries as a result.

Important Medical Conditions

If the patient has mild to moderate hepatic impairment or has a low weight, a reduced 5mg dosage is usually recommended. A maximum dose of 10mg also applies. Those with renal impairment should consult their doctor specifically regarding this subject, before taking Zaleplon. If a physician has recommended concomitant use of Zaleplon with Cimetidine, then a reduced 5mg dose is normally recommended. This is due to the interactive effects of the two drugs.

Capsule Size

Zaleplon is available in 5mg and 10mg capsules - please check with the pharmacist to confirm which dosage of capsule the patient has been issued with and always read the label before taking Zaleplon to ensure a dosage amount is correct.

Interactions

When more than one drug is present in the human body, it can change how a drug works. Sometimes a drug will not work at all due to reactions in the body with other medications. Adverse effects can also occur if Zaleplon reacts within the body to other substances a patient has taken.

The patient should consult with their doctor regarding any and all prescribed medications, non prescribed medications, drugs or over the counter medications. It is vitally important when taking Zaleplon to avoid alcohol completely. Also avoid taking any other drugs, substances or remedies that have not been discussed with a medical professional.

Some of the most common interactions are listed below but are not limited to:

  • Alcohol
  • Anti-anxiety drugs such as Alprazolam, Lorazepam or Zolpidem
  • Anti-seizure medication such as Phenytoin or Phenobarbital
  • Azole antifungals such as Ketoconazole or Cimetidine
  • Marijuana
  • Melatonin
  • Muscle relaxants such as Certirine or Diphenhydramine
  • Opioid pain relievers such as Codeine or Hydrocodone
  • Rifabutin or Rifampin
  • Sodium Oxybate

Please avoid taking any of the above noted medications with Zaleplon, unless specifically advised to do so by a qualified medical professional.

Warnings

As Zaleplon is a sedative, it causes a reduction in heart rate when taken. Any additional medications or substances causing side effects such as reduced heart rate, shallow breathing, drowsiness or dizziness, may cause more pronounced side effects, if taken along with Zaleplon. It is important to disclose all drugs - including prescribed and over the counter medications - to the physician during a consultation. If the patient has pre-existing medical conditions such as breathing problems, depression, or liver diseases, then Zaleplon is not normally recommended. Due to its sedative effect on the central nervous system, it is not usually deemed safe for these conditions.

It is possible to overdose on Zaleplon and the patient should never exceed the prescribed dose of the drug. If a patient has overdosed, you may notice them lose consciousness or experience trouble breathing. Additionally, if a patient has accidentally taken too much Zaleplon, regardless of if adverse side effects are experienced, seek medical attention immediately.

In cases of an overdose, the symptoms can be recognized if the patient exhibits some of the following symptoms:

  • Blue or green colored lips
  • Dizziness to the point of fainting
  • Severe confusion
  • Severe unsteadiness or clumsy behavior
  • Trouble breathing
  • Unusual dullness or sluggish feeling
  • Weak muscle tone

Allergic reactions to Zaleplon are rare but very serious. They can be recognized by symptoms such as swelling of the throat, tongue or face; hives, or if a rash develops; or if experiencing difficulty breathing. Contact medical services if the patient experiences any of these symptoms immediately.

It is possible to become dependent on Zaleplon after taking it for prolonged periods. The patient should stick closely to the program recommended by the physician. A patient may become physiologically dependent and begin to feel like they need Zaleplon to be able to sleep after prolonged use. Upon finishing prolonged use of Zaleplon, the patient may experience an effect known as 'rebound insomnia'. This is when the body has become reliant on the drug to get to sleep and is not naturally entering the initial stages of sleep. This effect can be reduced by the patient tapering their usage of the drug before finishing the program.

If a patient has been abusing Zaleplon or taking it at levels not medically recommended, they can develop difficult withdrawal symptoms, similar to the ones produced by dependence on benzodiazepines. Symptoms might include muscle and abdominal cramps, sadness, depression, vomiting, shakiness, and even seizures. These symptoms are difficult and dangerous to manage without assistance. If the patient feels they are becoming dependent or are at risk of becoming dependent, they should consult a doctor. Zaleplon is not usually recommended for people with a history of drug abuse or alcoholism.

Zaleplon is recommended for short-term use. As such, it is usually not prescribed or recommended for sustained use of 30 days or longer. Longer periods of use are more likely to lead to dependency issues and, although Zaleplon has a less addictive effect than the previously recommended benzodiazepine medications, it can still cause harmful patterns of behavior. Patients who develop Zaleplon dependencies may be more likely to feel they need to take higher doses to achieve the same results of sleep aid. This can, in turn, lead to bodily harm and a greater risk of overdose.

Geriatric patients may be more sensitive to the effects of Zaleplon. The impairment of cognitive and motor function may be greater in this patient group and a lower initial dosage is recommended. According to the Beers Criteria, Zaleplon is potentially an inappropriate medication in geriatric patients and use should be avoided. Zaleplon is likely to decrease motor skills in older adults and increase instances that can lead to injury, such as falls, fractures, and delirium. There are reported increases in emergency department visits, hospitalizations, and motor vehicle crashes. Also, studies show less improvement in sleep latency and duration in older adults. The Beers expert panel also recommends against providing sedative hypnotics such as Zaleplon to geriatric patients with dementia or cognitive impairment due to the potential for drug-induced adverse central nervous system effects. In addition, the expert Beers panel recommends against Zaleplon use in elderly patients with a history of falls, unless alternatives are not available since Zaleplon can induce ataxia, impaired psychomotor function, syncope, and additional falls. If Zaleplon must be used, a physician would normally consider reducing the use of any other central nervous system active medications that increase the risk of falls and fractures and implement other strategies to reduce fall risk.

To help aid in successful results from taking Zaleplon, the patient should avoid caffeine as much as possible and particular in the hours before attempting sleep. The patient should avoid using light emitting devices, such as phones or TV in the lead up to sleep and whilst in bed. Regular exercise helps to tire the body naturally and can help with a restful state of mind whilst in bed.

Storage

Zaleplon should be stored in a cool, dry environment between 68 to 77 degrees Fahrenheit. The drug should be stored in a light blocking container and out of the reach of children and animals. It is recommended that Zaleplon is NOT stored in the bathroom, as moisture can affect the drug and capsules.

Summary

During bouts of intermittent insomnia, Zaleplon can be an effective solution to the treatment of sleep loss. Bouts of insomnia brought on by anxiety or periods of stress can easily lead to periods of sleep loss, to which Zaleplon is a good short-term solution. Due to reduced side effects and risks, Zaleplon is a good alternative to other benzodiazepine sleep aid drugs, which have previously been used to treat insomnia.

Zaleplon should not be used as a long-term solution to sleep loss, as, although it has reduced risks, it is not a risk-free medication. It has the potential to develop issues, such as physiological and physical dependency if it is taken for longer than 30 days. The underlying reasons for insomnia should be understood and treated, alongside any short course of Zaleplon medication. If taken as instructed by a medical professional, then Zaleplon can help to restore a regular pattern of sleep and restfulness.

 

http://www.drugaddictiontreatment.com/types-of-addiction/prescription-drug-addiction/sonata-addiction/

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Last Reviewed:
December 24, 2017
Last Updated:
April 05, 2018
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