Zopiclone

Cyclopyrrolone / Z-Drug·Neurology - Sedatives & Hypnotics

Short-term treatment of insomnia (difficulty falling asleep and early morning awakening)

Authority requiredPBSHYPNOTICImovane, Imrest7.5 mg tablet+2

Max Dose

7.5 mg/day

Half-life

5 h

Bitter Taste

SEVERE

Sleep Maint.

BETTER

Rapid Summary

Overview

Non-benzodiazepine 'Z-Drug' hypnotic. Longer half-life than Zolpidem, making it better for patients who wake up at 3 AM, but causes a relentless metallic taste in the mouth.

Maximum Dose

Max 7.5 mg/day (Adults) or 3.75 mg/day (Elderly/Hepatic).

Clinical Focus

Has a longer duration than Zolpidem, so next-day hangover and falls risk in the elderly is significantly higher.

Bottom Line

Zopiclone is a Z-drug hypnotic for short-term insomnia with rapid onset, but causes metallic taste and next-day impairment, and carries the same dependence risk as benzodiazepines.

Formulation & Access

Brand Names

Imovane, Imrest

Oral Routes

Tablets (7.5 mg). Scored to snap into 3.75 mg.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Short-term treatment of insomnia (difficulty falling asleep and early morning awakening).

Clinical Place

Preferred over Zolpidem if the primary issue is sleep *maintenance* rather than just sleep onset.

Quick reference

Class & Role

Cyclopyrrolone / Z-Drug — Non-benzodiazepine 'Z-Drug' hypnotic.

Route / Formulation

Tablets (7.5 mg). Scored to snap into 3.75 mg. (Imovane, Imrest)

Usual Dose & Max

PO 7.5 mg STAT immediately before bed. Max 7.5 mg/day (Adults) or 3.75 mg/day (Elderly/Hepatic).

Key Indication Doses

Insomnia (Onset & Maintenance): PO 7.5 mg STAT immediately before bed. Elderly / Hepatic / Frail: Max 3.75 mg/day (Half a tablet).

Best Uses

Zopiclone is a Z-drug hypnotic for short-term insomnia with rapid onset, but causes metallic taste and next-day impairment, and carries the same dependence risk as benzodiazepines.

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis, severe hepatic impairment. Pregnancy Category C.

Key Risks

Gastrointestinal: Dysgeusia (a severe, lingering metallic/bitter taste in the mouth the entire next day. Affects up to 20% of patients). Neurological: Morning hangover, dizziness, ataxia. MODERATE — Parasomnias (sleepwalking), but slightly less common than Zolpidem. Psychiatric: Depression, confusion in the elderly.

Key Interactions

Alcohol and other CNS depressants (Synergistic respiratory depression). CYP3A4 inhibitors (e.g., Erythromycin) double blood levels, causing severe next-day sedation.

Monitoring

Warn the patient about the bitter taste. Do not let them take it at 2 AM when they wake up, or they will be profoundly impaired the next morning.

Clinical Pearl

The bitter taste is not from the pill on the tongue; it is secreted into the saliva from the bloodstream. Water and brushing teeth will not fix it. It only fades when the drug leaves the body.

Access

Authority requiredImovane, Imrest7.5 mg tablet

Brand: Imovane, Imrest
PBS status: Authority required
Formulation: Tablets (7

Zopiclone

Cyclopyrrolone / Z-Drug·Neurology - Sedatives & Hypnotics

Short-term treatment of insomnia (difficulty falling asleep and early morning awakening)

Authority requiredPBSHYPNOTICImovane, Imrest7.5 mg tablet+2

Max Dose

7.5 mg/day

Half-life

5 h

Bitter Taste

SEVERE

Sleep Maint.

BETTER

Rapid Summary

Overview

Non-benzodiazepine 'Z-Drug' hypnotic. Longer half-life than Zolpidem, making it better for patients who wake up at 3 AM, but causes a relentless metallic taste in the mouth.

Maximum Dose

Max 7.5 mg/day (Adults) or 3.75 mg/day (Elderly/Hepatic).

Clinical Focus

Has a longer duration than Zolpidem, so next-day hangover and falls risk in the elderly is significantly higher.

Bottom Line

Zopiclone is a Z-drug hypnotic for short-term insomnia with rapid onset, but causes metallic taste and next-day impairment, and carries the same dependence risk as benzodiazepines.

Formulation & Access

Brand Names

Imovane, Imrest

Oral Routes

Tablets (7.5 mg). Scored to snap into 3.75 mg.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Short-term treatment of insomnia (difficulty falling asleep and early morning awakening).

Clinical Place

Preferred over Zolpidem if the primary issue is sleep *maintenance* rather than just sleep onset.

Quick reference

Class & Role

Cyclopyrrolone / Z-Drug — Non-benzodiazepine 'Z-Drug' hypnotic.

Route / Formulation

Tablets (7.5 mg). Scored to snap into 3.75 mg. (Imovane, Imrest)

Usual Dose & Max

PO 7.5 mg STAT immediately before bed. Max 7.5 mg/day (Adults) or 3.75 mg/day (Elderly/Hepatic).

Key Indication Doses

Insomnia (Onset & Maintenance): PO 7.5 mg STAT immediately before bed. Elderly / Hepatic / Frail: Max 3.75 mg/day (Half a tablet).

Best Uses

Zopiclone is a Z-drug hypnotic for short-term insomnia with rapid onset, but causes metallic taste and next-day impairment, and carries the same dependence risk as benzodiazepines.

Avoid / Cautions

Severe respiratory failure, Myasthenia Gravis, severe hepatic impairment. Pregnancy Category C.

Key Risks

Key Interactions

Alcohol and other CNS depressants (Synergistic respiratory depression). CYP3A4 inhibitors (e.g., Erythromycin) double blood levels, causing severe next-day sedation.

Monitoring

Warn the patient about the bitter taste. Do not let them take it at 2 AM when they wake up, or they will be profoundly impaired the next morning.

Clinical Pearl

The bitter taste is not from the pill on the tongue; it is secreted into the saliva from the bloodstream. Water and brushing teeth will not fix it. It only fades when the drug leaves the body.

Access

Authority requiredImovane, Imrest7.5 mg tablet

Brand: Imovane, Imrest
PBS status: Authority required
Formulation: Tablets (7