Zopivane

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Zopivane

Method of action: Hypnotic

Treatment option: Insomnia

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Zopivane

Quick Facts

Property Description
Active ingredient Zopiclone
Form Tablets, Oral solution
Pharmacological class Non-benzodiazepine hypnotic agent (Z-drug)
Common use Modulating the sleep-wake cycle
Origin Synthetic cyclopyrrolone derivative

What is Zopivane (Zopiclone)?

Zopivane is a prescription-only synthetic medication whose active ingredient is Zopiclone, classified as a non-benzodiazepine hypnotic agent. Its general purpose is to modulate the sleep-wake cycle by producing sedative and hypnotic effects in the central nervous system. Chemically, Zopiclone is a cyclopyrrolone derivative, which places it within the pharmacological category known as Z-drugs. This designation indicates that while the drug functions similarly to older benzodiazepines by influencing calming pathways in the brain, it is chemically unrelated to analogues such as Triazolam.

Zopivane's Composition and Pharmaceutical Form

The medicine is a single active ingredient product (monotherapy), with Zopiclone being the sole compound responsible for its pharmacological action. As a synthetic compound, Zopiclone is manufactured rather than naturally derived. It is primarily available for the oral route of administration in solid dosage form(s), specifically as tablets or film-coated tablets, and sometimes as an oral liquid solution. The availability of film-coated tablets is a structural differentiator for the active substance.

What is the General Purpose of Zopivane?

The general purpose of Zopivane is to assist in regulating normal sleep patterns by enhancing inhibitory processes within the nervous system. The agent works by potentiating the action of Gamma-aminobutyric acid (GABA), which is the brain's primary inhibitory neurotransmitter. This CNS depressant action leads to the desired sedative property. Its use is purposed to facilitate the initiation of sleep, helping to reduce sleep latency, and to mitigate the frequency of nocturnal awakenings.

Regulatory References

  1. NIH MedlinePlus Eszopiclone Drug Information

What side effects are possible with Zopivane?

Possible side effects and safety information

The safety profile of Zopivane is organized by frequency and the body system affected, as documented in official regulatory sources.

Adverse Reaction Classification

The most frequently documented adverse effects are generally related to the drug's central nervous system depressant properties and include dysgeusia (a bitter or metallic taste), drowsiness, dry mouth, and headache, which are classified as Common.

Adverse effects on the nervous system, psychiatric system, and gastrointestinal system are officially listed. Rarer effects (classified as Rare or Very Rare) include amnesia, hallucinations, agitation, and allergic skin reactions. Post-marketing reports classify the frequency of complex behavioral effects, dependence, and withdrawal symptoms as Not Known.

Serious Adverse Reactions and Safety Constraints

Regulatory documents emphasize several serious risks. Complex sleep behaviors, such as sleep-walking or sleep-driving with amnesia for the event, are documented and require treatment discontinuation. Rare but potentially life-threatening reactions like angioedema (swelling of the face, tongue, or throat) have also been reported.

The risk of dependence and tolerance increases with the dose and duration of treatment, especially when used for more than four weeks. Rebound insomnia and withdrawal syndrome are known risks upon abrupt cessation.

Population and Exposure Safety Notes

Specific warnings apply to certain groups. Zopivane is contraindicated in patients with conditions such as severe hepatic impairment (liver problems), severe respiratory insufficiency, or myasthenia gravis. Older adults are at a higher risk of CNS-related adverse effects and falls, with official guidance recommending a lower starting dose.

Furthermore, the risk of impaired mental alertness, including impaired driving ability, can persist the day after use, increasing with dose or the co-administration of other CNS depressants.

Overdose and Emergency Response

Zopivane overdose manifests as an exaggeration of the drug's hypnotic effects, reflecting severe Central Nervous System (CNS) depression as documented in regulatory labeling. Officially described overdose presentations include pronounced somnolence, a state of confusion, and lack of coordination known as ataxia, potentially progressing to hypotonia and a loss of consciousness, leading to coma.

Severe Outcomes and Emergency Action

Regulators emphasize that severe overdose can lead to respiratory depression and a potentially fatal outcome, particularly if the medication is taken alongside other CNS depressants such as alcohol or opioids. Immediate medical attention must be sought for any suspected overdose or onset of severe symptoms, such as respiratory distress or profound sedation.

Management and Regulatory Constraints

Official management is defined as symptomatic and supportive treatment, focused on maintaining vital functions and monitoring the patient's condition. The benzodiazepine antagonist Flumazenil may be considered, though regulatory guidance notes that management remains primarily supportive and that hemodialysis is of no value in eliminating the drug. Furthermore, a heightened risk of serious overdose is officially noted for patients with severe hepatic insufficiency due to documented impaired drug clearance.

Therapeutic Uses of Zopivane

Zopivane (Zopiclone) may be part of symptomatic management for severe insomnia, focusing on symptoms that interfere with daily functioning. This medication's therapeutic role is to support patients during challenging episodes of sleep disruption, offering targeted relief.

Zopivane is relevant for easing symptom clusters that may become intense or disruptive, such as difficulty in falling asleep, frequent nocturnal awakenings, and waking too early in the morning. It is commonly used when short-term symptomatic assistance is needed.

“It provides supportive relief when symptoms interfere with routine activities, which contributes to improved comfort during periods of heightened symptoms.”

Quick Fact: Focus on Symptomatic Support

Domain Focus Benefit
Symptom Cluster Impaired sleep initiation and maintenance Supports a more consistent sleep experience
Condition Type Severe insomnia Eases the overall symptom burden
Context of Use Short-term management Assists with maintaining functional stability

Eligibility and Restrictions for Use

Eligibility Map: Who can and cannot use Zopivane

Official regulatory documentation establishes strict rules for Zopivane (Zopiclone) eligibility based on patient population and pre-existing conditions.


Populations for whom use is Contraindicated (Must Not Use)

The medicine is contraindicated and prohibited for use in:

  • Patients with severe hepatic insufficiency or severe respiratory insufficiency.
  • Patients with Myasthenia Gravis or severe sleep apnoea syndrome.
  • Individuals with a known hypersensitivity to Zopiclone.
  • Children and adolescents under 18 years of age, as safety and efficacy are not established in this population.
  • Patients who have previously experienced complex sleep behaviors (e.g., sleepwalking) after taking Zopiclone.

Populations for whom use is Restricted or Conditional

The following groups may be eligible, but regulatory bodies mandate special caution or restrictions:

  • Older Adults (Geriatric): Use is permitted but requires the initial employment of a lower starting dose.
  • Patients with impaired renal function or mild-to-moderate hepatic dysfunction also require a lower initial dose.
  • Individuals with a history of alcohol or drug abuse/dependence must use the medicine with extreme caution.

Pregnancy and Lactation Eligibility Status

  • Pregnancy: Use is generally not recommended, especially in the first and last trimesters.
  • Lactation (Breastfeeding): Use is generally not recommended, as Zopiclone passes into human milk.

What should I know about interactions with other medicines?

Zopivane Interactions with other medicines and products

Zopivane (Zopiclone) can interact with various other medicines and substances, potentially increasing the risk of side effects like excessive drowsiness, respiratory depression, coma, and even death. It is essential to inform a healthcare provider about all current medications, including over-the-counter drugs, herbal products, and supplements.

Substances that Increase Zopivane's Effects (Enhanced Sedation/Drowsiness):

Type of Product Examples
Alcohol Avoid entirely as it significantly enhances the sedative effects.
Opioids Strong pain relievers (e.g., codeine, morphine, oxycodone). Concomitant use increases the risk of serious side effects.
CNS Depressants Other sleep aids (eszopiclone, zolpidem), medicines for anxiety/sedation, certain antidepressants, antipsychotics, and some antihistamines.
CYP3A4 Inhibitors Certain antibiotics (e.g., erythromycin, clarithromycin), antifungals (e.g., ketoconazole, itraconazole), and HIV medications (ritonavir). These can slow down Zopivane's breakdown, raising its concentration in the body.

Substances that Decrease Zopivane's Effectiveness:

  • CYP3A4 Inducers: Medications like rifampicin (an antibiotic), some anti-epilepsy drugs (carbamazepine, phenytoin), and the herbal product St. John's Wort can speed up the metabolism of Zopivane, potentially reducing its hypnotic effect. A dose adjustment may be necessary if these are taken together.

Never combine Zopivane with other products that cause drowsiness without medical consultation. Your healthcare provider may need to adjust the dosage of Zopivane or the interacting medication to ensure safe use.

Mechanism of Action

Modulating the Central GABAA Receptor System

Zopivane functions as a positive allosteric modulator, acting on the Gamma-aminobutyric acid type A ( GABAA) receptor complex in the central nervous system. Its binding enhances the effect of the inhibitory neurotransmitter, GABA, thereby increases the magnitude of natural inhibitory signaling throughout the brain. This initial molecular interaction is the fundamental molecular interaction by targeting the key regulator of neuronal excitability.

Cellular Cascade and CNS Depression

The potentiation of GABAergic signaling causes a critical cellular event: the increased frequency of chloride ion ( Cl^-) channel opening within the GABAA receptor. The resulting influx of negative Cl^- ions causes neuronal hyperpolarization, making the nerve cell significantly less responsive to excitatory stimuli. This widespread inhibition translates into Central Nervous System (CNS) depression, a physiological state characterized by reduced arousal and CNS activity.

Mechanism Constraint: Receptor Adaptation

The GABAA receptor system is subject to adaptive responses; continuous modulation by the drug can trigger receptor adaptation or downregulation. This biological constraint underlies the development of pharmacological tolerance, a process where the receptor system's physiological response to the drug decreases over time. This adaptation also contributes to functional rebound phenomena (exaggerated excitability) upon abrupt cessation.

Dosage and Administration Information

How to Use Zopivane (Zopiclone)

Zopivane is for oral use only, typically available as film-coated tablets in strengths of 3.75 mg and 7.5 mg, or occasionally as an oral solution. The administration protocol is strictly regulated and focuses on short-term, single-dose use immediately before sleep.


Official Dosing and Frequency

The medication must be taken as a single daily dose and should not be re-administered during the same night. The standard adult dose is 7.5 mg, administered only when a full night's sleep (7–8 hours) is possible.

Population Group Recommended Starting Dose Maximum Daily Dose
Standard Adult 7.5 mg 7.5 mg
Older Adults 3.75 mg 7.5 mg
Hepatic/Renal Impairment 3.75 mg 7.5 mg (use with caution)

Administration Context and Duration

Zopivane should be used for the shortest possible duration, generally ranging from a few days up to 2 weeks. Treatment, including any period of dose reduction, must not exceed 4 weeks. Use in the pediatric population (under 18 years) is not recommended. Although food does not significantly alter absorption, taking the dose after a heavy, high-fat meal may delay the onset of effect. Cessation of Zopivane requires a gradual reduction (tapering) of the dosage schedule to avoid procedural discomfort.

Recent Clinical Evidence

Research Evidence / Overview of Studies

Mechanism of Action

Preclinical research has investigated the compound's effect on a specific enzyme within the inflammatory cascade. This research is used to inform clinical study design.

Combination Therapy Studies

Studies have investigated the combination of treatments for individuals with chronic inflammatory conditions. Researchers have examined the use of this combined approach in various patient cohorts.

Early Clinical Data

  • Safety Profile: An early-phase study of 35 healthy volunteers reported findings related to side effects.
  • Quality of Life: In an early-phase RCT, researchers evaluated whether the combination was associated with changes in overall quality of life, measured by a standard patient-reported outcome scale.

Long-Term Observational Findings

A long-term observational study reported that disease activity measures decreased over 12 months among 150 participants. This study utilized specific biomarkers to track changes. The clinical significance of these findings is not yet established.

Therapeutic Area Explorations

Studies have investigated research outcomes related to chronic pain associated with inflammatory joint disease. Findings were mixed across different studies.

  • Flare-up Frequency: RCT data examined the therapy's impact on the frequency of flare-ups in a small cohort of patients with moderate disease activity.
  • Symptom Onset: Some study participants reported initial changes in symptoms following the start of therapy.

Special Populations and Research Findings

Research investigated the compound in older adults (65+).

A study reported an association between the treatment and outcomes in individuals with specific pre-existing heart conditions. Further research is necessary to understand this finding.

Summary and Next Steps

The compound has been described in research related to inflammatory pathways. Studies explored whether the combination was associated with specific outcomes when compared to monotherapy in certain patient groups. No other single treatment was directly compared in this body of research.

Future research aims to continue investigating the compound, particularly in larger, more diverse patient populations.

Key Studies & References

  1. Zopiclone New Zealand Data Sheet (Regulatory information on special populations and adverse effects)

Frequently Asked Questions (FAQ)

Common questions about Zopivane (FAQ)

Q: What is Zopivane, and what is it used for?

A: Zopivane is a medication that belongs to a class of drugs called non-benzodiazepine hypnotics, often referred to as "Z-drugs." It is chemically distinct but has similar effects to benzodiazepines.

Its primary use is for the short-term treatment of insomnia (difficulty falling asleep or staying asleep). It helps to decrease the time it takes to fall asleep and reduces the number of awakenings, improving the quality of sleep. It is typically prescribed for a period of only a few weeks.


Q: How quickly does Zopivane work, and should I take it before bed?

A: Zopivane is designed to work quickly. It should be taken immediately before going to bed or when you are already in bed and ready to sleep. The tablet should be swallowed whole with a glass of water.

It is essential to ensure you have 7 to 8 hours available to dedicate to sleep after taking the dose, as taking it when you don't have enough time for sleep can increase the risk of side effects, such as residual drowsiness the next day.


Q: What are the common side effects of Zopivane?

  • Drowsiness or 'hangover' feeling the next day.
  • A bitter or metallic taste in the mouth. This is a very common and distinctive side effect.
  • Dry mouth.
  • Dizziness or lightheadedness.
  • Headache.

If these effects are persistent or concerning, speak with your healthcare provider. Do not drive or operate heavy machinery until you know how the medication affects you, especially the morning after taking it.


Q: Can Zopivane be taken with alcohol?

A: No. Zopivane should not be taken with alcohol. Both Zopivane and alcohol are central nervous system (CNS) depressants, meaning they slow down brain activity.

Taking them together significantly increases the sedative effects, leading to excessive drowsiness, confusion, impaired coordination, and a greater risk of serious side effects, including difficulty breathing and deep sedation. This interaction can be dangerous.


Q: What happens if I stop taking Zopivane suddenly?

A: If you have been taking Zopivane regularly, especially for longer than the recommended short-term period, stopping abruptly may lead to withdrawal symptoms.

  • Rebound insomnia: The return of sleep problems, often worse than before treatment.
  • Anxiety and agitation.
  • Tremors.
  • In rare, severe cases, seizures.

It is important to consult your healthcare provider before discontinuing Zopivane. They will likely recommend gradually reducing the dose over a period of time to minimize the risk of withdrawal effects.

How should Zopivane be stored and disposed of?

How to Store and Dispose of Zopivane

Zopivane (Zopiclone) must be stored and handled in accordance with official regulatory requirements to ensure its stability and security, as it is classified as a Schedule IV controlled substance.

Storage Requirement Official Guideline
Temperature & Environment Store at controlled room temperature (20 C to 25 C), protected from excess heat and moisture.
Handling & Security Keep in the original, tightly closed container and store in a secure place out of the reach of children and pets to prevent misuse.

Disposal: The preferred method for discarding unused or expired Zopivane is through an authorized drug take-back program. If a take-back program is unavailable, follow specific guidelines for non-flushed medicines, which typically involve mixing the medicine with an undesirable substance before discarding it in the household trash. Do not flush Zopivane down a toilet or drain.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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