Zaleplon

A to Z Drug Facts

Zaleplon

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(ZAL-eh-plahn)

Sonata

Class: Sedative and hypnotic

Action Interacts with the gamma-aminobutyric acid receptor complex.

Indications Short-term treatment of insomnia.

Contraindications Standard considerations.

Route/Dosage

ADULTS: PO 5 to 20 mg at bedtime. ELDERLY/DEBILITATED PATIENTS: PO 5 to 10 mg at bedtime. HEPATIC IMPAIRMENT (MILD TO MODERATE): PO 5 mg at bedtime.

Interactions

Alcohol, other CNS depressants: Additive or potentiation of CNS depressant effects. Cimetidine: May elevate zaleplon plasma levels, increasing the therapeutic and adverse effects. Rifampin: May reduce zaleplon plasma levels, reducing the effectiveness.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Migraine. RESP: Bronchitis; epistaxis. CNS: Depression; hypertonia; nervousness; abnormal thinking; headache; anxiety; amnesia; dizziness; depersonalization; hallucinations; hypesthesia; paresthesia; somnolence; tremor; vertigo. EENT: Conjunctivitis; abnormal vision; ear pain; eye pain; hyperacusis; parosmia. GI: Constipation; dry mouth; anorexia; colitis; dyspepsia; nausea. GU: Dysmenorrhea. DERM: Pruritus; rash; photosensitivity. OTHER: Back pain; chest pain; arthritis; abdominal pain; asthenia; fever; malaise; peripheral edema.

Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Elderly: Impaired motor or cognitive function with repeated exposure or unusual sensitivity is a concern. Amnesia: May occur. Depression: Administer with caution to depressed patients or those with suicidal tendencies. Signs and symptoms of depression may be intensified. Hepatic impairment: Use with caution and in reduced dosage. Withdrawal: Rebound insomnia on the first night following withdrawal occurs in some patients.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Store at room temperature in tightly closed, light-resistant container out of the reach of children.
Do not administer with or immediately after a high fat or heavy meal.
Anticipate administering the lowest dose possible, especially to patients at risk (ie, elderly and patients with decreased hepatic function).

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Ensure that side rails are raised after administration.
Assist patient with ambulation after administration.
Assess depressed patient for suicidal thoughts and if present, institute protective measures.
Monitor for problems of tolerance, dependence, changes in behavior and thinking, memory problems, and withdrawal symptoms if medication is abruptly stopped.

OVERDOSAGE: SIGNS & SYMPTOMS
	Drowsiness, mental confusion, lethargy, ataxia, hypotonia, hypotension, respiratory depression, coma, death

Patient/Family Education

Instruct patient to take the medication exactly as directed and not to increase or decrease the dose or use longer than as directed by primary caregiver.
Instruct patient to take zaleplon immediately before going to bed or after going to bed if patient has difficulty falling asleep. Avoid taking medication after a high-fat or heavy meal.
Instruct patient not to take zaleplon if able to get ³ 4 hours of sleep before active again and only for a short period of time (1 or 2 days and generally < 1 or 2 weeks) to avoid the problems of prolonged use.
Discuss with primary caregiver the benefits and risks of prolonged use including memory problems, tolerance, dependence, changes in behavior and thinking, and withdrawal symptoms.
Instruct patient to inform primary caregiver if taking or planning to take any otc or prescription medications.
Warn patient of the dangers of drinking alcohol and taking zaleplon or any other sleeping pill or CNS depressant.
Caution patient that zaleplon may have some residual sedation at first and to not drive an automobile, operate dangerous machinery, or engage in activities that require mental alertness and coordination until knowing how he/she will react to this drug.
Instruct patient to inform primary caregiver if having any unusual or disturbing thoughts or suffering from depression.
Inform patient of potential sleeping problems the first night or 2 after stopping the medication.
Caution patient to inform the primary caregiver if pregnant, planning to become pregnant, or breastfeeding.