What Is Zopiclone Used For? A UK Patient Guide

Zopiclone is a prescription-only sleeping medicine used for the short-term treatment of insomnia in adults. It may help people who have difficulty falling asleep, wake repeatedly during the night or wake earlier than expected. Because zopiclone can cause dependence and next-day impairment, it should be used only after a healthcare professional has assessed whether it is appropriate.

Important: This article provides general information and does not replace advice from a GP, pharmacist or other qualified healthcare professional.

What is zopiclone?

Zopiclone is a hypnotic medicine, commonly described as a “Z-drug”. It is prescribed to some adults with severe insomnia that is affecting normal daily life and when non-medical measures have not been sufficient. NICE recommends that hypnotic medicines such as zopiclone are prescribed for short periods only and within their licensed indications.

Zopiclone is available in different strengths, including 3.75 mg, 7.5 mg and 10 mg tablets. The strength and duration prescribed depend on factors such as age, overall health, other medicines and the severity of the sleep problem. Never choose a strength based solely on an online product description.

What is zopiclone used for?

Zopiclone is used for the short-term management of insomnia in adults. Insomnia can involve:

• Difficulty falling asleep.

• Waking several times during the night.

• Waking too early and being unable to return to sleep.

• Poor-quality sleep that causes significant daytime tiredness.

• Sleep problems that are causing substantial distress or interfering with normal activities.

Zopiclone may help reduce the time it takes to fall asleep and may make sleep less interrupted. It is not intended to improve ordinary occasional tiredness or to replace healthy sleep routines.

A prescriber may consider zopiclone when insomnia is severe and other appropriate measures have been considered. Treatment should be reviewed if sleep difficulties continue rather than extended automatically.

How does zopiclone work?

Zopiclone acts on chemical pathways in the brain associated with the neurotransmitter GABA. This reduces certain forms of brain activity and can produce a calming, sedative effect.

The medicine may make you feel sleepy relatively soon after taking it. For this reason, it is generally taken shortly before bedtime, when you are ready to sleep and can allow enough time for a full night’s rest.

Zopiclone does not correct every cause of insomnia. Sleep problems may be linked to anxiety, depression, pain, menopause, breathing disorders, shift work, caffeine, alcohol, prescribed medicines or an irregular sleep schedule. These causes may need separate assessment and treatment.

Who may be prescribed zopiclone?

Zopiclone may be considered for adults with severe, short-term insomnia after a clinical assessment. A healthcare professional will usually consider:

• How long the sleep problem has lasted.

• How severely it affects daily life.

• Whether non-medical approaches have been tried.

• Other medical conditions.

• Current medicines and substances.

• Previous problems with dependence or addiction.

• The person’s age and risk of falls or next-day impairment.

Zopiclone may not be suitable if you have breathing difficulties, sleep apnoea, severe liver disease, myasthenia gravis or a history of dependence. Tell your prescriber if you are pregnant, planning a pregnancy or breastfeeding.

Older adults may be more sensitive to dizziness, confusion, impaired coordination and falls. A clinician may recommend a lower dose or a different approach.

How should zopiclone be taken?

Take zopiclone exactly as prescribed. General guidance includes:

• Take the prescribed dose shortly before going to bed.

• Take it only when you can sleep for around seven to eight hours.

• Swallow the tablet with water.

• Do not take an extra tablet during the same night.

• Do not increase the dose if you feel it is not working.

• Do not take it more often or for longer than instructed.

• Do not share it with another person.

• Ask a healthcare professional before stopping regular treatment.

The patient information leaflet for an authorised UK zopiclone product states that it should be taken just before going to bed and that regular use, particularly over a long period, can lead to physical dependence and addiction.

If you forget to take your dose at bedtime, do not usually take it later during the night because this may leave you too drowsy the next day. Ask a pharmacist or prescriber if you are uncertain.

How long is zopiclone used for?

Zopiclone is designed for short-term use. NICE recommends that hypnotics should be prescribed for short periods only when insomnia is severe and interferes with normal daily life.

The risk of tolerance, dependence and addiction increases with higher doses and longer treatment. UK patient information warns that the risk is greater when zopiclone is used for longer than four weeks.

If you have been taking zopiclone regularly, do not stop suddenly without medical advice. A prescriber may recommend a gradual reduction to reduce withdrawal symptoms and rebound insomnia.

Zopiclone and alcohol

Avoid alcohol while taking zopiclone. Alcohol can increase the sedative effect and may raise the risk of:

• Extreme sleepiness.

• Poor coordination.

• Falls and accidents.

• Confusion or unusual behaviour.

• Slow or difficult breathing.

• Loss of consciousness.

Do not combine zopiclone with opioid painkillers, tranquillisers, other sleeping tablets or medicines that cause drowsiness unless your prescriber has specifically advised you to do so. Combining medicines that depress the central nervous system can be dangerous.

Can you drive after taking zopiclone?

Zopiclone can affect alertness, concentration, judgement, memory and coordination. Do not drive, cycle or operate machinery if you feel sleepy, dizzy, confused or less alert.

Next-day impairment may be more likely if you take zopiclone late at night, sleep for less than seven or eight hours, use a higher dose or combine it with alcohol or other sedating medicines. Make sure you are fully alert before driving.

Common side effects

Possible side effects include:

• Bitter or metallic taste.

• Dry mouth.

• Drowsiness or tiredness the next day.

• Dizziness or light-headedness.

• Headache.

• Reduced concentration.

• Memory difficulties.

• Nausea or indigestion.

• Weakness or reduced coordination.

• Vivid dreams or nightmares.

Contact your pharmacist or prescriber if side effects are persistent, severe or interfere with everyday activities.

Seek prompt medical advice if you experience confusion, hallucinations, severe agitation, worsening depression, suicidal thoughts or unusual behaviour. Some people may carry out activities while not fully awake, such as walking or preparing food, and may not remember them afterwards.

Dependence and withdrawal

Zopiclone can cause tolerance, dependence and addiction. Dependence means that the body or mind has become used to the medicine, and withdrawal symptoms may occur if it is stopped suddenly.

Possible withdrawal symptoms include:

• Anxiety or panic.

• Restlessness and irritability.

• Sweating or shaking.

• Headache.

• Disturbed sleep or rebound insomnia.

• Difficulty concentrating.

• Palpitations.

• Confusion or unusual perceptions.

The risk increases with dose and treatment duration and may be higher in people with a history of mental health difficulties or alcohol, drug or medicine misuse.

Speak to your prescriber before changing the dose or stopping treatment.

How to improve sleep without medicine

Medicines are only one part of managing insomnia. Helpful habits may include:

• Keep a consistent waking time every day.

• Go to bed only when you feel sleepy.

• Avoid caffeine, nicotine and alcohol close to bedtime.

• Reduce screen use before bed.

• Keep the bedroom dark, quiet and comfortable.

• Avoid large meals late at night.

• Exercise regularly, but not immediately before bed.

• Avoid long daytime naps.

• Use the bed for sleep rather than work or extended screen time.

If poor sleep continues, a GP or pharmacist can help identify possible causes and discuss suitable treatment options.

Frequently asked questions

Key points for patients

Zopiclone may be helpful for severe short-term insomnia, but it is not a routine long-term solution. Use it only as prescribed, avoid alcohol, allow enough time for sleep and do not drive if you are impaired.

If you are considering treatment, speak with a GP, pharmacist or registered online prescriber. A proper assessment helps ensure that the medicine, dose and treatment duration are appropriate for your circumstances.