zaleplon (redirected from Starnoc)

zaleplon /zal·e·plon/ (zal´e-plon) a nonbenzodiazepine sedative and hypnotic used in the short term treatment of insomnia.

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zaleplon

Sonata

Pharmacologic class: Pyrazolopyrimidine, nonbenzodiazepine hypnotic

Therapeutic class: Sedative-hypnotic

Controlled substance schedule IV

Pregnancy risk category C

Action

Binds to omega-1 receptor of gamma-aminobutyric acid receptor complex, relaxing smooth muscles, reducing anxiety, and producing sedation. Also has anticonvulsant effect.

Availability

Capsules: 5 mg, 10 mg

⊘Indications and dosages

➣ Insomnia

Adults younger than age 65: 10 mg P.O. at bedtime. Dosage above 20 mg is not recommended.

Dosage adjustment

• Mild to moderate hepatic impairment
• Elderly or debilitated patients

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• tartrazine sensitivity
• severe renal impairment (use not recommended), mild to moderate hepatic impairment, respiratory impairment, depression
• history of suicide attempt
• patients weighing less than 50 kg (110 lb)
• patients older than age 65
• pregnant or breastfeeding patients (use not recommended)
• children younger than age 18 (safety not established).

Administration

• Give at bedtime.
• Don't administer with high-fat meal.

Route	Onset	Peak	Duration
P.O.	Rapid	1 hr	3-4 hr

Adverse reactions

CNS: headache, amnesia, anxiety, hallucinations, light-headedness, dizziness, drowsiness, depersonalization, transient memory or psychomotor impairment, incoordination, malaise, vertigo, asthenia, hyperesthesia, paresthesia, tremor

CV: peripheral edema

EENT: abnormal vision, eye pain, ear pain, hearing sensitivity, epistaxis

GI: nausea, abdominal pain, colitis, dyspepsia, anorexia

GU: dysmenorrhea

Musculoskeletal: myalgia

Skin: photosensitivity

Other: altered sense of smell, fever

Interactions

Drug-drug. Cimetidine: decreased metabolism and increased effects of zaleplon

CNS depressants (including antihistamines, opioids, other sedative-hypnotics, phenothiazines, tricyclic antidepressants): additive CNS depression

CYP450-3A4 inducers (such as carbamazepine, phenobarbital, phenytoin, rifampin): decreased blood level and reduced efficacy of zaleplon

CYP450-3A4 inhibitors (such as erythromycin, ketoconazole): increased zaleplon blood level

Drug-food. High-fat meal: delayed drug absorption

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Monitor drug efficacy. Insomnia persisting after 7 to 10 days warrants reevaluation for underlying psychological or physical illness.
• Stay alert for adverse drug reactions.

Patient teaching

• Explain therapy to patient. Emphasize importance of taking drug just before bedtime or after trying to sleep - but only if he'll be able to get at least 4 hours of sleep.
• Inform patient that high-fat meal slows drug absorption and delays drug effects.
• Caution patient to avoid driving and other hazardous activities while under drug's influence.
• Instruct patient to avoid alcohol during therapy.
• Tell patient rebound insomnia may occur for 1 or 2 nights after he stops taking drug.
• Advise female of childbearing age to notify prescriber if she is or plans to become pregnant or if she's breastfeeding.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, herbs, and behaviors mentioned above.

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zaleplon Sonata^®, see there