Zaleplon

Brand names

• Sonata
• Starnoc

Usage

For the short-term treatment of insomnia.

How it works

By depressing activity in the central nervous system (the brain and spinal cord), zaleplon causes drowsiness and mild sedation. Because the medicament is metabolized quickly compared with similar medications, zaleplon is associated with a lower incidence of side effects, such as daytime drowsiness.

Side effects

Serious

Hallucinations, abnormal thoughts or behavior, contusion or disorientation, unsteadiness, dizziness, lightheadedness, unusual nervousness, agitation, difficulty breathing.

Common

Daytime drowsiness, general pain or discomfort, memory problems, headache, dizziness.

Less common

Abdominal pain, weakness, fever.

Possible interactions

Other medicaments:

Zaleplon taken concurrently with:

• cimetidine (Tagamet, others) may increase zaleplon effects.
• medicines that inhibit both aldehyde oxidase (primary removal mechanism) and CYP 3A4 will inhibit removal of zaleplon and may lead to zaleplon toxicity.
• medicines that induce both aldehyde oxidase (primary removal mechanism) and CYP 3A4 will blunt benefits of zaleplon by decreasing blood levels.
• rifampin (Rifater, others) may decrease zaleplon benefits.
• ritonavir (Norvir) and perhaps other protease inhibitors may lead to toxicity.

Zaleplon may increase the effects of:

• chlorpromazine (Thorazine).
• narcotics or other CNS-depressant medicaments.

Foods:

This medicament is best taken on an empty stomach because food delays absorption.

Herbal medicines or minerals:

Kava kava and valerian may exacerbate central nervous system depression (avoid this combination). Kola nut, Siberian ginseng, mate, ephedra may blunt the benefits of this medicine. While St. John's wort is indicated for anxiety, it is also thought to increase (induce) cytochrome P450 enzymes and could tend to blunt zaleplon effectiveness.

Beverages:

Avoid caffeine-containing beverages: coffee, tea, cola, chocolate.

Alcohol:

This medicament should not be combined with alcohol.

Tobacco smoking:

Nicotine is a stimulant and should be avoided.

Marijuana smoking:

May cause additive drowsiness.

Discontinuation:

This medicament should not be stopped abruptly, even after a week of use. Ask your doctor for help regarding an appropriate withdrawal schedule.

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