Eszopiclone; Zopiclone; Zolpidem/Strong CYP3A4 Inhibitors Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Some medicines may slow down how quickly your liver processes your sleep medicine.

What might happen:

You may notice an increase in side effects such as confusion, memory loss, sleep-walking or daytime drowsiness.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Call you doctor as soon as possible if you have confusion/not thinking clearly, memory loss, daytime drowsiness, or have been told you were sleep-walking or doing other activities when you are asleep. Your doctor may want to change your sleeping pill or the dose of your sleeping pill. Use caution and know how these medicines affect you before driving or operating machinery.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Lunesta (eszopiclone) US prescribing information. Sunovion Pharmaceuticals Inc. August, 2019.
  • 2.Becquemont L, Mouajjah S, Escaffre O, Beaune P, Funck-Brentano C, Jaillon P. Cytochrome P-450 3A4 and 2C8 are involved in zopiclone metabolism. Drug Metab Dispos 1999 Sep;27(9):1068-73.
  • 3.Greenblatt DJ, von Moltke LL, Harmatz JS, Mertzanis P, Graf JA, Durol AL, Counihan M, Roth-Schechter B, Shader RI. Kinetic and dynamic interaction study of zolpidem with ketoconazole, itraconazole, and fluconazole. Clin Pharmacol Ther 1998 Dec;64(6):661-71.
  • 4.Von Moltke LL, Greenblatt DJ, Granda BW, Duan SX, Grassi JM, Venkatakrishnan K, Harmatz JS, Shader RI. Zolpidem metabolism in vitro: responsible cytochromes, chemical inhibitors, and in vivo correlations. Br J Clin Pharmacol 1999 Jul;48(1):89-97.
  • 5.Ambien CR (zolpidem tartrate) US prescribing information. Sanofi-Aventis U.S. LLC August, 2019.
  • 6.Jalava KM, Olkkola KT, Neuvonen PJ. Effect of itraconazole on the pharmacokinetics and pharmacodynamics of zopiclone. Eur J Clin Pharmacol 1996;51(3-4):331-4.
  • 7.Luurila H, Kivisto KT, Neuvonen PJ. Effect of itraconazole on the pharmacokinetics and pharmacodynamics of zolpidem. Eur J Clin Pharmacol 1998 Apr;54(2):163-6.
  • 8.Imovane (zopiclone) Canada prescribing information. Sanofi-Aventis Canada Inc. October 20, 2014.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.