zaleplon (Sonata)
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Introduction
Tradename: Sonata. DEA-controlled substance: class 4.
Indications
- treatment of insomnia
Dosage
Tabs: 5 & 10 mg.
Pharmacokinetics
- bioavailability is 30%
- peak serum levels one hour after oral dose
- peak serum concentration of 27 ng/mL after 15 mg PO
- metabolized in the liver by cytochrome P450 3A4 to desmethylzaleplon (active) plus other inactive metabolites
- elimination 1/2life of 1 hour (unchanged in older adults)
- 20 mg of zaleplon is comparable to 10 mg of zolpidem
elimination via liver
Adverse effects
- most common
- psychomotor impairment at doses > 15-20 mg
- transient leukopenia (rare)
- increase serum transaminases (rare)
- blurred vision (> 40 mg)
- minimal abuse potential
- rare risks for sleepwalking, sleepdriving, & other unusual behaviors (i.e., using a stove while sleeping)[3]
Drug interactions
- any drug that inhibits cyt P450 3A4 may increase levels of zaleplon
- any drug that induces cyt P450 3A4 may diminish levels of zaleplon
- drug interaction(s) of Z-drugs with opiates
- drug interaction(s) of gabapentinoid with psychotropic agent
Mechanism of action
- non-benzodiazepine GABA receptor agonist
- pyrazolopyrimidine
More general terms
References
- ↑ Drugdex(R) Drug Evaluation
- ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Jump up to: 3.0 3.1 FDA News Release. April 30, 2019 FDA requires stronger warnings about rare but serious incidents related to certain prescription insomnia medicines. Updated warnings for eszopiclone, zaleplon and zolpidem. https://www.fda.gov/news-events/press-announcements/fda-requires-stronger-warnings-about-rare-serious-incidents-related-certain-prescription-insomnia
- ↑ Marbin A et al Zaleplon Versus Zolpidem Use in Older Adults Being Treated for Insomnia: A Review. Am J Geriatr Psychiatr. 2023. 31(3)S68-S69 Not indexed in PubMed https://www.sciencedirect.com/science/article/abs/pii/S1064748123000544