Zopiclone Alcohol

Zopiclone is a chiral cyclopyrrolone with hypnotic properties, possessing a pharmaceutical profile of high efficacy and low toxicity, similar to that of benzodiazepines. Zopiclone has been commercialized as a racemic mixture however, the (S)-enantiomer is more active and less toxic than the (R)-enantiomer [11]. Although enzymatic hydrolysis of esters or transesteriflcation processes of alcohols have been widely applied for enzymatic resolution or desymmetrization... 

KuitunenT, MattilaMJ, SeppalaT (1990) Actions and interactions of hypnotics on human performance single doses of zopiclone, triazolam and alcohol. Int ClinPsychopharmacol 5 (Suppl 2) 115-130... 

The addition of alcohol to the Z drugs, zaleplon, Zolpidem, and zopiclone, produces additive sedative effects without altering their pharmacokinetics (20). 

Vermeeren A, Riedel WJ, van Boxtel MP, Darwish M, Paty I, Patat A. Differential residual effects of zaleplon and zopiclone on actual driving a comparison with a low dose of alcohol. Sleep 2002 25(2) 224-31. 

To date, no clinically significant pharmacokinetic interactions between alcohol and zopiclone have been reported. Zolpidem enhances alcohol performance impairment (the effect appears to be short-lived). ... 

It is very difficult to assess and compare the results of the very many studies of this interaction because of the differences between the tests, their duration, the dosages of the benzodiazepines and alcohol, whether given chronically or acutely, and a number of other variables. However, the overall picture seems to be that benzodiazepines and related drugs including diazepam, " alprazolam,bromazepam, brotizolam, chlo-rdiazepoxide, " clobazam, dipotassium clorazepate, flunitrazepam, flurazepam, loprazolam, " lorazepam, lormetazepam, medazepam, midazolam, nitrazepam, " " oxazepam, temazepam, " triazolam, and zopiclone enhance the effects of alcohol i.e. cause increased drowsiness, impaired performance and driving skills. 

Some of the benzodiazepines and related drugs that are used primarily to aid sleep, such as flunitrazepam, flurazepam, "" "" nitrazepam, " and temazepam, when taken the night before alcohol or in the evening with alcohol, can still interact with alcohol the next morning. However, midazolam,- loprazolam, lormetazepam, triazolam, Zolpidem, and zopiclone have been reported not to do so. The sedative effects of midazolam alone, and midazolam with fenta-nyl have been shown to have dissipated within 4 hours, and to not be affected by alcohol after this time. However, some patients may metabolise midazolam more slowly and so an interaction could still be possible, especially in older patients or those receiving additional drugs. ... 

Several studies have reported that alcohol increases plasma levels of diazepam and that alcohol accelerates the absorption of diazepam, but others have suggested that alcohol has no significant effect on diazepam pharmacokinetics. Plasma levels of brotizolam and clobazam may be increased by alcohol. One study reported that the plasma levels of triazolam were increased by alcohol, but other studies have found only a minimal pharmacokinetic interaction. However, an in vitro study demonstrated that alcohol inhibited the metabolism of triazolam by the cytochrome P450 isoenzyme CYP3A. Another in vitro study reported that the formation of flunitrazepam metabolites was weakly inhibited by alcohol, but a pharmacokinetic study suggested that there was no interaction. Alcohol appears to have minimal effects on the pharmacokinetics of alprazolam, and zopiclone. ... 

The pharmacokinetics of alcohol do not appear to be affected to a clinically significant extent by diazepam, flunitrazepam, zolpidem, or zopiclone but alprazolam may increase blood-alcohol levels. 

Psychological In a Norwegian study of 35756 drivers who were arrested for driving under the influence of drugs, 20236 tested positive for non-alcoholic drugs 79 tested positive for zopiclone and 43 tested positive for zolpidem 89% of those who tested positive for zopiclone and 74% of those who tested positive for zolpidem were impaired according to the clinical test of impairment [20 ]. 

Drugs employed have sedative or hypnotic properties with a rapid onset and induce memory loss during the period when the drug is active. The most-prevalent drugs detected, apart from alcohol, are the benzodiazepines and h5 notics (zolpidem and zopiclone). A wide range of other drugs, such as GHB, ketamine, sildenafil, methadone, buprenorphine, diphenhydramine, trimeprazine, acepromazine, thiopental, pentobarb, doxylamine, and cyamemazine, have also been reported in DFC cases. 

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