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zaleplon (Sonata)

Tradename: Sonata. DEA-controlled substance: class 4. Indications: - treatment of insomnia Dosage: 5-20 mg PO QHS. Tabs: 5 & 10 mg. Pharmacokinetics: 1) bioavailability is 30% 2) peak serum levels one hour after oral dose 3) peak serum concentration of 27 ng/mL after 15 mg PO 4) metabolized in the liver by cytochrome P450 3A4 to desmethylzaleplon (active) plus other inactive metabolites 5) elimination 1/2life of 1 hour (unchanged in older adults) 6) 20 mg of zaleplon is comparable to 10 mg of zolpidem Adverse effects: 1) most common a) headache b) somnolence c) dizziness 2) psychomotor impairment at doses > 15-20 mg 3) transient leukopenia (rare) 4) increase serum transaminases (rare) 5) blurred vision (> 40 mg) 6) minimal abuse potential * Boxed warning: - rare risks for sleepwalking, sleepdriving, & other unusual behaviors (i.e., using a stove while sleeping) [3] Drug interactions: 1) any drug that inhibits cyt P450 3A4 may increase levels of zaleplon 2) any drug that induces cyt P450 3A4 may diminish levels of zaleplon Mechanism of action: 1) non-benzodiazepine GABA receptor agonist 2) pyrazolopyrimidine

Interactions

drug adverse effects (more general classes)

General

sedative/hypnotic (tranquilizer)

Properties

MISC-INFO: elimination route LIVER pregnancy-category B safety in lactation -

Database Correlations

PUBCHEM cid=5719

References

  1. Drugdex(R) Drug Evaluation
  2. Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: 220233 (subscription needed) http://www.prescribersletter.com
  3. 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
  4. 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