Home Drug Guide Zaleplon

Drug Guide

Generic Name

Zaleplon

Brand Names Sonata

Classification

Therapeutic: Sedative/Hypnotic for Insomnia

Pharmacological: GABA-A Receptor Agonist, Non-benzodiazepine

FDA Approved Indications

Short-term treatment of insomnia, primarily for sleep onset difficulties

Mechanism of Action

Zaleplon binds selectively to GABA-A receptor complexes containing the alpha-1 subunit, enhancing GABA-mediated chloride ion influx, leading to sedative effects and facilitating sleep onset.

Dosage and Administration

Adult: 10 mg taken immediately before bedtime; may be adjusted to 5 mg or 20 mg based on response and tolerability.

Pediatric: Not indicated for pediatric use.

Geriatric: Initially 5 mg due to increased sensitivity; dose adjustment may be necessary.

Renal Impairment: Use with caution; consider dose reduction.

Hepatic Impairment: Use with caution; typically start with 5 mg.

Pharmacokinetics

Absorption: Rapidly absorbed, peak plasma levels in approximately 1 hour.

Distribution: Widely distributed; volume of distribution approx. 0.5-0.8 L/kg.

Metabolism: Extensively metabolized in the liver primarily via aldehyde oxidase and CYP3A4.

Excretion: Metabolites excreted mainly in urine; parent compound minimally excreted.

Half Life: Approximately 1 hour, supporting its rapid onset and short duration of action.

Contraindications

Hypersensitivity to zaleplon or any component

Precautions

History of drug abuse or dependency, hepatic impairment, depression, or suicidal ideation.
Use caution in patients with a history of complex sleep behaviors such as sleepwalking or sleep-driving.

Adverse Reactions - Common

Headache (Common)
Dizziness (Common)
Nausea (Common)
Somnolence (Common)

Adverse Reactions - Serious

Complex sleep behaviors (e.g., sleepwalking, sleep-driving) (Rare)
Angioedema, hypersensitivity reactions (Rare)
Respiratory depression (Rare)

Drug-Drug Interactions

CNS depressants (additive sedative effects)
OATP inhibitors (may increase zaleplon levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of excessive sedation, sleep behaviors, or adverse reactions.

Diagnoses:

Risk for injury due to impaired cognition or sleep behaviors.
Risk for overdose.

Implementation: Administer immediately before bedtime. Avoid alcohol and other CNS depressants. Monitor hepatic function in long-term use.

Evaluation: Assess sleep quality, side effects, and adverse reactions.

Patient/Family Teaching

Take drug exactly as prescribed, immediately before bed.
Avoid alcohol and CNS depressants.
Report any sleep behaviors such as sleepwalking.
Avoid driving or operating machinery until alertness is confirmed.

Special Considerations

Black Box Warnings:

Complex sleep behaviors (e.g., sleepwalking, sleep-driving, sleep-eating) may occur and have led to injuries.
Use with caution in the elderly due to increased risk of falls.

Genetic Factors: Variability in CYP3A4 activity may affect drug levels.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Excessive sedation, respiratory depression, coma.

Treatment: Supportive care, airway management, possible use of flumazenil in specific cases (off-label), monitor vital signs, and provide respiratory support as needed.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable for shelf life as indicated on packaging.