The medicine "Imovan" the instructions for use are defined as sleeping pills, belonging to the group of cyclopyrrolones. The drug has tranquilizing, hypnotic, muscle relaxant, sedative, anticonvulsant properties.
Pharmacodynamics
The therapeutic effect of the Imovan drug (instructions indicate this) is associated with a specific agonistic effect on omega receptors (previously they were called benzodiazepine receptors of the first and second types). The medication can reduce the time before falling asleep and reduce the frequency of early and night awakenings, as well as increase the duration and improve the quality of sleep. Polysomnography data demonstrate that the Imovan drug in patients with insomnia reduces the first phase of sleep and prolongs the second, while maintaining the third and fourth (deep sleep) stages and the paradoxical (fast sleep) phase. The study by registering a polysomnogram of withdrawal syndrome did not reveal significant rebound insomnia after taking the medicine for twenty-eight days. Other tests showed that when using the medication for seventeen weeks, the disappearance of the sleeping pill is not observed.
Pharmacokinetics
Hypnotic "Imovan" is absorbed rapidly, regardless of food intake. In the blood plasma with oral administration of 3.75 and 7.5 milligrams of the drug within the one and a half to two hours, the highest concentrations are reached, comprising about 30 and 60 ng / ml, respectively. Communication with plasma proteins is unsaturated and weak (about 45%). At the level of protein binding, the risk of interacting with other drugs is very low. From the systemic bloodstream, the Imovan medication is fairly quickly distributed. The instruction reports that its concentrations in breast milk are similar to those observed in plasma. The half-life of the drug in unchanged form when taken in recommended doses is an average of five hours. The drug is mainly excreted in the form of metabolites with urine (about 80%) and feces (about 16%).
Indications for appointment
The medicine "Imovan" instruction shows how to use in the treatment of situational, transient, chronic insomnia in adults. In particular, it is used for difficulties with falling asleep, early and night awakenings.
Release form and composition
The medicine is available in the form of white film-coated oval tablets with a risk on one side. One unit of the product includes an active component - zopiclone - in a mass of 7.5 milligrams. Imovan tablets also contain sodium carboxymethyl starch, titanium dioxide, calcium hydrogen phosphate dihydrate, magnesium stearate, lactose monohydrate, wheat starch, hypromellose.
Method of administration and duration of treatment
An oral medication is indicated immediately before a night's sleep. If possible, therapy should be short-term and not exceed four weeks, including the period of reduced dosage. Take the drug for a longer time than prescribed by the instruction, it is allowed only after the specialist evaluates the patient's condition. It is always necessary to start therapy with the minimum effective dose, increasing it if necessary, but the maximum permissible dose should not be exceeded. With transient insomnia (for example, caused by a change of place during the trip), the course of treatment does not exceed two to five days. With situational insomnia, it is two to three weeks. In case of chronic insomnia, long-term therapy is required, its duration is determined by the doctor.
Recommended Dosage
The daily dose for people under 65 is 7.5 milligrams. Elderly patients (over 65 years old) and those who have abnormal liver function or moderate respiratory failure are prescribed 3.75 milligrams per day. Taking medicine in a mass of more than 7.5 milligrams per day is allowed only in extreme cases. Therapy of patients with renal failure, despite the fact that in this case there is no accumulation of the drug and its metabolites, it is necessary to start with a daily dose of 3.75 milligrams.
Side effects
About the drug "Imovan" reviews are mostly positive, it is often well tolerated. But almost all patients note that after taking the medicine, a bitter aftertaste remains in the mouth. Some people talk about the appearance of a headache, dizziness against the background of the use of sleeping pills. Among the possible negative effects, muscle hypotension, residual drowsiness after waking up, diplopia, asthenia, and a decrease in libido should also be noted. There is a risk of developing digestive disorders: nausea, dyspepsia, dry mouth. Sometimes skin reactions appear, such as rashes and itching, in very rare cases - anaphylactic reactions, angioedema shock. In some patients, after taking sleeping pills, hallucinations, depression, nightmares, problems with coordination of movements, aggressiveness, irritability, depressed mood, walking in a dream, inappropriate behavior (may occur in combination with amnesia) occur. Even when using Imovan tablets in therapeutic doses (the instruction warns about this), mental and physical dependence may develop.
Withdrawal syndrome
In some people, withdrawal of the drug develops withdrawal symptoms. Its symptoms may be different, most often they manifest in the form of anxiety, confusion, rebound insomnia, tachycardia, irritability, tremor, headache, delirium, excessive sweating, nightmares, tachycardia, agitation, hallucinations. In very rare situations, convulsive seizures occur.
Contraindications
People with hypersensitivity to the ingredients of Imovan should abandon its use. Also, sleeping pills for patients with severe pseudoparalytic myasthenia, severe liver failure (with a risk of encephalopathy), and severe sleep apnea, severe respiratory failure, are not prescribed. The drug is contraindicated in the age of eighteen years. For people with a history of drug, alcohol, drug dependence, the medication is prescribed with caution, as in this case there is an increased risk of increased dependence or abuse.
Use during pregnancy and lactation
It is not recommended to take sleeping pills "Imovan" for pregnant and lactating women. When using the drug in the third trimester, a newborn can develop such negative effects as hypotension, respiratory depression, hypothermia. Women planning or suspecting pregnancy should stop taking the medication.
Overdose
Usually, an overdose is manifested by symptoms of central nervous system depression to varying degrees: from simple drowsiness to coma (depending on the dose taken). In mild cases, apathy, drowsiness, confusion occurs, in more serious cases - lethargy, respiratory depression, ataxia, hypotension, coma. Very rarely, atrioventricular blockade occurs. An overdose does not pose a threat to life if taking sleeping pills is not combined with taking other drugs that depress the central nervous system, or alcohol. Also, symptoms of an overdose can be aggravated if the general condition of the patient is weakened or there are concomitant diseases. In such cases, even death is possible (extremely rare). When taking the drug in excessive doses, symptomatic and supportive treatment in a hospital is indicated. In this case, the greatest attention should be paid to cardiovascular and respiratory functions. Such measures as the use of activated charcoal and gastric lavage will be effective only if they are carried out shortly after using the Imovan medication.
Analogs
Generics for this sleeping pill are drugs such as Somnol, Thorson, Relaxon, Piklodorm and others. As a rule, they are cheaper than the original, but at the same time they are less effective.
special instructions
As mentioned earlier, taking sedatives, including the drug Imovan, can lead to the development of psychological and physical dependence. The risk increases with long-term treatment and taking sleeping pills at high doses, with abuse of alcohol, psychotropic substances, as well as in the presence of anxiety. If the appearance of physical dependence abruptly discontinues the drug therapy, the withdrawal syndrome, which was described above, may develop. To avoid this, you need to reduce the dose of the drug gradually. Observance of two rules will help to prevent the risk of such a side effect as anterograde amnesia : you should drink a pill just before bedtime (avoid a long period of time between taking the medicine and going to bed) and sleep at least six hours (do not interrupt sleep earlier than after six hours after falling asleep). The medication is not indicated for the treatment of depressive conditions and may even mask their symptoms.
Drug interaction
The simultaneous use of sleeping pills "Imovan" and alcohol can lead to increased sedation. In addition, you can not take medications along with treatment with medicines that depress the central nervous system: barbiturates, antidepressants with sedative effects, tranquilizers, antipsychotics, antitussive drugs, anesthetics, narcotic analgesics, antiepileptic drugs with a central effect. If used together, the inhibitory effect on the central nervous system may increase. Also, you should not drink Imovan tablets along with preparations containing trimipramine, because the concentration in the plasma of the latter and its effect will be reduced. Co-administration of sleeping pills with buprenorphine increases the risk of respiratory depression (the outcome can even be fatal).
Where to buy "Imovan"
The drug is sold in most pharmacies. Sleeping pills are available on prescription. Some people who want to buy a medicine without a prescription, resort to the services of online pharmacies. However, it should be remembered that in this case you run the risk of acquiring low-quality, fake or expired goods.