Before starting treatment, the patient should be warned about the short duration of the course of treatment and about the possibility of developing the "cancellation" syndrome after treatment with Sonata® Adamed. The duration of treatment should be as short as possible, in no case should exceed 2 weeks. To prolong treatment it is possible only after careful clinical inspection of the patient. Sleep disorders can be the result of physical or mental disease. If after a short-term treatment with the drug
Sonata® Adamed sleep does not normalize or sleep disturbance progresses, the diagnosis should be revised.
In the event that a patient wakes up shortly after midnight as a result of a short half-life of zaleplon, another medication with a longer half-life may be required. Patients should be warned that more than one capsule per night is not allowed.
The use of benzodiazepines and benzodiazepine-like short-acting drugs for several weeks can be accompanied by a decrease in the hypnotic effect.
The use of benzodiazepines and benzodiazepine-like drugs can lead to the development of physical and mental dependence, the probability of which is associated with taking large doses of the drug, prolonged treatment, alcohol and drug dependence.
With the resulting physical dependence, abrupt withdrawal of the drug leads to the development of symptoms of the syndrome of "withdrawal": headache, muscle pains, a sharply expressed state of anxiety, increased tension and irritability, psychomotor agitation, confusion. In severe cases, autoaggression, depersonalization, hearing loss, paresthesia in the extremities, an increased response to light, sound and physical stimuli, hallucinations and epileptic seizures are possible.
Upon cessation of treatment with benzodiazepines and drugs benzodiazepinopodobnyh possible recurrence or appearance of transient and more pronounced than at the beginning of the treatment of symptoms of insomnia ( "cancel" syndrome). It is possible to develop other related phenomena, such as changes in mood, anxiety, sleep disturbance, or anxiety.
Benzodiazepines and benzodiazepine-like drugs can cause development of anterograde amnesia and impaired psychomotor functions.
In order to avoid the development of these symptoms, the drug should be taken only if patients have the possibility of continuous sleep for at least 4 hours after taking the medication.
In patients taking sedatives and hypnotics, such combinations of actions as "driving in a dream", "eating in a dream" or "sex in a dream" can occur. Such effects were reported in patients who did not quite wake up after taking sedatives or hypnotics, and they usually did not remember these events. In these cases it is recommended to stop taking zaleplon.
Treatment zaleplon should be discontinued in case of increased excitability, irritability, aggressiveness, extraversion, impaired perception and thinking, "nightmarish" dreams, hallucinations, psychotic disorders and especially behavioral disorders. Elderly patients are most likely to develop such symptoms.
Caution is necessary when appointing zaleplon to patients who have a history of allergic reactions in response to taking sedatives and hypnotics.Very rarely, when taking zaleplon, anaphylactic / anaphylactoid reactions that require urgent medical attention may develop. The repeated use of zaleplon in such patients is contraindicated.
The use of the drug in patients with severe hepatic insufficiency because of the risk of encephalopathy is contraindicated.
The use of the drug in patients with moderate hepatic insufficiency is contraindicated for a drug at a dose of 10 mg because of the impossibility of reducing the dose and the risk of encephalopathy is contraindicated.
The use of the drug in patients with severe renal failure is contraindicated.