Zaleplon Zolpidem and zopiclone

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Pharmacology and toxicology

Zaleplon, Zolpidem, zopiclone, and eszopiclone are newer drugs with sedative-hypnotic properties, which have an agonistic effect on central benzodiazepine receptors. Chemically, they are not related to benzodiazepines. They usually have a short halflife. A prospective controlled study on 40 first-trimester zopiclone-exposed women found no increased rate of major malformations (Diav-Citrin 1999). There was a normal outcome among 18 Zolpidem-exposed pregnancies (e.g. Wilton 1998). Data for zaleplon and eszopiclone are insufficient to assess the safety in pregnancy.

Recommendation. These drugs should not be prescribed for pregnant women. Their inadvertent use is not grounds for termination of pregnancy. Detailed fetal ultrasonography may be considered after first-trimester exposure. The drugs of first choice for sleeping disorders are sedating antihistamines and benzodiazepines.

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