zaleplon SONATA

Class: Nonbenzodiazepine/​Pyrazolopyrimidine
FDA Indications: Short-term Treatment Of Insomnia
Off-Label Use: NONE
FDA Schedule IV
Forms: 5, 10mg capsule
Dose Range: 5-20 mg/day
Starting: Start at 5 mg QHS for elderly, 10 mg QHS otherwise. High-fat/heavy meal can ↑ absorption and delay TMAX by ~2°
Stopping: Taper to avoid rebound insomnia

NAMI drug fact sheet

Contraindications: None, other than patients with known hypersensitivity to zaleplon
Serious Side Effects: "complex" behaviors i.e., somnambulism, sleep related eating and sleep-driving
Side Effects: sedation/somnolence, dizziness, amnesia, headache
1° MOA: GABAAR α1 subunit agonist
Target: GABAA α1
t½: 1 (1-1.5)° TMAX:
Absorption Rate: Rapid
Substrate of: Aldehyde oxidase; 3A4
Inhibits: ∅ ; Induces:
Active Metabolites:
  • - shortest t½ amongst ALL hypnotic agents ∴ good choice for early insomnia, but not helpful for sleep maintenance
  • - ~4° duration of action, ∴ ∅ next-day sedation even when taken in the middle of the night
  • - preserves normal sleep architecture
  • - preferential binding of GABAAR α1 subunits > α23 subunits → sedation > anxiolysis
Special Populations

Category C—∅ studies of zaleplon in pregnant women ∴ not recommended for use during pregnancy

RID 1.5%; Probably safe. Levels in milk averaged 14 ug/liter

Start at 5mg qhs

2019 BEE℞S Recommendation: Avoid. Nonbenzodiazepine benzodiazepine receptor agonist hypnotics (ie, Z drugs) have adverse events similar to those of benzodiazepines in older adults (eg, delirium, falls, fractures); increased emergency room visits/ hospitalizations; motor vehicle crashes; minimal improvement in sleep latency and duration.

No dosage adjustment necessary

Cut dose in half in hepatic insufficiency


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.