Alcoholic drinks enhance the sedative effect of benzodiazepines, as well as related components. Due to the reduced concentration of attention in this combination, it is not recommended to work with different mechanisms or to drive a car.
It is recommended not to combine the drug with alcoholic beverages or drugs containing alcohol in its composition.
The combination with rifampicin lowers the effectiveness of the action and the plasma level of zopiclone, as this increases its hepatic metabolism. Because of this, the above substances should be used together only under the condition of constant clinical observation of the patient. If necessary, the prescription of another hypnotic drug.
Other drugs that depress the function of the central nervous system: Morphine derivatives (such as antitussive drugs, painkillers, as well as drugs used in substitution treatment during the elimination of drug dependence (in addition to buprenorphine)), barbiturates with neuroleptics, tranquilizers, other sleeping pills, anticonvulsants, hypnotic antidepressants , as well as anesthetics, antihypertensive drugs (with a central effect), thalidomide with baclofen and pisotifen, and in addition antihistamine (H1) drugs. All of the above substances in conjunction with Imovan increase the inhibitory effect on the function of the central nervous system.
Along with this, simultaneous use with morphine derivatives, as well as barbiturates increases the likelihood of suppression of the function of respiratory organs (when taking medicines in higher doses, this combination can provoke the patient's death).
Opioid analgesics can increase the feeling of euphoria, because of which a person may become psychologically dependent on the substances taken.
The process of zopiclone metabolism is carried out with the help of hemoprotein P450 (CYP) 3A4, so that as a result of the combination with inhibitors of the element CYP3A4, the parameters of the substance in the plasma are able to increase. The use of CYP3A4 together with the inducers reduces the zopiclone index inside the plasma.
When combined with buprenorphine, which is used in the substitution treatment of drug dependence, the likelihood of suppressing the respiratory function increases, which can eventually lead to death. It is necessary to carefully evaluate the risks and efficacy of this drug combination. It is necessary to warn the patient that it is necessary to strictly adhere to the dosages prescribed by the doctor.
Simultaneous use with clozapine increases the possibility of the patient developing collapse, which is accompanied by cardiac arrest or breathing.
The combination of zopiclone with erythromycin, clarithromycin, nelfinavir or telithromycin, and moreover with voriconazole, ritonavir, itraconazole, as well as ketoconazole slightly enhances the soothing properties of the active ingredient of Imovan.