Zopiclone is safe for many adults when used as prescribed — but for some people it is unsuitable or needs significant caution. This is exactly what your prescriber assesses, and why our pharmacists double-check every prescription. Here’s what they’re looking for.
Zopiclone is usually not prescribed if you…
- Are under 18;
- Have myasthenia gravis (a muscle-weakness condition);
- Have severe breathing problems or respiratory failure;
- Have severe sleep apnoea — zopiclone can further suppress breathing during sleep;
- Have severe liver problems — the medicine is cleared by the liver and can accumulate;
- Have had a previous allergic reaction to zopiclone or its ingredients.
Extra care and possibly a lower dose if you…
- Are over 65 — higher risk of next-day drowsiness, confusion and falls; the 3.75 mg dose is usually used;
- Have kidney or mild-to-moderate liver problems;
- Have depression or another mental health condition — sleep medicines can mask or worsen underlying illness;
- Have a history of alcohol or drug dependence — the dependence risk is higher, so alternatives are often preferred;
- Are pregnant, trying to conceive, or breastfeeding — zopiclone is generally avoided; taken late in pregnancy it can affect the baby, and small amounts pass into breast milk. Discuss options with your GP or midwife.
Medicines that interact with zopiclone
Tell your prescriber and pharmacist about everything you take, including over-the-counter and herbal products. Key interactions include:
- Other sedatives — benzodiazepines, other sleeping tablets, and opioid painkillers (codeine, tramadol, morphine): combined sedation can dangerously suppress breathing;
- Some antidepressants and antipsychotics, which add to drowsiness;
- Sedating antihistamines (including many pharmacy sleep and allergy remedies);
- Certain antibiotics and antifungals (e.g. clarithromycin, erythromycin, ketoconazole), which slow zopiclone’s breakdown and intensify its effects;
- Some epilepsy and TB medicines (e.g. carbamazepine, phenytoin, rifampicin), which can make zopiclone less effective;
- Alcohol — never combined; see zopiclone and alcohol;
- Grapefruit juice can increase zopiclone levels — best avoided during a course.
The bottom line
None of this list is a reason to worry — it’s a reason the prescription system exists. An honest medical history plus a pharmacist’s interaction check is what makes zopiclone safe for the people it suits. Unsure about anything on your own medicine list? Ask our pharmacists — checking interactions is free.
Frequently asked questions
Can I take zopiclone while pregnant or breastfeeding?
Zopiclone is generally avoided in pregnancy and breastfeeding — it can affect the baby if taken late in pregnancy, and small amounts pass into breast milk. Discuss safer options with your GP or midwife.
Can I take zopiclone with codeine or other painkillers?
Combining zopiclone with opioid painkillers such as codeine, tramadol or morphine is dangerous — the combined sedation can suppress breathing. Tell your prescriber about every painkiller you use.
Is zopiclone safe for people over 65?
It can be prescribed, but with extra caution and usually at the lower 3.75 mg dose, because older adults face higher risks of next-day drowsiness, confusion and falls.
Why should I avoid grapefruit juice with zopiclone?
Grapefruit juice slows the enzyme that breaks zopiclone down, which can raise levels of the medicine in your blood and intensify its effects. It’s best avoided during a course.
Questions about your sleep medication? Speak to one of our pharmacists — advice is free and confidential. If you already have a prescription, you can nominate our pharmacy to dispense and deliver it.
This article is general health information based on NHS and BNF guidance. It is not medical advice, and it is not an advertisement for a prescription-only medicine. Zopiclone is available only on prescription in the UK and cannot be purchased from this website. Always follow your prescriber’s instructions and read the patient information leaflet. If you need urgent help call NHS 111; in an emergency call 999. [Clinical review placeholder — reviewed by NAME, Superintendent Pharmacist, GPhC reg. NUMBER, on DATE.]