Limovan & An Overview Of Insomnia

Limovan is a non-benzodiazepine sedative and hypnotic that functions by acting on selective omega 1 receptors. It is molecularly distinct from benzodiazepine and is classified as cyclopyrrolone. It is used for the short-term treatment of insomnia (sleeping disorder). If used for the long term; it can cause dependence and withdrawal on stopping. Initially, it was considered that it is less addictive than benzodiazepines but according to recent statistics, it’s otherwise. It can also cause Daytime drowsiness, dizziness, lightheadedness, bitter taste, dry mouth, headache, or stomach upset. IMOVANE pharmacological properties are: hypnotic, sedative, anxiolytic, anti-convulsant, and muscle-relaxant. All the above-mentioned effects of the drugs are due to its action on chloride ion channel opening action because of the neurotransmitter GABA. It’s not indicated for these purposes though.

History and background:

Insomnia is the inability to sleep or total lack of sleep. Insomnia remained a problem for patients with psychiatric disorders leading to the discovery of sedatives and hypnotics. Benzodiazepines are used for sedation and hypnosis but these cause addiction, dependence, and hangover. In mid-eighties, scientist strived to discover a formulation which has fewer side effects. Limovan was created and first presented in 1986 by Rhône-Poulenc S.A., presently part of Sanofi-Aventis, the fundamental overall producer. At first, it was advanced as an enhancement for benzodiazepines; however, a new meta-investigation discovered it was no greater than benzodiazepines in any of the aspects. On April 4, 2005, the U.S. Drug Enforcement Administration (DEA) recorded zopiclone under SCHEDULE IV, because of proof that the medication has habit-forming properties like benzodiazepines. Limovan, as generally sold around the world, is a racemic combination of two stereoisomers, just one of which is active. In 2005, the drug organization Sepracor of Marlborough, Massachusetts started promoting the dynamic stereoisomer eszopiclone under the name Lunesta in the United States. This had the outcome of setting what is a conventional medication in the greater part of the world under patent control in the United States. Nonexclusive types of Lunesta have since opened up in the United States. Zopiclone is presently accessible off-patent in various European nations, just as Brazil, Canada, and Hong Kong.

Uses:

Limovan is a non-benzodiazepine sedative and hypnotic that functions by acting on selective omega 1 receptors. It is molecularly distinct from benzodiazepine and is classified as cyclopyrrolone. It is used for the short-term treatment of insomnia (sleeping disorder). If used for the long term; it can cause dependence and withdrawal on stopping. Its pharmacological properties are: hypnotic, sedative, anxiolytic, anti-convulsant, and muscle-relaxant. All the above-mentioned effects of the drugs are due to its action on chloride ion channel opening action because of the neurotransmitter GABA. It’s not indicated for these purposes though.

Insomnia:

According to studies, zopiclone diminished sleep latency expanded the span of rest, and diminished the quantity of nighttime arousals. Zopiclone deferred the beginning of REM sleep yet didn't decrease reliably the absolute term of REM periods. The term of stage 1 rest was abbreviated, and the time spent in stage 2 sleep expanded. In many investigations, stage 3 and 4 sleep would, in general, be expanded, yet no change and real reductions have additionally been noticed. The impact of Zopiclone in front of an audience 3 and 4 rest varies from that of the benzodiazepines, which stifle moderate wave rest. The clinical meaning of this finding isn't known. Limovan should be taken for short-term use and the smallest effective dose should be started. It ought to be taken in a single dose and not to be taken on the same night. If used for the long term; it can cause dependence and withdrawal on stopping. Generally, the duration of treatment varies from a few days to two weeks with a maximum, including the tapering off, of four weeks In specific cases an expansion past the most extreme treatment time frame might be fundamental; if so it should happen after re-assessment of the patient's status. A sleepless patient should always be assessed thoroughly for any underlying conditions which might lead to sleeplessness. This assessment needs to be done before any sedative/hypnotic medication is started. The failure of insomnia to remit after 7-10 days of treatment may point to an underlying condition which has direct or indirect effect on the sleep patterns of the patient. Worsening of insomnia or the emergence of new abnormalities of thinking or behavior may be the consequence of an unrecognized psychiatric or physical disorder. Such idiosyncratic effects have been observed in people taking medications acting on the same receptors. IMOVANE should be used with caution in patients who in the past manifested paradoxical reactions to alcohol and/or sedative medications. IMOVANE 5 mg has some amount of lactose as an adjuvant. Patients with rare hereditary diseases of galactose intolerance (galactosemia or glucose-galactose malabsorption) should not take IMOVANE 5 mg. Lactose is not added to IMOVANE 7.5 mg.

Dosage:

Adults:

The suggested portion for grown-ups is 2 tablets (7.5 mg Limovan). This portion ought not to be surpassed. The tablet ought to be taken not long before resigning.

Hindered renal capacity:

Even though aggregation of Limovan, as well as its metabolites, have not been appeared in patients with hindered renal capacity, a beginning portion of 3.75 mg is suggested in these patients.

Hindered hepatic capacity:

As the end of Limovan might be diminished in patients with hepatic brokenness, a lower portion of 3.75 mg Limovan daily is suggested. The standard portion of 7.5 mg Limovan might be utilized with an alert at times relying upon viability and agreeableness.

Persistent respiratory deficiency:

In patients with persistent respiratory deficiency, a beginning portion of 3.75 mg Limovan is suggested at first. The dose in this way might be expanded to 7.5 mg.

Old:

A beginning portion of 3.75 mg is suggested, this portion may therefore be expanded to 7.5 mg whenever considered clinically essential relying upon patient adequacy and worthiness.

Pediatric populace:

Limovan ought not to be utilized in youngsters and teenagers under 18 years. The security and viability of Limovan in kids and youths who matured less than 18 years have not been set up.

Mode of administration:

Limovan is administered only orally.limovan is available commercially in the form of tablets and also in the form of liquids for those who have difficulty swallowing tablets.

Limovan v/s benzodiazepines:

Limovan is zopliclone that is non-benzodiazepine sedative.Benzodiazepines act on both recetors while zopiclone is selective benzodiazepine agonist.Innitially,zoplicone replaced benzodiazepines because of less addiction potential but with time it has been proved that they both share addictive potential. Sleep effects of zopiclone differ to those of benzodiazepines: REM sleep is substantially unaffected by zopiclone and slow-wave sleep is either unaffected or increased. Objective and subjective measurements during the day after bedtime administration of zopiclone showed a lack of residual effects and no residual impairment of cognitive functions. zopiclone discontinuation is accompanied by minimal rebound effect and relevant withdrawal symptoms as compared to benzodiazepines. Zopiclone has mot been found to have any potential to abuse in alcoholics. Efficacy and safety data on zopiclone suggest that this new drug can represent a useful alternative to benzodiazepines.

Limovan v/s Stilnox:

Limovan is zolpiclone and stilnox is the brand name for zolpidem. According to a study, Stilnox was at least as effective as zopiclone, showed significantly less rebound on discontinuation, and was better tolerated. According to another study, Zolpidem users reported more severe dependence and a lower level of necessity regarding the use of hypnotics than Zopiclone users did. Extended use and high dose medications were found to be linked to high levels of dependence.

Limovan v/s Lunesta:

Limovan is zopiclone and Lunesta is the brand name for Eszopiclone. According to data of insomnia severity index, after a four week medication plan, eszopiclone and zopiclone had the same efficacy increasing total sleep time as well as sleep efficiency according to polysomnography. According to a study, both of these cause headaches, dysgeusia, dizziness, and irritability. Both are categorized as controlled substances.

Central Nervous System Effects

Sedation and amnesia:

Zopiclone is a sedative-hypnotic that reduces CNS functions, including memory. The following can occur:

• Asthenia (a chronic medical condition in which a person is unable to move certain body parts)
• Fatigue
• Ataxia (a movement disorder in which there is a lack of inability to coordinate)
• Impairment of concentration
• Somnolence
• Amnesia can be causes in a dose-dependent fashion

Evidence for mild, transient memory impairment by the selective zopiclone has also been reported (Anonymous, 2005b).

Sensory:

• Changes in taste perception
• Paraesthesias
• Abnormal vision

Movement:

• Hyperkinesia
• Dyskinesia,
• Involuntary muscle contractions

Psychosis:

According to Wagner and Wagner, 2000; UMC, 2005, these have been noticed.

• Hallucinations
• Nightmares, and
• Behavioral disturbances, including agitation and aggression

Affect:

• Irritability
• Confusion
• depressed mood

Suicide:

Sedative hypnotics that act through benzodiazepine receptors are used for suicide purposes. According to a study of toxicology, it is increasingly used for this purpose.

Cognitive Function:

Drugs belong in to this class and benzodiazepine like agents can affect cognition. Lack of concentration and attention deficit are some of the effects. The risk of confusion is greater in the elderly and patients with cerebral impairment.

Anxiety, restlessness:

An increase in daytime anxiety and/or restlessness has been observed during treatment with IMOVANE. This may be a manifestation of interposing withdrawal, due to the short elimination half-life of the drug.

Complex sleep behaviors:

Complex sleep behaviors have been recorded in some patients taking Limovan. Complex sleep behavior includes:

• sleep-walking,
• sleep-driving
• Engaging in other activities while not fully awake.
• preparing and eating food, making phone calls, or having sex

These practices may happen following the first or any subsequent utilization of IMOVANE. Patients can be truly harmed or harm others during complex sleep behaviors. Such harms might be deadly. Patients normally don't recollect these occasions. Postmarketing reports have shown that complex sleep behaviors may happen with IMOVANE at suggested dosages, with or without the accompanying utilization of liquor or other focal sensory systems (CNS) depressants (see DRUG INTERACTIONS). Stop taking IMOVANE quickly if a patient encounters any such behaviors.

Drug dependence and withdrawal:

When used for a prolonged period, Limovan can cause dependence. In such cases, withdrawal effects can occur when the drug is suddenly stopped. Withdrawal symptoms, similar to those noted with barbiturates and alcohol, include:

• convulsions
• tremor
• abdominal and
• muscle cramp
• vomiting
• sweating
• dysphoria
• perceptual disturbances
• insomnia
• Rebound insomnia (a phenomenon which occurs when the drug is discontinued in which sleeplessness returns in a more severe form than before. This can also cause anxiety and other psychological distress symptoms.)

Tolerance:

Tolerance can occur with chronic use of limovan Tolerance is the decrease in responsiveness, which occurs when drugs are used chronically. Thus to maintain the pharmacological action of the drug, the dose of the drug has to be increased with time. Long term use of benzodiazepines for insomnia is not recommended.

Cardiovascular:

Palpitations can occur.

Gastrointestinal effects:

Following gastrointestinal effects can occur:

• Nausea and vomiting
• Abdominal pain
• Increase salivation can cause respiratory difficulty.
• Diarrhea
• Dyspepsia; hepatitis

Kidney/genitourinary:

Rarely, acute interstitial nephritis can occur.

Respiratory:

• Increase in viral infections.
• Dyspnea

Dermatologic effects:

• Rash
• Urticaria
• Spots on skin
• Sweating
• Pruritus
• Angioedema that occurs can involve the tongue, glottis, or larynx which leads to airway obstruction that can be fatal if not managed.
• Severe adverse reactions to the drugs are very rare.

The drug should be stopped if any rash is observed. This may be because of the drug hypersensitivity.

CONTRAINDICATIONS

IMOVANE is contraindicated in patients with:

• Myasthenia gravis
• Hypersensitivity to any drug.
• Severe impairment of respiratory function (e.g., significant sleep apnea syndrome)
• Severe hepatic insufficiency
• Complex sleep behaviors after taking any non-benzodiazepine sedative-hypnotic.

Zopiclone should be used with caution in patients if increased salivation causes respiratory difficulty, because it may produce increase salivation. Give the least amount of drug to patients in whom depression accompanies anxiety and suicidal tendency may be present. Avoid use in patients with severe hepatic insufficiency

Can I take Limovan if I am pregnant or breastfeeding?

Imovane is contraindicated in pregnancy. If IMOVANE is prescribed to a woman of child-bearing potential, the patients should informed of the risks and future pregnancy prospects should be explored accordingly if she intends to become pregnant or suspects that she is pregnant Limovan passes into the breast milk and there is a possibility that it can affect your baby. It is possible to use zopiclone but monitoring for excessive sleeping in the baby should be done. You should discuss the risk and benefits with the doctor before using this drug.

How quickly does the treatment work?

Limovan starts to work within 20 minutes and lasts for 7 to 8 hours. It should be used for short-term sleep problems and treatment with Limovan should not extend beyond 4 weeks.

Is it safe to take Limovan?

Yes, it’s safe to take Limovan if you have trouble sleeping if taken as directed by your physician but taking it for the long term may cause dependence and withdrawal effects on stopping the drug abruptly.

How long does a dose of Limovan last?

A single dose of Adderall lasts for 5 to 7 hours.

Are there any side effects of the treatment?

All the medicines have some unwanted side effects. Sometimes these are serious but most of the time they are not. Your doctor has assessed benefits over risks and then prescribed this drug so don’t be alarmed by the list of side effects. You should avoid this drug with alcohol as it exaggerates side effects. The risk can also be increased if you use more than the recommended dose. If swelling of the face, lips, mouth, or throat may cause difficulty in swallowing or breathing and fainting occurs, stop taking medication and tell your doctor immediately.

Do I require a prescription for taking Limovan?

Yes, you need a proper prescription by certified Heath care professional for taking Adderall. Otherwise, it is illegal to have Adderall as it is classified as a controlled substance by Drug Enhancement Authority (DEA)

Why is it not safe to buy Limovan online?

It is not safe because this drug may be fake. FDA strongly discourages consumers from buying online because of the issue of counterfeit. Online Pharmacies which sell substance-controlled drugs without a prescription poses threat to public health.

I cannot swallow the capsule, what should I take?

If you are facing difficulty in swallowing tablets of Limovan, you can take it in the form of liquid but the liquid form has to be ordered specially by your doctor.

Is this treatment a safe option for children?

The safety and effectiveness of IMOVANE in children and young adults below the age of 18 have not been established. IMOVANE should not be prescribed in pediatric patients.

How long do I have to take Limovan?

Imovane use shouldn’t be beyond 7 to 10 days duration. Before prescription, the patient should be evaluated for risks. Prescriptions for IMOVANE should be written for short-term use (7-10 days) and it should not be prescribed in quantities exceeding a 1-month supply. You need to adhere to the directions of your primary care physician cautiously.

Can I take Limovan with other medication?

Certain drugs shouldn’t be used alongside Limovan because some drugs decrease their efficacy and the interaction of some drugs with it can cause lethal effects. Taking other medicines You must tell your doctor if you are taking any other medicines, even those bought without any prescription. All medications have a potential risk of interaction with other medications. These include:

• medicines to treat depression, anxiety, and mental illness
• St John's wort, (hypericum), a herbal remedy for depression
• other drugs which affect mental capacities
• benzodiazepines (sedatives)
• pain relievers, such as opioids or narcotic analgesics
• alcohol, (ethanol), contained in some medicines eg cough syrups
• muscle relaxants
• antihistamines
• medicines used to treat epilepsy
• antiviral medication
• rifampicin, erythromycin, or clarithromycin (medicines used to treat infections)
• ketoconazole or itraconazole (medicines used to treat fungal infections)

All these drugs might interact with Imovane. Drugs might needed to be changed or dosages should be adjusted based on healthcare consults. Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking Imovane.

Is Limovan hard on the liver?

In therapeutic doses, it rarely affects the liver. so it is completely safe for the liver. However, in case of overdosing it causes liver injury and ultimately liver failure if not treated promptly.

Can I take Limovan with alcohol?

Alcohol should not be used while treatment with Limovan because it decreases the effectiveness and enhances the side effects.

Can I take Limovan if I am pregnant or breastfeeding?

Imovane is contraindicated in pregnancy. If IMOVANE is prescribed to a woman of child-bearing potential, the patients should informed of the risks and future pregnancy prospects should be explored accordingly if she intends to become pregnant or suspects that she is pregnant

Limovan passes into the breast milk and there is a possibility that it can affect your baby. It is possible to use zopiclone but monitoring for excessive sleeping in the baby should be done. You should discuss the risk and benefits with the doctor before using this drug.

How quickly does the treatment work?

Limovan starts to work within 20 minutes and lasts for 7 to 8 hours. It should be used for short-term sleep problems and treatment with Limovan should not extend beyond 4 weeks.

Is it safe to take Limovan?

Yes, it’s safe to take Limovan if you have trouble sleeping if taken as directed by your physician but taking it for the long term may cause dependence and withdrawal effects on stopping the drug abruptly.

How long does a dose of Limovan last?

A single dose of Adderall lasts for 5 to 7 hours.

Are there any side effects of the treatment?

All the medicines have some unwanted side effects. Sometimes these are serious but most of the time they are not. Your doctor has assessed benefits over risks and then prescribed this drug so don’t be alarmed by the list of side effects.

You should avoid this drug with alcohol as it exaggerates side effects. The risk can also be increased if you use more than the recommended dose.

If swelling of the face, lips, mouth, or throat may cause difficulty in swallowing or breathing and fainting occurs, stop taking medication and tell your doctor immediately.

Do I require a prescription for taking Limovan?

Yes, you need a proper prescription by certified Heath care professional for taking Adderall. Otherwise, it is illegal to have Adderall as it is classified as a controlled substance by Drug Enhancement Authority (DEA)

Why is it not safe to buy Limovan online?

It is not safe because this drug may be fake. FDA strongly discourages consumers from buying online because of the issue of counterfeit. Online Pharmacies which sell substance-controlled drugs without a prescription poses threat to public health.

I cannot swallow the capsule, what should I take?

If you are facing difficulty in swallowing tablets of Limovan, you can take it in the form of liquid but the liquid form has to be ordered specially by your doctor.

Is this treatment a safe option for children?

The safety and effectiveness of IMOVANE in children and young adults below the age of 18 have not been established. IMOVANE should not be prescribed in pediatric patients.

How long do I have to take Limovan?

Imovane use shouldn’t be beyond 7 to 10 days duration. Before prescription, the patient should be evaluated for risks. Prescriptions for IMOVANE should be written for short-term use (7-10 days) and it should not be prescribed in quantities exceeding a 1-month supply. You need to adhere to the directions of your primary care physician cautiously.

Can I take Limovan with other medication?

Certain drugs shouldn’t be used alongside Limovan because some drugs decrease their efficacy and the interaction of some drugs with it can cause lethal effects. Taking other medicines You must tell your doctor if you are taking any other medicines, even those bought without any prescription. All medications have a potential risk of interaction with other medications. These include:

All these drugs might interact with Imovane. Drugs might needed to be changed or dosages should be adjusted based on healthcare consults. Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking Imovane.

Is Limovan hard on the liver?

In therapeutic doses, it rarely affects the liver. so it is completely safe for the liver. However, in case of overdosing it causes liver injury and ultimately liver failure if not treated promptly.

Can I take Limovan with alcohol?

Alcohol should not be used while treatment with Limovan because it decreases the effectiveness and enhances the side effects.