What are Z-drug medicines and what are the risks I need to be aware of?
This leaflet provides information for patients who have been prescribed z-drugs to treat conditions such as insomnia. Treatment should be as short as possible and should not exceed four weeks including the period of tapering off. Examples of z-drugs include zopiclone, zolpidem and eszopiclone.
Z-drugs have serious risks of addiction, dependence and withdrawal reactions. Patients can become physically dependent on z-drugs, which means you might experience withdrawal signs and symptoms after stopping your medication or significantly reducing the dose you are taking. Drug addiction is a combination of behavioural, mental and physical factors, that may include a strong desire to take the drug and difficulties in controlling drug use. Although related, addiction and dependence are different and someone who is physically dependent on a drug is not necessarily addicted to it.
The healthcare professional who prescribed the z-drug or your pharmacist should explain how long it is safe for you to take your medicine for and how to safely stop taking it.
For further information on using z-drugs safely, and a full list of possible side effects, read the Patient Information Leaflet (PIL) that came with your medicine, and keep it handy.
How can I take my z-drug medicine safely?
Only take the medicine as directed by your healthcare professional.
• Do not increase the dose, take an extra dose or take for a longer period than prescribed.
• Do not take any other medicines to “top up” your symptom control. Z-drugs can be dangerous in combination with other substances, such as opioids, benzodiazepines or alcohol.
Taking more medication than prescribed can cause overdose.
If you have any questions about your z-drug medicine or side effects, or if you do not understand how to take your medicine, talk to the person who prescribed your medicine, your doctor, or to a pharmacist. Keep talking to them about your symptoms – there may be different treatments that can help.
• Do not allow others to take any z-drug medicines given to you. Your medicine has been prescribed or specifically recommended for you by your prescriber and can be dangerous if taken by other people – it could even cause fatal overdose.
• Always keep medicines out of sight and reach of children.
Taking too much z-drug medicine is called an overdose, whether it is intentional or not. This can be very serious and may cause death.
How do I know if I’m becoming addicted?
Addiction can happen gradually. It can make you feel that you are no longer in control of how much medicine you need to take or how often you need to take it. You might feel that you need to carry on taking your medicine, even when it doesn’t help with your symptoms. Dependence is different and you may not realise you are physically dependent.
If your symptoms are becoming difficult to manage, or you feel that the same dose of your medicine is having less of an effect, talk to your doctor. This may mean you are developing tolerance to the effects of this medicine or are becoming addicted to it.
Signs that you may be addicted to z-drugs include:
• Craving for the medicine.
• Feeling that you need to take more medicine than prescribed, taking it more frequently or more than instructed on the pack – even though the medicine is causing unwanted effects on your overall health.
• Feeling that you need to take additional medicines to achieve the same relief.
• Taking z-drugs for other reasons than why they were prescribed.
• Experiencing withdrawal side effects when you stop taking the medicine suddenly.
If you notice any of the above, talk to your doctor or pharmacist.
When and how can I safely stop taking my Z-drug medicine?
Do not stop taking or reduce the dose of your medicine suddenly, as this may cause unpleasant withdrawal side effects. It is important to get the right help and support when it is time to stop taking your medicine.
Talk to your doctor, nurse or a pharmacist. They will be able to help you to come off your z-drug medicine slowly to reduce unpleasant withdrawal side effects. Safely coming off z-drug can take a long time (e.g. weeks or months). Every person is different. Take any unused z-drugs back to a pharmacy for safe disposal.
Withdrawal side effects may include a combination of the following: • Headache • Shaky • Anxiety • Irritable/ agitated • Nightmares • Difficulty concentrating • Confusion • Hallucinations • Loss of sense of reality
If you experience any of these, talk to the person who prescribed your medicine or a pharmacist. In an emergency, dial 999.