New Boxed Warning for Some Insomnia Drugs

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FDA says it is requiring that a Boxed Warning be added to prescribing information and the Medication Guides for Lunesta (eszopiclone), Sonata (zaleplon), and Ambien, Ambien CR, Edular, Intermezzo, and Zolpimist (zolpidem) regarding rare but serious injuries that have happened involving sleepwalking, sleep driving, and engaging in other activities while not fully awake. An agency drug safety communication says the “complex sleep behaviors have also resulted in deaths.”

The agency is also requiring a Contraindication in the drugs’ labeling to avoid use in patients who have previously experienced an episode of complex sleep behavior with eszopiclone, zaleplon, or zolpidem.

The communication says that serious injuries and death from complex sleep behaviors have occurred in patients with and without a history of such behaviors, even at the lowest recommended doses, and the behaviors can occur after just one dose. According to FDA the behaviors can occur after taking the medicines with or without alcohol or other central nervous system depressants that may be sedating such as tranquilizers, opioids, and anti-anxiety medicines.

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