Zopiclone and warfarin?

[Caitlyn6]

My 80 year old dad is having trouble having a good nights sleep- waking up after a couple of hours and finding it hard to get back to sleep. GP has prescribed zoplicone 3.75 for two weeks. He has a metal heart valve and is on warfarin since year 2000. Just checking there is any interference between the two drugs? Also I think it is worry that is keeping him awake at night due to the pandemic and he also has cancer and I think he is abit depressed. Does anyone take long term antidepressants that help with sleep that don’t interfere with warfarin or stomach cancer? Many thanks.

[Smarticus]

Hi, two out of three. I take zopiclone and warfarin, triple those doses and no problems. perhaps speak with his GP? Sleep is a funny thing, make sure his diet is healthy and he is getting some exercise. HTH

edit to say zopiclone is a "sleeping tablet" not an antidepressant

[Caitlyn6 in reply to Smarticus]

Thanks. Are u on zopiclone long term then? I was under the impression it was only short term?

[Smarticus in reply to Caitlyn6]

Hi, it is "supposed" to be for around 7 days. At one point I was on it for 2 years!!! eeek

[Caitlyn6 in reply to Smarticus]

Thanks 🙏

[JennyRx]

There’s no interactions between zopiclone and warfarin. Z drugs like zopiclone tend to be only used short term due to possible addiction with a loss of effectiveness.

It helps to kick start a new sleeping pattern but other sleep hygiene behaviours can help. There’s lots online - helping people sleep is a huge industry as many many of us don’t sleep well.

[Cliff_G]

Caitlyn, as others have said there should be no interaction between the two, or at least nothing that would not be picked up by his regular INR checks. However, Zopiclone is not something to take long term. I was moved from Z to Mirtazapine and it has really helped. It's an anti-depressant used off label for sleep assistance, though it is thought to be most effective for that in people who are somewhat depressed, and it would sound like that's your Dad (unsurprisingly, so sorry for this). You take it a couple of hours before bedtime. I was started on 30 mg and found it very effective on sleep, somewhat too much. I dropped to 15 mg which was still effective and have actually settled out at 7.5 mg (halving the minimum 15 mg tablet), but at 15 and more I definitely felt its anti-depressant effect too, which I didn't mind at all! Still getting over my aortic disdissection

[Caitlyn6 in reply to Cliff_G]

Thank you. I will share this info with my dad.

[Georgie777 in reply to Caitlyn6]

Hi Caiitlyn - I would be very cautious with the zopiclone - it is very addictive - and it can give you day time anxiety. So keep an eye on your dad for any mood changes in the day. I would research it first if I was you - it would be better if he doesn't start it at all and maybe tries some herbal remedies.

[Caitlyn6 in reply to Georgie777]

Thanks for that. I read it’s very addictive. He took it last night and slept great . I’m not sure what he can take with his stomach cancer but i will continue to look into alternative sleeping tablets or antidepressants.

[Caitlyn6 in reply to Cliff_G]

Can I ask if mirtazapine is ok to take in the elderly. My dad is 80. I read the leaflet that comes with it and it sounds abit scary. How did u find it initially?

[Cliff_G]

Caitlyn, afraid I have no idea whether it is suitable for the elderly but this pubmed.ncbi.nlm.nih.gov/239... suggests it may well be ok. I was started on 30 mg which knocked me out for sleeping very well, I found 15 mg was also adequate for sleep but still found the dry mouth etc side effects uncomfortable and have settled at 7.5 mg (half a 15, which is the smallest) which does just enough for sleep along with the whole raft of good sleeping practices. Mirtazapine is prescribed for depression at much higher doses, I believe.

[Caitlyn6 in reply to Cliff_G]

Thank you. I will do some research and look up that link.

[Cliff_G in reply to Cliff_G]

Also "... and the newer antidepressants ... mirtazapine ... are all relatively safe in the elderly. They have lower anticholinergic effects than older antidepressants and are thus well tolerated by patients with cardiovascular disease." from bcmj.org/articles/geriatric...

[Caitlyn6 in reply to Cliff_G]

👍 thanks again