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Approved Formulary
Search results for:
zaleplon
zaleplon
- Restricted Medications Non-Formulary
Brand names: Sonata
No brands, forms, or strengths have been added for this generic.
Display Anxiolytics, Sedatives, and Hypnotics, Miscellaneous Class:
282492
Medication comments:
| Per policy, orders for these non-formulary agents will be changed to formulary equivalents. | |
|---|---|
| Non-Formulary Agent | Formulary Equivalent |
| zaleplon (Sonata) 5 mg | zolpidem (Ambien) 5 mg |
| zaleplon (Sonata) 10 mg | zolpidem (Ambien) 10 mg (5 mg if female or ≥ 65 years old) |
| 2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults. | |
|---|---|
| Medication: | zaleplon (Sonata) |
| Criteria 1: Potentially inappropriate medication use in older adults. (Table 2) | |
| Drug(s) | nonbenzodiazepine benzodiazepine receptor agonist hypnotics (“Z-drugs”) |
| Rationale | Nonbenzodiazepine benzodiazepine receptor agonist hypnotics ("Z-drugs") have adverse events similar to those of benzodiazepines in older adults (e.g., delirium, falls, fractures, increased emergency room visits/hospitalizations, motor vehicle crashes); minimal improvement in sleep latency and duration. |
| Recommendation | Avoid |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3) | |
| Drug(s) ⇆ disease or syndrome | nonbenzodiazepine benzodiazepine receptor agonist hypnotics (“Z-drugs”) ⇄ Delirium |
| Rationale | Avoid in older adults with or at high risk of delirium because of the potential of inducing or worsening delirium. |
| Recommendation | Avoid |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | nonbenzodiazepine benzodiazepine receptor agonist hypnotics (“Z-drugs”) ⇄ Dementia or cognitive impairment |
| Rationale | Avoid because of adverse CNS effects. |
| Recommendation | Avoid |
| Quality of evidence: Moderate, Strength of Recommendation: Strong | |
| Drug(s) ⇆ disease or syndrome | nonbenzodiazepine benzodiazepine receptor agonist hypnotics ("Z-drugs") ⇄ History of falls or fractures |
| Rationale | May cause ataxia, impaired psychomotor function, syncope, or additional falls. If one of the drugs must be used, consider reducing the use of other CNS-active medications that increase the risk of falls and fractures. (i.e., anticholinergics, selected antidepressants, antiepileptics, antipsychotics, sedative/hypnotics including benzodiazepines and, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids) and implement other strategies to reduce fall risk. |
| Recommendation | Avoid unless safer alternatives are not available. |
| Quality of evidence: High, Strength of Recommendation: Strong | |
| Criteria 4: Potentially clinically important drug-drug interactions that should be avoided in older adults. (Table 5) | |
| Interacting drug(s) or class(es) | nonbenzodiazepine benzodiazepine-receptor agonist hypnotics (i.e., "Z-drugs") ⇄ CNS-active agents |
| Risk Rationale | Increased risk of falls and of fracture with the concurrent use of ≥3 CNS-active agents (antiepileptics including gabapentinoids, antidepressants, antipsychotics, benzodiazepines, Nonbenzodiazepine benzodiazepine receptor agonist hypnotics, opioids, and skeletal muscle relaxants). |
| Recommendation | Avoid concurrent use of ≥3 CNS-active drugs Click for list; minimize the number of CNS-active drugs. |
| Quality of evidence: High, Strength of Recommendation: Strong | |
Last updated: Sep. 19, 2025
- Therapeutic Interchange Policy zolpidem (Ambien)
- Black Box Warnings Risk of Serious Injuries With Certain Prescription Insomnia Medications