NICE technology appraisal guidance
Issued: April 2004
TA77

Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ta77

1 Guidance

1.1 When, after due consideration of the use of nonpharmacological measures, hypnotic drug therapy is considered appropriate for the management of severe insomnia interfering with normal daily life, it is recommended that hypnotics should be prescribed for short periods of time only, in strict accordance with their licensed indications.

1.2 It is recommended that, because of the lack of compelling evidence to distinguish between zaleplon, zolpidem, zopiclone or the shorter-acting benzodiazepine hypnotics, the drug with the lowest purchase cost (taking into account daily required dose and product price per dose) should be prescribed.

1.3 It is recommended that switching from one of these hypnotics to another should only occur if a patient experiences adverse effects considered to be directly related to a specific agent. These are the only circumstances in which the drugs with the higher acquisition costs are recommended.

1.4 Patients who have not responded to one of these hypnotic drugs should not be prescribed any of the others.