Table 1. Conformity to Z-drug prescribing recommendations.

Zopiclone Recommendation	Eszopiclone Recommendation (for comparison)	Proportion Potentially Non-Conforming
The starting dose should be limited to 3.75mg and can be increased as needed to the minimum effective dose not exceeding 7.5mg	The starting dose should be limited to 1mg and can be increased as needed to the minimum effective dose not exceeding 3mg	373/499 (75%) who received a first dose after 72 hours exceeded 3.75mg
The dose should not exceed 5mg in patients who are older or who have renal or hepatic impairment	The dose should not exceed 2mg in older patients and in those with severe liver disease	643/999 (64%) Age 65 or older exceeded 5mg
		210/362 (58%) Age 80 or older exceeded 5 mg
		From the cohort study (102 Users in 2180 Admissions):
		13 (13%) had stage III or greater renal impairment • 6 (50%) were on dialysis
		8 (8%) had cirrhosis
Dose adjustment may be necessary with concomitant CNS depressing drugs	Not specifically addressed	From the cohort study (102 Users in 2180 Admission):
		21 (21%) received concomitant narcotics
		20 (20%) received concomitant benzodiazepines
Use should generally not exceed 7–10 days. Use for more than 2–3 consecutive weeks requires complete re-evaluation of the patient.	Not specifically addressed	257/607 (39%) with stays longer than 10 days received 10 or more days of treatment • 171/257 (68%) was standing use
Patients should be instructed to wait for at least 12 hours after dosing before driving or engaging in other activities requiring full mental alertness, especially for older patients and for patients who take the 7.5 mg dose.	Patients taking the 3mg dose are cautioned against driving or engaging in other hazardous activities which need mental alertness the day after use	N/A