Prescriptions for Stilnox hard to track
DOCTORS and regulators are hampered in their attempts to keep tabs on prescribing of the controversial sleeping drug zolpidem because of its private prescription status.
Experts from the National Prescribing Service say that while GPs and others can contact the national doctor-shopping hotline to find out if patients have already been prescribed recent supplies of other drugs of potential abuse, such as morphine, zolpidem is not covered by this system because it is not subsidised under the Pharmaceutical Benefits Scheme.
National Prescribing Service CEO Lynn Weekes says the loophole — while not amounting to an argument to add zolpidem to the PBS— illustrates some of the flaws in the current system of drug data collection.
Zolpidem hit the headlines again this week after the National Drugs and Poisons Schedule Committee of the Therapeutic Goods Administration decided not to recategorise the drug as schedule 8, a move that would have placed it under the same prescribing restrictions as morphine.
However, the TGA itself at the same time announced it was imposing a ‘‘ black box’’ warning on the drug, which means a more prominent declaration warning of the drug’s previously recognised bizarre sleep-related side effects will be printed on the prescribing information included inside the packaging.
Zolpidem — often referred to as Stilnox, which is the best known of various brand name under which it is sold — has been controversial for over a year, after an avalanche of publicity that has included cases of patients sleepwalking, eating and even crashing cars during sleep. One patient, in a case originally publicised by the TGA itself, apparently woke up with a paintbrush in hand after painting part of the front door.
Other brand names include Dormizol, Somidem, Stildem, Stilnoxium and Zolpidem.
Existing prescribing information already makes clear zolpidem should not be used for longer than four weeks, but some cases have emerged where patients have apparently been prescribed the drug over much longer periods than this — a practice believed to increase the risk of side-effects.
Mairead Costigan, a 30-year-old Sydney woman, fell to her death from the Sydney Harbour Bridge nearly six months ago after taking zolpidem for more than eight months.
However, she had been switched to another sleeping medication, zopiclone, six days before her death, and it is also believed that she had received zolpidem prescriptions