A member of DOCS Education writes:

DOCS Education’s single-dose protocol for one-hour appointments calls for zaleplon. Medicaid in Illinois will not cover zaleplon, but will cover zolpidem. Can zolpidem be as effective as zaleplon for one-hour appointments? What is the equivalent dose for zolpidem when compared to zaleplon?

Dr. Anthony Feck, Dean of DOCS Education Faculty, responds:

The pharmacologic properties of zaleplon and zolpidem are not similar enough for the drugs to be used interchangeably in the DOCS-recommended sedation protocols. Zaleplon is used in the sedation protocols for its quick onset of action, short duration of action, short half-life and sedation efficacy. Zolpidem, on the other hand, while having a quick onset of action, has a much longer duration of action. Zolpidem also has a relative lack of myorelaxant properties.

If you're looking for a short-acting sedation medication that is low in cost, triazolam is a better alternative to zaleplon than zolpidem.

A member of DOCS Education writes:

Thank you so much for your response, Dr. Feck.

The patient currently takes carbamazepine, but also takes clozapine, which is carrying a D-interaction for benzodiazepines. This is why I originally looked past lorazepam and triazolam despite the carbamazepine.

Dr. Anthony Feck, Dean of DOCS Education Faculty, adds

I see. I would use the zaleplon protocol without the diazepam. Each capsule is approximately $4.50.

A member of DOCS Education writes:

Will do. It's unfortunate that patients who reside in facilities such as nursing homes and assisted living are unable to get prescriptions filled when once it is not covered by Medicaid.

Since our discussion, I have gone ahead and ordered zaleplon for in-office use and will provide the prescription as needed.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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