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Sonata belongs to a new class of fast-acting sleeping pill prescribed for insomnia, and should reduce the frequency of nighttime wakenings. If you experience early awakening that occurs close to morning, you may want to seek another treatment, as Sonata is removed from the body too quickly to help this condition. You should only take Sonata when you have time for at least 4-6 hours of sleep. Sonata is usually prescribed for no more than a week or two, though it may be used for up to five weeks on the advice of your doctor. Sonata is metabolized much more quickly than other common sleep medications, so is far less likely to leave you feeling sleepy in the morning.

While Sonata works effectively to decrease the amount of time it takes to get to sleep, it's best to combine it with a 'sleep hygiene' regimen. Maintaining a regular bedtime, avoiding caffeine and heavy foods in the evening, and giving yourself time to relax before going to bed, are all ways to make your Sonata treatment as successful as possible.

Sonata is only available by prescription.

Sonata Side Effects

Sonata may interfere with some laboratory tests, consult your doctor or the test lab in advance for instructions. Notify your doctor if you experience any side effects at all on waking the next morning if you have had a full night's rest.

Normal Side Effects: Drowsiness. Take Sonata only on going to bed, not more than 5-15 minutes before actually lying down.

Consult your doctor about the best way to discontinue Sonata, as you will likely have difficulty sleeping for a night or two after you stop taking it. This is normal, but the effect can be minimized by slowly stepping off your treatment. If you continue to maintain a regular bedtime schedule, this will also help to minimize rebound sleeplessness.

Common Side Effects: Headache.

Possible Side Effects: Abdominal pain or upset, amnesia (may occur if you do not sleep for at least 4 hours after taking a dose), decreased appetite, drowsiness (daytime), dizziness, diarrhea, high blood sugar, menstrual pain, migraine, muscle pain or weakness, nausea, water retention.

Rare Side Effects - Consult your doctor immediately if any of the following occur: agitation, blurred vision, confusion, dysmenorrhea, ear pain, hallucination, irritability, loss of appetite, muscle spasm, muscle tremor, nightmares, nosebleed, rash, sensitivity to light or noise, sleep walking, suicidal or abnormal thoughts, visual disturbances.

Cautions: There are few cautions for Sonata use, and fewer absolute contraindications for this treatment. While the possibility exists that allergic reaction could occur, or that you may experience unpleasant side effects, this sleep medication is considered to be very safe.

Please inform your physician of any of the following circumstances, drug allergies, or medications you may be taking now. Be sure that your doctor clearly explains how to use this medication, and any special precautions you may need to take.

• Allergy: An allergic reaction to Sonata in the past, or during treatment, is a contraindication for continued use. This is very rare.
• Depression or mental illness: Your doctor might consider another treatment, as Sonata may not be suitable in combination with all other medications for these conditions, and may make the condition worse. The risk of unusual mental side effects may be increased, report any changes in thinking or behavior to your doctor.
• Elderly or debilitated: You should be monitored more carefully by your physician, and start with a lower dose.
• History of alcoholism or drug abuse: May increase your risk of dependence or of dangerous drug interactions, may be more likely to have some liver impairment.
• Kidney or liver impairment: Your doctor may decrease your dose of Sonata, especially in cases of liver problems, by 50%. If you have severe liver damage, you should not take this medication.
• Lung condition (serious): In rare cases Sonata has exacerbated respiratory problems.
• Pregnancy or intention to become pregnant: Sonata is not considered safe for pregnant or nursing women.
• Sleep Apnea (temporary suspension of breathing during sleep) - Sonata may worsen this condition. Individuals with sleep apnea should not generally use sedatives as sleep aids.

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Sonata is a central nervous system depressant, and may react strongly with other medication that has a similar effect. Be cautious about taking Sonata with any medication that warns it 'may cause drowsiness' or cautions you against driving or operating heavy machinery. Check the labels on over the counter medication, as these will not all mix safely with Sonata.

• Alcohol - Sonata and alcohol can accelerate central nervous system depression. Avoid mixing the two, as this could increase side effects and possibly be dangerous. Drinking alcohol may also contribute to insomnia, decreasing the effectiveness of your treatment, even if you do not directly mix them. Sonata users are generally advised to avoid alcohol use.
• Barbiturates like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal (butalbital, aspirin, and caffeine), Phenobarbitol, or Seconal, may result in oversedation.
• Benadryl, or other products containing diphenhydramine.
• Benzodiazepines (a class of antidepressants, anti-panic agents, sleep medications, and muscle relaxants) such as Ativan (lorazepam), Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium (chlordiazepoxide), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, may increase the risk of side effects from Sonata.
• Butazolidine (phenylbutazone) - May decrease effectiveness of Sonata.
• Caffeine - This stimulant may decrease the effectiveness of Sonata treatment, do not take it in the afternoon or evening while taking Sonata. Caffeine may be found in soda, coffee, tea (except herbal teas), and chocolate.
• Desyrel (trazodone) - Risk of additive CNS depression.
• Doriglute (glutethimide) - May decrease effectiveness of Sonata.
• Ephedra - This herb may decrease Sonata's effectiveness.
• Ginseng - This herb may decrease Sonata's effectiveness.
• Kava kava - Do not take this herb while using Sonata.
• Kola nut - This herb may decrease Sonata's effectiveness.
• Ma Huang - This herb may decrease Sonata's effectiveness.
• Medicines that affect aldehyde oxidase or CYP 3A4 like Tagamet (cimetidine) will interact with Sonata. Depending on whether inhibit or increase these mechanisms, they can lead to toxic levels of Sonata or decrease its effectiveness.
• Mysoline (primidone) - Can decrease Sonata's effectiveness.
• Narcotic pain medication, like Codeine, Demerol (meperidine), Buprenex (buprenorphine), Darvon (propoxyphene), Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine, OxyContin (oxycodone), Percocet (oxycodone, acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine), Vicodin (hydrocodone, acetaminophen), or Vicoprofen (hydrocodone, ibuprofen) should not be mixed with Sonata, except under the direction of your physician. If your doctor gives you instructions concerning how long to wait between taking these medications, follow them exactly.
• Norflex (orphenadrine) - Risk of oversedation.
• Norvir (ritonavir) may lead to a toxic buildup of Sonata.
• Nicotine - This stimulant may decrease the effectiveness of Sonata treatment.
• Rifater (rifampin) may decrease the benefits of Sonata.
• Skeletal muscle relaxants such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with this medication.
• Sleep medication like Ambien (zolpidem) or over the counter sleeping pills should not be used with Sonata.
• St. John's Wort - Do not take this herb while using Sonata.
• Tranquilizers like Haldol (haloperidol) and antipsychotics of the phenothiazine class, such as Mellaril (thioridazine), Trilafon (perphenazine), and Thorazine (chlorpromazine), may cause oversedation in combination with Sonata.
• Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the risk of side effects from Sonata.
• Valerian - Do not take this herb while using Sonata.

If you are unsure about the safety of combining any medication with Sonata, consult your doctor or pharmacist.

Sonata Dosages

Sonata is available in 5 mg and 10 mg doses. A 10 mg dose is the most common, individuals are not advised to take more than 20 mg of Sonata per day. Patients with a low body weight or who are over 60 years of age are generally started on 5 mg per day and more closely monitored.

The lowest effective dose should be used, to prevent habituation that would make Sonata less effective. If you must use the maximum dose or use Sonata for a longer period of time, try to reduce your dose (under the advice of your doctor) every couple days to see if a smaller amount will work.

Sonata Directions

Take Sonata on an empty stomach right as you are going to bed. If you take Sonata with food, especially fatty foods, it will increase the amount of time it takes for Sonata to work. The tablets may be broken or crushed. Do not take double doses of this medication; take it only as much and only as often as your doctor suggests.

Sonata may make you sleepy very suddenly within 10-20 minutes of taking it; if you are not lying down, you may experience a decrease of coordination or find that it is difficult to think clearly. Sonata should be taken only at bedtime, and you should not attempt to drive or operate machinery for at least six hours after taking Sonata. If you have less than six hours to sleep, it is much more likely that you will still feel sedated or lethargic when you get up. Be cautious if you plan to drive or perform dangerous tasks the next morning, avoid these activities if you find yourself feeling tired or experience slowed reactions.

Sonata may cause rebound sleeplessness if you stop taking it abruptly. Your doctor may advise you to gradually lower your dose before stopping Sonata treatment to minimize this.

Store Sonata away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.

Keep Sonata away from children; both when storing it, and when discarding any unused medication.

Sonata and Pregnancy

Sonata is not advised for pregnant or nursing women. Animal studies have indicated the possibility of abnormal bone formation in the fetus.

Breastfeeding is not recommended during Sonata treatment; nursing mothers are advised either not to take this medication or to stop breastfeeding.

Sonata and Children

The safety of Sonata for individuals under the age of 18 has not been established.

Sonata and Seniors

If you are over 60 years of age, Sonata may be prescribed at the lower starting dose of 5 mg. It may stay in your system longer, increasing the risk of falling if you are still sedated when you get up in the morning. Watch more carefully for feelings of confusion, fatigue, loss of balance, nightmares, and anger or irritability while taking Sonata.

Seniors may be more prone to decreased liver function that makes side effects from Sonata more likely.

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Sonata is a trademark of Wyeth-Ayerst

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The information contained in this document is provided for educational purposes and information only. It is not a substitute for consultation with a physician or Health professional, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor, physician or Health professional can say if a medication, a drug alternative or drug combination, is safe for you. Information intended for US residents only.