Dispensing of zolpidem and benzodiazepines in Brazilian private pharmacies: a retrospective cohort study from 2014 to 2021
Open accessAbstract
Objective: The study aimed to evaluate Zolpidem and Benzodiazepines prescription and dispensing data in private pharmacies in Brazil from 2014 to 2021. Methods: This retrospective cohort study was carried out with retrospective open data from the Brazilian Federal Government from January 2014 to August 2021 containing medicines registered in the National Controlled Products Management System (SNGPC). Results: Between January 2014 and August 2021, a total of 32,441,392 sales of thirteen drugs from the z-drug and benzodiazepine classes used to treat sleep disorders were recorded in Brazil. Throughout the entire period, clonazepam emerged as the most popular drug, accounting for 29.8% of total sales. Alprazolam followed in second place with 20.6% of sales, while zolpidem came in third with 14.4%. The normal-release form of zolpidem was consistently the highest-selling variant during the evaluation period. However, the fast-acting-release form exhibited the most significant growth, indicated by a noticeable upward trend in sales since 2020. In contrast, the extended-release form of zolpidem remained stable over the years. Conclusion: The increased sales of zolpidem in Brazilian private pharmacies raise concerns about potential misuse and dependence on this drug mainly for the treatment of insomnia. The epidemic of sleeping pills arises in a scenario of expectancy of short-term amelioration of symptoms, with no correspondence in best clinical practice. Education and counseling for both healthcare professionals and the general population are essential to address this growing health concern and ensure the safe and appropriate use of medications for sleep disorders.
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In 2014, 338,367 boxes of zolpidem were sold, increasing to 810,353 in 2021; sales of zopiclone also rose during this period, from 15,060 boxes in 2014 to 83,910 in 2021.
“In 2014, 338,367 boxes of zolpidem were sold, increasing to 810,353 in 2021; sales of zopiclone also rose during this period, from 15,060 boxes in 2014 to 83,910 in 2021.”
From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [10]
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Experimental — accuracy not yet measuredBetween 2014 and 2021, zolpidem was the 3rd most sold hypnotic in Brazil, accounting for 14.4% of total hypnotic sales, following clonazepam and alprazolam.
“Between 2014 and 2021, zolpidem was the 3rd most sold hypnotic in the country, accounting for 14.4% of total hypnotic sales, following clonazepam and alprazolam.”
From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [10]
The Results report that zolpidem ranked third after clonazepam and alprazolam, accounting for 14.4% of sales among the drugs studied. The Methods (section 2.2) limit those records to 13 selected drugs sold through Brazilian private pharmacies from January 2014 to August 2021; they do not establish 14.4% of all hypnotic sales in Brazil for the full 2014–2021 period. (LLM, conf=0.87)
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- Authors
- Carvalho, F., Tonon, A. C., Hidalgo, M. P., Martins Costa, M., & Mengue, S. S.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Corresponding author
- Mengue, Sotero Serrate
- Venue
- Frontiers in Pharmacology
- Publisher
- Frontiers Media SA
- Published
- 2024-11-11
- Volume
- 15
- Pages
- 1405838-1405838
- ISSN
- 1663-9812 (ISSN-L)
- PMC
- PMC11586159
- OpenAlex
- W4404218145
- Cited by
- 4
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Pharmacology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lume (Universidade Federal do Rio Grande do Sul) (submittedVersion, cc-by-nc-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- zolpidem, benzodiazepines, private pharmacies, medication dispensing, sales trends, clonazepam, alprazolam, insomnia, drug addiction, controlled substances, medication misuse, Brazil
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