Hemolytic anemia after zopiclone overdose.

INTRODUCTION: Zopiclone is associated with methemoglobinemia. We report a case of zopiclone overdose manifested with another hematological complication, hemolysis. CASE: A 46-year-old woman overdosed with 50-100 tablets of 7.5 mg zopiclone. Oxidative hemolysis was evident by anemia, bite cells, raised unconjugated bilirubin and lactate dehydrogenase, lowered haptoglobin, and reticulocytosis. DISCUSSION: In zopiclone overdose, there may be oxidative stress rendering the development of not only methemoglobinemia but also hemolysis.