zolpidem (Intermezzo)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is Intermezzo, and how does it work (mechanism of action)?

Intermezzo contains a low dose of zolpidem, the same active ingredient in Ambien. Zolpidem belongs to a class of drugs called sedatives or hypnotics. Zolpidem shares some characteristics of a family of sedatives called benzodiazepines which includes diazepam (Valium). Benzodiazepines cause sedation, muscle relaxation, act as anticonvulsants (antiseizure medications), and reduce anxiety. Zolpidem has selectivity in that it has little of the muscle relaxant and antiseizure effects and more of the sedative effect. Therefore, it is used primarily as a medication for sleep. The FDA approved Intermezzo in November 2011. The first formulation of zolpidem (Ambien) was approved in 1992.

What brand names are available for Intermezzo?

Intermezzo

Is Intermezzo available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for Intermezzo?

Yes

What are the side effects of Intermezzo?

The most common side effects of zolpidem are:

Other important side effects include:

When the drug is abruptly discontinued. Zolpidem can cause abnormal behavior with confusion, paradoxical insomnia or "complex sleep-related behaviors," which may include sleep-driving (driving with no memory of having done so). If these side effects occur, zolpidem should be discontinued. Zolpidem is a controlled substance because it is likely to be abused and may cause dependence.

What is the dosage for Intermezzo?

The recommended dose is 1.75 mg for women and 3.5 mg for men once per night when a patient wakes up in the middle of the night and has difficulty falling back to sleep. Tablets should be placed under the tongue and allowed to dissolve completely before swallowing. Tablets should not be swallowed whole. The action of Intermezzo may be delayed by food if food is consumed with or immediately prior to administration of Intermezzo.

Which drugs or supplements interact with Intermezzo?

Alcohol has an additive effect with zolpidem and the two should not be combined. Zolpidem should not be combined with other sedative drugs because of the additive effects.

Itraconazole (Sporanox) and ketoconazole (Nizoral, Extina, Xolegel, Kuric) may increase the blood concentration of zolpidem by reducing the activity of the enzymes that breakdown zolpidem in the liver. Conversely, rifampin may reduce the concentration of zolpidem by increasing the activity of of the enzymes that breakdown zolpidem.

Is Intermezzo safe to take if I'm pregnant or breastfeeding?

There are no adequate studies of zolpidem use in pregnant women.

Zolpidem is excreted in human breast milk and may adversely affect the infant.

What else should I know about Intermezzo?

How should I keep Intermezzo stored?

Intermezzo should be stored at room temperature, 20 C - 25 C (68 F - 77 F).

Last Editorial Review: 7/27/2015

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See more info: Intermezzo on RxList
Reviewed on 7/27/2015
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