zolpidem, Ambien, Ambien CR, Zolpimist, Edluar, Tovalt ODT (discontinued) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

DOSING: The recommended adult dose of zolpidem is 10 mg as conventional tablets or spray or 12.5 mg as extended-release tablets. In elderly patients, an initial dose of 5 mg as conventional tablets or 6.25 mg as extended-release tablets is recommended because elderly patients have decreased ability to eliminate zolpidem from the body, and accumulating zolpidem may cause side effects.

DRUG INTERACTIONS: 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.

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

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

SIDE EFFECTS: The most common side effects of zolpidem are drowsiness, dizziness, and a "drugged" feeling, which probably reflect the action of the drug. Other side effects include confusion, insomnia, euphoria, ataxia (balance problems), and visual changes. Zolpidem can cause withdrawal symptoms (muscle cramps, sweats, shaking, and seizures) 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.

REFERENCES:

FDA Prescribing Information for zolpidem

AHFS Drug Information for zolpidem


Last Editorial Review: 6/15/2010



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