- What is zolpidem, and how does it work (mechanism of action)?
- What brand names are available for zolpidem?
- Is zolpidem available as a generic drug?
- Do I need a prescription for zolpidem?
- What are the uses for zolpidem?
- What are the side effects of zolpidem?
- What is the dosage for zolpidem?
- Which drugs or supplements interact with zolpidem?
- Is zolpidem safe to take if I'm pregnant or breastfeeding?
- What else should I know about zolpidem?
What is zolpidem, and how does it work (mechanism of action)?
- Zolpidem belongs to a class of drugs called sedatives or hypnotics. Zolpidem shares some characteristics of a family of sedatives called benzodiazepines. Benzodiazepines cause sedation, muscle relaxation, act as anti-convulsants (anti-seizure medications), and reduce anxiety. Zolpidem has selectivity in that it has little of the muscle relaxant and anti-seizure effects and more of the sedative effect. Therefore, it is used primarily as a medication for sleep. The oral spray form of zolpidem, Zolpimist, has more rapid absorption than the tablet form because it is absorbed through the lining of the mouth.
The FDA approved zolpidem in December 1992.
What are the uses for zolpidem?
- Zolpidem is used for treating insomnia.
- Conventional tablets are used for short-term treatment of insomnia associated with difficulty falling asleep.
- Long acting tablets are used for treating insomnia associated with difficulty falling asleep or staying asleep.
- Zolpidem improves initiation of sleep and keeps patients asleep longer.
What are the side effects of zolpidem?
The most common side effects of zolpidem are:
- Drowsiness
- Headache
- Weakness
- Dizziness
- A "drugged" feeling, which probably reflect the action of the drug
Other side effects include:
- Confusion
- Insomnia
- Diarrhea
- Depression
- Dry mouth
- Rash
- 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.

SLIDESHOW
Sleep Disorders: Foods That Help Sleep or Keep You Awake See SlideshowWhat is the dosage for zolpidem?
- The recommended adult dose of zolpidem conventional tablets or spray is 5 mg for females, the elderly, or fragile individuals, and 5 to 10 mg for males.
- The maximum dose is 10 mg daily.
- For females and the elderly, give 6.25 mg of extended-release tablets; and males should receive 6.25 to 12.5 mg.
- The maximum dose of extended-release tablets is 12.5 mg daily.
- Elderly patients have decreased ability to eliminate zolpidem from the body, and accumulating zolpidem may cause side effects.
Which drugs or supplements interact with zolpidem?
- 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 the enzymes that breakdown zolpidem.
Is zolpidem 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 zolpidem?
What preparations of zolpidem are available?
- Tablets: 5 and 10 mg.
- Tablet (extended release): 6.25 mg and 12.5 mg.
- Oral spray: 5 mg/spray
How should I keep zolpidem stored?
Zolpidem should be stored at room temperature, 20-25 C (68-77 F), in an air-tight container.
Summary
Zolpidem (Ambien, Ambien CR, Zolpimist, Edluar, [Tovalt ODT has been discontinued]) is a sedative medication prescribed for the treatment of insomnia. Side effects, drug interactions, warnings and precautions, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.
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A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep: 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement).
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Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
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Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
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Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
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Insomnia Treatment (Sleep Aids and Stimulants)
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions, environmental changes, and stressful events. Treatments may include non-drug treatments, over-the-counter medicines, and/or prescription medications.
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AHFS Drug Information for zolpidem