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 brand names are available for zolpidem?
Ambien, Ambien CR, Intermezzo, Zolpimist, Edluar
Is zolpidem available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for zolpidem?
Yes
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:
Other side effects include:
- Insomnia
- Diarrhea
- Depression
- Dry mouth
- Rash
-
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.
What 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.
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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.