Zolpidem

Zolpidem helps you fall asleep if you have difficulty falling asleep or staying asleep. After taking zolpidem, you may get up and do an activity such as drive, eat, and have sex while not fully awake.

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Pharmacist Nazley Mohammadi, PharmD overviews the uses and common side effects of Zolpidem
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Zolpidem Overview

Reviewed: October 8, 2012
Updated: 

Zolpidem is a prescription medication used in adults for the short-term treatment of insomnia (difficulty falling asleep). Zolpidem belongs to a group of drugs called hypnotics. It works by slowing down brain activity so you can fall asleep.

Zolpidem comes in tablet, extended release tablet, spray, and sublingual forms. Zolpidem is taken by mouth just before bedtime.

Common side effects of zolpidem include daytime drowsiness, dizziness, and diarrhea. Do not drive or operate heavy machinery until you know how zolpidem affects you.

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Zolpidem Cautionary Labels

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Uses of Zolpidem

Zolpidem is a prescription medicine used in adults for the treatment of a sleep problem called insomnia (difficulty falling asleep or staying asleep). It slows brain activity to allow sleep.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Zolpidem Brand Names

Zolpidem may be found in some form under the following brand names:

Zolpidem Drug Class

Zolpidem is part of the drug class:

Side Effects of Zolpidem

Warning: Impairment from sleep drugs can be present despite feeling fully awake.

You may still feel drowsy the next day after taking zolpidem. Do not drive or operate heavy machinery or take part in anything that requires alertness after taking zolpidem until you are certain you are alert.

Serious side effects of zolpidem may include:

  • getting out of bed while not being fully awake and taking part in an activity that you do not know you are doing
  • abnormal thoughts and behavior including:
    • more outgoing or aggressive behavior than normal
    • confusion 
    • agitation
    • hallucinations (seeing or hearing things that aren't there)
    • worsening of depression
    • suicidal thoughts or actions
  • memory loss
  • anxiety
  • severe allergic reactions including:
  • swelling of the tongue or throat
  • trouble breathing
  • nausea and vomiting

Call your doctor right away if you have any of the above side effects or any other side effects that worry you while using zolpidem.

The most common side effects of zolpidem are:

  • drowsiness
  • dizziness
  • diarrhea
  • "drugged feelings"

Some people experience symptoms such as trouble sleeping, nausea, flushing, lightheadedness, uncontrolled crying, vomiting, stomach cramps, panic attack, nervousness, and stomach area pain after stopping sleep medicine. This may last a couple days. 

This is not a complete list of zolpidem side effects. Ask your doctor or pharmacist for more information.

Zolpidem Interactions

Tell your doctor about all the medicines you take including prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products. Do not take zolpidem with other medicines that make you sleepy. Be sure to tell your doctor if you take:

  • antidepressants such as imipramine (Tofranil) and sertraline (Zoloft)
  • chlorpromazine (Thorazine)
  • antifungal medicines such as itraconazole (Sporanox) and  ketoconazole (Nizoral)
  • medications for anxiety
  • cold medicines or allergy medicines
  • medicines for mental illness
  • pain medicines
  • medicines for seizures
  • rifampin (Rifadin, Rimactane)
  • sedatives
  • sleeping pills
  • tranquilizers.

This is not a complete list of zolpidem drug interactions. Ask your doctor or pharmacist for more information.

Zolpidem Precautions

The FDA (U.S. Food and Drug Administration) lowered the recommended zolpidem dose for women from 10 mg to 5 mg for immediate-release products and from 12.5 mg to 6.25 mg for extended-release products on January 10, 2013 because new data show that blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving. Women appear to be more susceptible to this risk because they eliminate zolpidem from their bodies more slowly than men.

After taking zolpidem, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night. You should be aware that impairment from sleep drugs can be present despite feeling fully awake. You have a higher chance for doing these activities if you drink alcohol or take other medicines that make you sleepy with zolpidem.

Reported activities include:

  • driving a car ("sleep-driving")
  • making and eating food
  • talking on the phone
  • having sex
  • sleep-walking

Call your doctor right away if you find out that you have done any of the above activities after taking zolpidem.

  • Take zolpidem right before you get in bed, not sooner.
  • Do not take zolpidem if you drink alcohol.
  • Do not take zolpidem with other medicines that can make you sleepy. 
  • Do not take zolpidem if you cannot get a full night's sleep or stay in bed 7 or 8 hours before being active again.
  • Do not take zolpidem if you are allergic to anything in it. Severe allergic reactions have occurred with zolpidem use. Seek emergency medical attention if you have unexplained rash, itching, hives, wheezing or trouble breathing, or unexplained swelling (especially of the throat, lips, or mouth).

Zolpidem can cause dizziness or drowsiness. Do not drive or operate heavy machinery until you know how zolpidem affects you.

Zolpidem Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of zolpidem there are no specific foods that you must exclude from your diet when receiving zolpidem.

 

Inform MD

Before receiving zolpidem, tell your doctor about all of your medical conditions, including if you:

  • have a history of depression, mental illness, or suicidal thoughts
  • have a history of drug or alcohol abuse or addiction
  • have kidney or liver disease
  • have a lung disease or breathing problems
  • are pregnant, planning to become pregnant, or breastfeeding

Tell your doctor about all of the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements.

Zolpidem and Pregnancy

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Zolpidem and Lactation

Tell your doctor if you are breastfeeding or are planning to breastfeed. Zolpidem is excreted into human milk. It is not known if zolpidem will harm your nursing baby.

 

Zolpidem Usage

Take zolpidem exactly as prescribed. Do not take more zolpidem than prescribed for you.

  • Take zolpidem right before you get into bed.
  • Do not take zolpidem unless you are able to stay in bed a full night (7–8 hours) before you must be active again.
  • Zolpidem should be taken without food.
  • Call your doctor if your insomnia worsens or is not better within 7 to 10 days. This may mean that there is another condition causing your sleep problem.
  • If you take too much zolpidem or overdose, call your doctor or poison control center right away, or get emergency treatment.

Zolpidem Dosage

Take zolpidem exactly as your doctor has prescribed it. Follow the directions on your prescription label carefully. 

Zolpidem Immediate-Release

The recommended zolpidem immediate-release dose for adult men is 10 mg once daily immediately before bedtime. The total zolpidem immediate-release dose should not exceed 10 mg per day.

For women, the recommended zolpidem immediate-release dose is 5 mg once daily immediately before bedtime. The FDA lowered the recommended dose for women from 10 mg to 5 mg for immediate-release products on January 10, 2013 because new data show that blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving. Women appear to be more susceptible to this risk because they eliminate zolpidem from their bodies more slowly than men.

Zolpidem Extended-Release

The recommended dose of zolpidem extended-release tablets for adult men is 12.5 mg once daily immediately before bedtime. The total zolpidem extended-release tablets dose should not exceed 12.5 mg per day.

For women, the recommended zolpidem extended-release dose is 6.25 mg once daily immediately before bedtime. The FDA lowered the recommended dose for women from 12.5 mg to 6.25 mg for extended-release products on January 10, 2013. See above.

Zolpidem Sublingual Tablet and Spray

The recommended dose is 5 mg for women and 5 or 10 mg for men, immediately before bedtime.

For geriatric patients and patients with liver impairment, the recommended dose is 5 mg for men and women.

 

 

Zolpidem Overdose

If you take too much zolpidem call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If zolpidem is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Other Requirements

  • Store zolpidem at room temperature.
  • Keep zolpidem and all medicines out of reach of children.
  • Zolpidem is a federally controlled substance (C-IV) because it can be abused or lead to dependence. Keep zolpidem tablets in a safe place to prevent misuse and abuse. Selling or giving away zolpidem tablets may harm others, and is against the law.

 

Zolpidem FDA Warning

Zolpidem is a federally controlled substance (C-IV) because it can be abused or lead to dependence. Keep zolpidem tablets in a safe place to prevent misuse and abuse. Selling or giving away zolpidem tablets may harm others, and is against the law. Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines or street drugs.