Belsomra Vs Ambien: Differences, Similarities, & Which to Take

What Is Belsomra (Suvorexant)?

Belsomra, with the active ingredient suvorexant, is an oral medication FDA-approved to treat insomnia with specific difficulty falling asleep or trouble staying asleep. FDA approved means that the FDA has determined that the drug is safe and effective when used as prescribed for the approved conditions. It is a controlled substance federally categorized as a schedule IV (four) drug due to its risk of dependence and misuse.²

Belsomra works in the central nervous system (CNS) to affect the activity of certain chemicals in the brain that help a person stay awake. This effect may help a person to fall asleep and stay asleep more easily. Belsomra works for up to 8 hours and is taken just before sleep.¹

What Is Ambien?

Ambien, with the active ingredient zolpidem, is an oral medication FDA-approved to treat short-term insomnia with specific difficulty falling asleep. FDA approval means the drug has been shown to be safe and effective for a specific use based on data from clinical trials. Ambien has been sometimes used to treat other neurological disorders besides insomnia. This usage is called off-label (non-FDA approved) treatment and should only be done at the direction of a prescriber after taking time to understand the risks of use.¹

Ambien is thought to work in the CNS by preventing over-excitation of neurons. This may lead to less stimulation in the brain and an easier time falling asleep. Ambien is effective for about 3 hours and is taken just before trying to fall asleep. Ambien is also available as a controlled release tablet. It is a controlled substance federally categorized as a schedule IV (four) drug due to its risk of dependence and misuse.³

Key Differences Between Belsomra Vs Ambien

Ambien and Belsomra are both used to treat insomnia, but there are some key differences that can affect which medication may be best for you. They impact the CNS in different ways and have slightly different intended uses as well. Other practical differences between the two drugs include generic availability and price. Ambien is available both as a brand-name and a generic medication, whereas Belsomra is only available as a brand-name medication.

Here are the key differences between Belsomra versus Ambien:^{1, 2, 3}

Key Components	Belsomra	Ambien
What is the generic name?	suvorexant (generic not available)	zolpidem
What is the active ingredient?	suvorexant	zolpidem
What forms does it come in?	oral tablet	oral tablet extended release oral tablet
What are the typical dosages?	5mg to 20mg	5mg to 12.5mg
Who is approved to take it?	adults	adults

How Do Ambien Vs Belsomra Work?

Ambien and Belsomra both work in the CNS to help a person fall asleep, but the two drugs work in different ways. A major difference is that Belsomra will keep working for about 8 hours to help a person stay asleep, while Ambien starts to lose its effect after a few hours.^{1, 2} This explains why Ambien is only for treating difficulty falling asleep but Belsomra can treat both trouble falling asleep and staying asleep.^{1, 2}

How Are Belsomra & Ambien the Same?

Belsomra and Ambien are both controlled substances used to treat insomnia in adults. They both are taken by mouth just before the intended time of sleep and both medications work in the brain to promote sleep. Ambien and Belsomra can both cause complex sleep behaviors like sleepwalking and sleepdriving, which can be dangerous. Finally, both medications carry significant risks of misuse, abuse, and dependence that can be dangerous. ^{1, 2}

What Are Belsomra Vs Ambien Used to Treat?

Belsomra and Ambien are both used to treat insomnia and are only intended for use in adults. Belsomra is specifically used to treat insomnia marked by trouble falling asleep and staying asleep, while Ambien is just for insomnia marked by trouble falling asleep. Finally, Ambien is intended for short term treatment only.^{1, 2}

The table below compares the medical and mental health conditions Belsomra & Ambien are used to treat:^{1, 2}

Condition	Belsomra	Ambien
Insomnia	FDA-approved	FDA-approved

Which Is Better for Insomnia, Belsomra or Ambien?

Determining whether Belsomra or Ambien is better for you can depend on what type of insomnia you have and other specific conditions you may have, if any. If you have trouble staying asleep Belsomra may be a better option since it works for longer. If you only have infrequent trouble falling asleep, Ambien may be the better option.

Ambien is contraindicated (not recommended) for patients that are known to sleepwalk. Belsomra is contraindicated (not recommended) with patients that have narcolepsy. Deciding which drug is a better fit for you is a decision that should be made with your prescriber after an in depth conversation about your health history and specific goals of treatment.^{1, 2}

Belsomra Vs Ambien Dosages

Ambien and Belsomra dosage will vary based on each person’s specific health history, and how they respond to initial treatment. They are both available as tablets to be taken by mouth. For safety and effectiveness, always only take the exact dose prescribed. Taking more than prescribed can lead to dangerous side effects with no change in how effective the drug is. The goal of treatment with both drugs is to find the lowest possible dose that is effective for treating insomnia.^{1, 2}

An important note with both Belsomra and Ambien is that taking the dose with food can delay how quickly the medication works. The effect of sleepiness can be delayed over an hour if taken with food or just after food. To feel the effect of Ambien or Belsomra as quickly as possible, take on an empty stomach or with just a small snack.^{1, 2}

Belsomra Form & Dosages

Belsomra is available as an oral tablet ranging from 5 mg, 10 mg, 15 mg, and 20 mg. The recommended starting dose is 10 mg taken within 30 minutes of going to bed with at least 7 hours remaining before your planned awakening. Depending on other medications a patient is taking or how well a person responds to treatment, the dose may be increased or decreased. Each person’s dose is specific to them and you should follow your prescription exactly as directed, and Belsomra is not intended to be taken every night.²

Ambien Form & Dosages

Ambien is available as an oral tablet in either 5 mg or 10 mg, or an extended release tablet in either 6.25 mg or 12.5 mg. The recommended starting dose of Ambien is different for men and women, with men starting at either 5 mg or 10 mg and women starting at 5 mg. This is because Ambien lasts longer in women than in men. It is important that Ambien is only taken once per night, 30 minutes before bedtime with at least 7 hours before planned awakening. The maximum dose of Ambien is 10 mg of immediate release or 12.5 mg of the extended-release form. Ambien is not intended to be taken every night.^{1, 3}

Side Effects of Belsomra Vs Ambien

Ambien and Belsomra have similar side effects that are mostly related to the impacts on a person’s central nervous system. It is important to understand these potential side effects and have a plan to treat them if they occur. Common side effects are often mild but if they become severe or do not resolve on their own, seek medical help. It is important to remember each person may experience different side effects. If you experience any serious side effects, seek medical attention right away.

Common side effects from taking Belsomra may include:²

• Headache
• Dizziness
• Drowsiness
• Abnormal dreams
• Dry mouth
• Diarrhea
• Cough and/or respiratory infection

Serious side effects from taking Belsomra may include:²

• Daytime impairment including falling asleep while driving
• Worsening depression and suicidal ideation
• Complex sleep behaviors including sleepdriving and sleepwalking
• Sleep paralysis and cataplexy-like symptoms
• Impaired respiratory function
• Abuse, misuse, and dependence

Common side effects from taking Ambien may include:¹

• Drowsiness
• Dizziness
• Depression
• Abnormal dreams
• Diarrhea
• Constipation
• Headache
• Lethargy
• Inflammation of sinuses or throat

Serious side effects from taking Ambien may include:¹

• Complex sleep behaviors including sleepdriving and sleepwalking
• CNS depression and daytime impairment including falling asleep while driving
• Severe anaphylactic reaction (sudden life-threatening allergy response)
• Abnormal thinking and changes in behavior
• Worsening depression and suicidal ideation
• Respiratory depression (slowed breathing)
• Hepatic encephalopathy (loss of brain function due to liver damage)
• Withdrawal when stopped abruptly

*All medications, including Ambien and Belsomra, have a risk of side effects, including serious side effects. This is not a complete list of side effects. You should talk with your healthcare professional about the benefits and risks of any medication before starting treatment.

Warnings & Precautions for Ambien & Belsomra

There are specific warnings and precautions for both Ambien and Belsomra that are important to be aware of before using either medication. If any of the following warnings apply to you, the medication may not be a safe option. Heeding these warnings can help prevent severe side effects from happening and causing serious harm or death. Be sure to review all warnings and precautions with your prescriber before starting treatment.

Risks to consider when taking Belsomra include:²

• Worsening depression or suicidal thoughts: Belsomra can make depression symptoms worse and cause thoughts of suicide or self harm. It is important to identify any thoughts of this nature and get help immediately if they occur.
• CNS depression and daytime impairment: Belsomra can impair your ability to stay awake and function properly during the day, even when taken as prescribed. Special precaution should be taken while driving especially when combined with any other substance that can also cause CNS depression.
• Risk of addiction or misuse: Taking Belsomra can lead to physical dependence, abuse and misuse. Talk with your prescriber if you have struggled with addiction in the past or suspect you are dependent on the medication before stopping.
• Complex sleep behaviors: Taking Belsomra can cause sleepwalking, sleepdriving, or other activities while not fully awake that can be dangerous. Be sure to monitor for this behavior and stop Belsomra immediately if this happens.
• Sleep paralysis: Taking Belsomra can cause disturbing effects such as hallucinations or the inability to move or speak for several minutes during sleepwake transitions. Alert your prescriber immediately if this happens.
• Risk of respiratory depression: Belsomra can cause slowing of breathing which can be dangerous in patients with underlying lung disease. Special caution should be taken in patients that have lung disease or who take other medications that can impair breathing.

Risks to consider when taking Ambien include:^{1, 3}

• Severe allergic reactions: Ambien can cause severe allergic reactions that lead to swelling of the throat and airways leading to emergency situations. If you suspect any allergic reactions, call 911 and get help immediately.
• Abnormal thinking and behavioral changes: Ambien can cause changes in the way you think or act including aggressiveness and agitation and experiencing hallucinations. Any suspicion of changes in behavior should be reported to your prescriber right away.
• Hepatic encephalopathy: Ambien can cause a dangerous liver condition that leads to liver impairment and changes in mental status. If you have liver disease or decreased liver function, Ambien may not be the right choice for you.
• Worsening depression or suicidal thoughts: Ambien can make depression symptoms worse and cause thoughts of self harm or suicide. It is important to identify any thoughts of this nature and get help immediately if they occur.
• Risk of respiratory depression: Ambien can cause slowing of breathing which can be dangerous in patients with underlying lung disease. Special caution should be taken in patients that have lung disease or take other medications that can impair breathing.
• Complex sleep behaviors: Taking Ambien can cause sleepwalking, sleepdriving, or other activities while not fully awake that can be dangerous. Be sure to monitor for this behavior and stop Ambien immediately if this happens.
• CNS depression and daytime impairment: Ambien can impair your ability to stay awake and function properly during the day, even when taken as prescribed. Special precaution should be taken while driving especially when combined with any other substance that can also cause CNS depression.
• Abuse, dependence and withdrawal symptoms: Taking Ambien can lead to dependence and risk of abuse. When stopping Ambien, if done too quickly, you may experience withdrawal symptoms. If you would like to stop taking Ambien, speak with your prescriber first.

Can You Take Belsomra or Ambien While Pregnant?

You should not take Belsomra or Ambien while pregnant or nursing. Ambien is known to cross the placenta leading to respiratory depression (slowed breathing) and sedation in newborns. It is also known to be present in breastmilk and cause respiratory depression and sedation in nursing babies. Any newborns or infants exposed to Ambien should be closely monitored and treated immediately for slowed breathing or sedation.^{1, 3}

Belsomra is a newer medication and there are currently not enough reports of patients taking the medication during pregnancy or while nursing newborns. However, animal studies have shown that it most likely leads to negative effects in newborns and infants.² Taking any medication during pregnancy is a serious decision that should be discussed at length with your health care team.

Is it Safe to Take Belsomra or Ambien Every Night?

Belsomra and Ambien are not meant to be used every night and should only be used as needed and as infrequently as possible. Using either medication every night increases your risk of experiencing side effects both common and serious. The more frequently a person uses hypnotic sleeping medications, the more likely they are to develop a physical dependence to the medication. If you feel you need the medication every night or are unable to skip nights, consult your prescriber right away.^{1, 2}

Potential Drug Interactions With Ambien & Belsomra

Both Ambien and Belsomra can cause dangerous reactions when combined with specific medications. Since both drugs affect the CNS, using them with other medications that also work in the CNS may lead to dangerous interactions. Alert your prescriber of all medications you currently take to ensure the drug choice and dose is correct and safe for you.

Some medications are known to have significant drug interactions with Ambien. These include opioids, sertraline, fluoxetine, ketoconazole, rifampin, and St. John’s wort. Some known medications to interact with Belsomra include rifampin, ketoconazole, antiviral medications, and some antibiotics like ciprofloxacin, erythromycin, and clarithromycin.^{1, 2} You should always have a current list of medications to share with your prescriber or pharmacist. This can help identify potentially dangerous interactions.

Disclaimer: Taking certain medications, herbs, or supplements alongside Ambien and Belsomra can change how these medications work in your body or increase the risk of serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Can You Take Ambien or Belsomra With Alcohol?

Do not consume any alcohol while taking Ambien or Belsomra. Both medications depress the central nervous system. Since alcohol has similar effects but with a different mechanism,, side effects from the medications including impaired function can be much worse. Even if you think one or two drinks will not do much, do not combine either medication with alcohol, as combined effects can be severe. If you plan to drink alcohol, be sure to abstain from taking the medication that day to ensure no potentially harmful interactions. Discuss with your prescriber regarding your alcohol use to reduce these risks.^{1, 2, 3}

Belsomra Vs Ambien Cost

For most people, Ambien will be the less expensive option compared to Belsomra. Ambien has been available as a generic (zolpidem) for years, but since Belsomra is a newer medication, it is not yet available as a generic. If you have prescription insurance, utilizing your coverage is usually the cheapest option for either medication. If not, work with your pharmacist to find a drug coupon or prescription assistance. You should be able to find generic Ambien for less than $20 a month.

If insurance does not cover Belsomra, talk to your prescriber. They may need to provide your insurance company with further information to have the drug covered. Otherwise you may qualify for prescription savings plans through the Belsomra manufacturer. Whichever avenue you decide to take, your pharmacy should be able to help you find the best price.

Which Is Right for You: Ambien or Belsomra?

Deciding whether Ambien or Belsomra is right for you will depend on many factors. The decision should be a joint decision between you and your prescriber. Be sure to consider cost, coverage, and availability, in addition to the type of insomnia needing treatment, other medications you take, and your specific risk factors. Remember that sometimes you may need to try more than one medication to know which will work for you. As always, clear communication with your healthcare team can help to identify the correct drug and dose.

How to Get a Prescription for Belsomra or Ambien

Ambien and Belsomra are both controlled substances that require a prescription to be written by a qualified healthcare professional, such as a psychiatrist, primary care physician, nurse practitioner, or physician assistant. Be sure to check with your prescriber that they are authorized to write prescriptions in your state, especially if you are using a telehealth provider. If you do not have a provider, you can look up covered health care professionals with your insurance or search for online providers too. Finding a prescriber you feel comfortable discussing your health with is key to accessing quality care.

Questions to Ask Your Health Team About Ambien & Belsomra

Spending time discussing your health history with your provider is important for identifying which drug, Ambien or Belsomra, is right for you, your treatment options and goals, and deciding on the correct dose. This time can help to understand your health history and uncover any risks that you may have taking either medication.

Questions to ask your prescriber about Ambien and Belsomra include:

• Is it safe to take Ambien or Belsomra with my other medications?
• Will Ambien or Belsomra be covered by my insurance?
• Am I able to drink alcohol while taking Ambien or Belsomra?
• Can I take Ambien or Belsomra every night?
• What should I do if I want to stop taking Ambien or Belsomra?
• Does my medical history increase my risk of side effects for either?
• How long can I expect side effects to last?
• If I need to be up early, should I still take Ambien or Belsomra?
• How often should I see you for checkups while taking Ambien or Belsomra?
• What should I do if I am unsure whether either of these medications is right for me?
• How will I know if I am sleepwalking?
• How do Ambien and Belsomra compare to over-the-counter sleep aids as effective treatments for insomnia?
• How do Belsomra or Ambien compare to Quviviq for treating insomnia?
• What are some other alternatives to Ambien?