Zolpidem is a medication prescribed to treat insomnia, which is characterized by difficulty falling or staying asleep. It is not suited for everyone and can interact with some medications. But zolpidem may be a solution if insomnia is disruptive to your sleep schedule.
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What Is Zolpidem?
Zolpidem is a sleep medication classified as a sedative-hypnotic. Zolpidem is FDA-approved to treat insomnia, a condition marked by difficulties with falling or staying asleep. Zolpidem’s main physiological effect involves slowing down brain activity to help a person fall asleep and stay asleep. FDA approval signifies that a medication has been found to be safe and effective for a specific use based on data from clinical trials
How Does Zolpidem Work?
Zolpidem works by influencing the activity of a brain chemical called gamma-aminobutyric acid (GABA). For some, GABA may help calm the nerves in the brain, promoting relaxation and sleepiness. By increasing GABA’s effects, zolpidem helps to quiet the brain activity, making it easier for you to fall asleep and stay asleep throughout the night.
What Is Zolpidem Used to Treat?
Zolpidem is FDA-approved for the treatment of insomnia, a condition characterized by difficulty falling or staying asleep. Zolpidem is occasionally prescribed off-label, meaning it’s used for conditions not specifically approved by the FDA, such as certain neurologic disorders.
Common Side Effects of Zolpidem
Common side effects of zolpidem include sleepiness, dizziness, diarrhea, and grogginess. While some people may experience some common side effects of zolpidem, not everyone experiences them. These symptoms often do not require medical attention unless they become severe or persistent. However, it’s important to note that there may be other side effects not listed here.
Common side effects of zolpidem include:1
- Sleepiness
- Dizziness
- Diarrhea
- Grogginess or feeling drugged
- Headache
- Nausea
*All medications, including zolpidem, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Zolpidem
Zolpidem may cause serious side effects for some who take it. Seek immediate medical help if experiencing any of these while taking zolpidem.
Serious side effects of zolpidem include:1
- Complex sleep behaviors
- Severe allergic reactions
- Abnormal thoughts and behavior
- Worsening depression and suicidal thoughts
- Breathing problems
- Withdrawal symptoms
*All medications, including zolpidem, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
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Zolpidem Warnings & Precautions
Zolpidem can impair alertness and coordination, particularly in the morning, especially when combined with alcohol or other drugs. Your prescriber may make a change with your medication if your insomnia persists after 7 to 10 days. Patients should watch for signs of severe allergic reactions, abnormal behaviors, and worsening depression. Zolpidem may not be recommended for patients with breathing issues or severe liver problems.
Warnings and precautions for zolpidem include:1
- CNS-depressant effects: Zolpidem can make you feel less awake, especially in the morning, especially if you mix it with alcohol or other drugs. Be cautious when performing tasks requiring focus.
- Need to evaluate for other diagnoses: If you continue to have trouble sleeping after 7 to 10 days, consult your doctor to explore other possible causes.
- Severe anaphylactic/anaphylactoid reactions: Serious allergic reactions like swelling of the tongue or throat may occur. Seek immediate medical attention if you experience any of these symptoms.
- Abnormal thinking and behavioral changes: Be vigilant for changes in behavior such as increased agitation. Notify your doctor promptly if you notice any changes.
- Depression and thoughts of suicide: Zolpidem may cause worsened depression, and may increase the risk of thoughts suicide or self-harm. Your doctor will prescribe the lowest effective dose and monitor your mood closely.
- Respiratory issues: If you have breathing problems, zolpidem may worsen them. Your doctor will recommend alternative treatments.
- Hepatic impairment: Individuals with severe liver problems should avoid zolpidem due to potential risks. Your doctor will suggest alternative treatments.
- Withdrawal effects: Abruptly stopping zolpidem may lead to withdrawal symptoms such as stomach cramps or tremors. Your doctor will assist you in gradually reducing your dose.
What to Avoid When Taking Zolpidem
When taking zolpidem, avoid combining it with alcohol, opioids, or certain medications like sertraline or ketoconazole. These combinations can increase drowsiness or breathing issues. Always consult your doctor before using zolpidem with other substances to prevent harmful interactions.
6 substances you should avoid while taking zolpidem include:1
- Alcohol: Drinking alcohol with zolpidem can worsen drowsiness and impair driving ability, increasing the risk of accidents. Avoid alcohol while taking zolpidem to prevent excessive drowsiness and potential accidents.
- Opioids: Combining zolpidem with opioids, commonly used for pain relief, can lead to severe drowsiness and respiratory depression. This combination can be dangerous and even life-threatening.
- Sertraline: Sertraline is an antidepressant used to treat depression, anxiety, and other mood disorders. Taking zolpidem with sertraline can increase the levels of zolpidem in your body, leading to stronger sedative effects and an increased risk of drowsiness, confusion, and impaired coordination.
- Ketoconazole: Ketoconazole is an antifungal medication used to treat fungal infections. When taken with zolpidem, ketoconazole can increase zolpidem levels in the body, leading to stronger sedative effects and an increased risk of drowsiness and impaired coordination.
- Rifampin: Rifampin is an antibiotic used to treat tuberculosis and other bacterial infections. Rifampin can reduce zolpidem levels in the body, making it less effective for treating insomnia.
- St. John’s Wort: St. John’s Wort is an herbal supplement used for depression and anxiety. Taking St. John’s Wort with zolpidem may lower zolpidem levels in the body, reducing its effectiveness in treating insomnia.
Zolpidem Dosages for FDA-Approved Treatment
Dosages of zolpidem vary depending on factors like age and condition being treated. The typical range for immediate-release tablets is 5 mg to 10 mg once nightly. Extended-release tablets come in 6.25 mg and 12.5 mg strengths, taken orally.2 They release the medication gradually to maintain sleep. Zolpidem is approved for adults aged 18 and older. Follow your healthcare provider’s instructions carefully and avoid exceeding the recommended dose to prevent adverse effects.
Do you have sleep apnea? Find out with at-home sleep study.
Find out if a sleep study is right for you! Do a sleep study from the comfort of your own bed. Circle Medical will send you a small WESPER sleep monitoring device, which pairs with an app on your phone. After a two-night study, you can discuss the results with your provider at Circle Medical. The cost with insurance ranges from $0 to $250.
Zolpidem Forms & Strengths
Zolpidem is available in tablet form with strengths of 5 mg and 10 mg, and extended-release tablets with strengths of 6.25 mg and 12.5 mg. The most appropriate form and strength depend on individual needs, including the severity of insomnia and the desired duration of action.
Prescribers consider factors such as age, liver function, and potential for next-day impairment when choosing between immediate-release and extended-release forms and determining dosage. Immediate-release tablets typically take effect within 15 to 30 minutes, while extended-release forms provide longer-lasting effects.
Zolpidem is available in the following forms and strengths:1,2
- 5 mg oral tablet
- 10 mg oral tablet
- 6.25 mg extended-release oral tablet
- 12.5 mg extended-release oral tablet
How Long Does it Take for Zolpidem to Start Working?
Zolpidem typically starts working within about 30 minutes after taking it. The usual starting dose for adults is one 10 mg tablet, taken right before bedtime. However, for individuals aged 65 years or older, or those with kidney or liver issues, doctors may prescribe a lower starting dose of 5 mg to minimize potential side effects.
How Should I Take Zolpidem?
To take zolpidem tartrate tablets, follow your doctor’s instructions carefully. Take one tablet at night just before bedtime. It’s important to take zolpidem on an empty stomach, as food may delay its effects. Avoid alcohol before taking zolpidem, and don’t take it if you’re unable to stay in bed for a full night.1
For extended-release tablets, swallow them whole without crushing or chewing, and take them only as prescribed. Inform your healthcare provider if you have concerns about the medication’s effectiveness or if your sleep problems persist or worsen.2
What Happens If I Miss a Dose of Zolpidem?
If you miss a dose of zolpidem, skip it and take the next dose as scheduled. Never take a double dose to make up for a missed dose. Maintaining your prescribed dosing regimen is important for the medication’s effectiveness and safety. If you have any concerns, consult your healthcare provider for guidance.
Can You Overdose on Zolpidem?
Yes, it is possible to overdose on zolpidem, especially when combined with other central nervous system depressants. Symptoms of an overdose may vary but can include severe drowsiness, confusion, difficulty breathing, slowed heart rate, and loss of consciousness, ranging from somnolence to coma. In some cases, overdosing on zolpidem can lead to cardiovascular or respiratory complications and, rarely, fatal outcomes.
What Should You Do If You Take Too Much Zolpidem?
If you take too much zolpidem, seek immediate medical help. Treatment involves supportive treatments such as IV fluids, monitoring your vital signs, and potentially gastric lavage (pumping the stomach). Flumazenil is a medication that may help, but it can also cause side effects. Doctors will monitor your vital signs and treat any complications. Discuss all medications you are taking with your doctor to reduce your risks from overdose.
How to Get a Prescription for Zolpidem
You’ll need to consult a healthcare provider as it is only available with a prescription. Doctors, including primary care physicians and psychiatrists, can prescribe zolpidem after evaluating your medical history and sleep patterns. They may conduct a physical exam and discuss your symptoms to determine if zolpidem is appropriate for you.
Circle Medical - Treatment For Insomnia
Book a video consultation with a Board-Certified primary care provider to discuss your insomnia symptoms and receive treatment. Insurance accepted. Same & next day appointments available.
To find a psychiatrist, you can start by asking your primary care doctor for a referral. Additionally, online directories, community health centers, and insurance provider websites can help you locate psychiatrists in your area.
Frequently Asked Questions
Is Zolpidem a Strong Sleeping Pill?
Zolpidem is considered a potent sleeping aid. It is used to help a person fall asleep and stay asleep. It is important to use sleep medications cautiously and for short durations as directed by your prescriber, typically no longer than a few weeks. Zolpidem is available only with a doctor’s prescription.
Is Zolpidem Safe for Long-term Use?
Long-term use of zolpidem, such as taking it nightly over an extended period, may pose risks. Continuous use can lead to tolerance, where higher doses are needed to achieve the same effects, and dependence, where stopping the medication abruptly can cause withdrawal symptoms. Additionally, prolonged use increases the likelihood of experiencing adverse effects.
Is Zolpidem a Form of Xanax?
No, zolpidem (Ambien) is not a form of Xanax (alprazolam). While both medications are used to treat insomnia, they belong to different drug classes and have distinct mechanisms of action.
Xanax is a benzodiazepine primarily used to treat anxiety disorders and panic attacks, although it may be prescribed off-label for the treatment of insomnia.3 In contrast, zolpidem is a sedative-hypnotic specifically indicated for the short-term treatment of insomnia.
Are Ambien & Zolpidem the Same Thing?
Yes, Ambien and Zolpidem are essentially the same thing. Zolpidem is the generic name for the medication, while Ambien is a brand name. Both contain the active ingredient zolpidem and are used to treat insomnia. Ambien is available in immediate-release and extended-release formulations, while Zolpidem may also be sold under different brand names. It’s important to follow your doctor’s guidance regarding the specific formulation prescribed.4
Is Zolpidem Habit-forming or Addictive?
Yes, zolpidem has the potential to be habit-forming or addictive. It is classified as a Schedule IV controlled substance due to its abuse potential.1 Addiction to zolpidem is characterized by behaviors such as impaired control over drug use, compulsive use, continued use despite harm, and craving. Individuals with a history of addiction or substance abuse should be closely monitored when using zolpidem or any other hypnotic medication.
Can Zolpidem Be Used During Pregnancy or While Breastfeeding?
Zolpidem should generally be avoided during pregnancy and breastfeeding. It may cause respiratory depression and sedation in newborns when used late in pregnancy. Limited data suggest it may pass into breast milk, potentially causing excess sedation in infants. While the benefits of breastfeeding should be considered, women taking zolpidem may need to interrupt breastfeeding temporarily to minimize drug exposure to the infant.1
Are There Zolpidem Alternatives?
Yes, there are alternatives to zolpidem, such as Lunesta, Restoril, Silenor, and Rozerem, which are other prescription sleep medications. Antidepressants and over-the-counter antihistamines may also be considered. Additionally, melatonin is a natural supplement commonly used to improve sleep and can be discussed with a healthcare provider as an alternative option.
Questions to Ask Your Healthcare Provider About Zolpidem
If you’re considering zolpidem for insomnia, it’s essential to ask your healthcare provider about its potential benefits and risks. Questions may include inquiries about dosage, potential side effects, and alternatives to zolpidem. Additionally, discuss any concerns with your psychiatrist or therapist. If you’re considering changing prescribers, online psychiatry services can be a convenient option for seeking a new healthcare provider.
Questions to ask your care team about zolpidem include:
- How safe is zolpidem?
- How long will it take for me to adjust to taking zolpidem?
- Am I at risk for more serious symptoms if I am already taking other medications?
- What is the best dosage to reduce side effects?
- Are there any lifestyle changes I should make while taking zolpidem?
- Can I take zolpidem if I have certain medical conditions?
- How should I taper off zolpidem if I decide to stop taking it?
- Are there any potential interactions between zolpidem and other substances, like alcohol or herbal supplements?
- What are the common side effects of zolpidem, and when should I seek medical attention?
- Can zolpidem affect my ability to drive or operate machinery?
- Is zolpidem habit-forming, and what steps can I take to prevent dependence?
- How often should I follow up with my healthcare provider while taking zolpidem?
- How does zolpidem compare to Belsomra?
- How does zolpidem compare to over-the-counter sleep aids as effective treatment for insomnia?
- How effective are zolpidem vs. Quviviq for treating insomnia?
In My Experience
In my experience, zolpidem has effectively treated short-term sleep problems in many patients. One individual, stressed from work, found that zolpidem improved his sleep quality. Yet, another patient faced challenges with tolerance and dependence. Good communication between patients and prescribers is important, as each person may respond differently. Seek immediate help from a healthcare professional if you experience any adverse effects or have concerns about dependence.
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