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Zolpidem (Oral route)

Pronunciation:

zole-PI-dem

Brand Names:

  • Ambien
  • Ambien CR

Dosage Forms:

  • Tablet, Extended Release
  • Tablet

Classifications:

Therapeutic—

Nonbarbiturate Hypnotic

Uses of This Medicine:

Zolpidem is used to treat insomnia (sleeping problems). It belongs to the group of medicines called central nervous system (CNS) depressants. These medicines will slow down the nervous system. Zolpidem will help you get to sleep faster and sleep through the night. In most cases, sleep medicines should only be used for short periods of time, such as 1 or 2 days, and for no longer than 1 or 2 weeks.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of zolpidem in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of zolpidem in the elderly. However, confusion, dizziness, and falling are more likely to occur in the elderly, who are more sensitive than younger adults to the effects of zolpidem.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alprazolam
  • Buspirone
  • Butabarbital
  • Carbamazepine
  • Carbinoxamine
  • Chlordiazepoxide
  • Chlorpromazine
  • Clonazepam
  • Clorazepate
  • Cobicistat
  • Crizotinib
  • Dabrafenib
  • Dexmedetomidine
  • Diazepam
  • Diphenhydramine
  • Doxylamine
  • Eslicarbazepine Acetate
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Fentanyl
  • Flumazenil
  • Flurazepam
  • Fospropofol
  • Halazepam
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Lorazepam
  • Meclizine
  • Meprobamate
  • Midazolam
  • Mitotane
  • Oxazepam
  • Oxycodone
  • Pentobarbital
  • Phenobarbital
  • Piperaquine
  • Prazepam
  • Primidone
  • Promethazine
  • Propofol
  • Quazepam
  • Ramelteon
  • Secobarbital
  • Tapentadol
  • Temazepam
  • Thioridazine
  • Triazolam
  • Zaleplon

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Bupropion
  • Ciprofloxacin
  • Desipramine
  • Fluvoxamine
  • Ketoconazole
  • Perampanel
  • Rifampin
  • Sertraline
  • St John's Wort
  • Telaprevir
  • Venlafaxine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol
  • food

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse, history of or
  • Drug abuse or dependence, history of—Dependence on zolpidem may develop.
  • Depression, history of or
  • Lung disease or other breathing problems or
  • Mental illness, history of or
  • Myasthenia gravis (muscle disease) or
  • Sleep apnea (breathing problems during sleep)—Use with caution. May make these conditions worse.
  • Liver disease—Use with caution. Higher blood levels of zolpidem may result, increasing the chance of side effects.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may become habit-forming (causing mental or physical dependence).

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Take zolpidem just before going to bed, when you are ready to go to sleep. This medicine works very quickly to put you to sleep.

Swallow the extended-release tablet whole. Do not divide, crush, or chew it.

Do not take this medicine when your schedule does not permit you to get a full night's sleep (7 to 8 hours). If you must wake up before this, you may continue to feel drowsy and may experience memory problems, because the effects of the medicine have not had time to wear off.

Zolpidem should not be taken with food or right after a meal. It will work faster if you take it on an empty stomach.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treatment of insomnia:
    • For oral dosage form (extended-release tablets):
      • Adults—6.25 milligrams (mg) (for women) or 6.25 or 12.5 mg (for men) once a day at bedtime. Your doctor may increase your dose as needed. However, do not take more than 12.5 mg per day.
      • Older adults—6.25 mg once a day at bedtime.
      • Children—Use and dose must be determined by the doctor.
    • For oral dosage form (tablets):
      • Adults—5 milligrams (mg) for women and 5 or 10 mg for men once a day at bedtime. Your doctor may increase your dose as needed. However, do not take more than 10 mg per day.
      • Older adults—5 mg once a day at bedtime.
      • Children—Use and dose must be determined by the doctor.

Missed dose—

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Use this medicine only when you cannot sleep. You do not need to keep a schedule for taking it.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

Zolpidem may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Stop taking this medicine and call your doctor right away if you have a rash, itching, hives, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

If you think you need to take zolpidem for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Even though zolpidem is taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Also, this medicine may cause double vision or other vision problems. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert or not able to see well.

If you develop any unusual and strange thoughts or behavior while you are taking zolpidem, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine may cause you to do things while you are still asleep that you may not remember the next morning. It is possible you could drive a car, sleepwalk, have sex, make phone calls, or prepare and eat food while you are asleep or not fully awake. Tell your doctor right away if you learn that this has happened.

Do not change your dose or stop taking it without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of zolpidem or taking alcohol or other CNS depressants with zolpidem may lead to breathing problems and unconsciousness. Some signs of an overdose are severe drowsiness, severe nausea or vomiting, staggering, and troubled breathing.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
Chest pain
confusion
confusion about identity, place, and time
discouragement
false or unusual sense of well-being
fast, irregular, pounding, or racing heartbeat or pulse
feeling sad or empty
fever
general feeling of discomfort or illness
irritability
lack of appetite
lightheadedness
loss of interest or pleasure
shakiness and unsteady walk
tiredness
trouble concentrating
trouble sleeping
unsteadiness, trembling, or other problems with muscle control or coordination
unusual tiredness or weakness
Less common or rare
Anxiety
bladder pain
bloody or cloudy urine
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
cold sweats
crying
decreased awareness or responsiveness
depersonalization
difficult, burning, or painful urination
dizziness, faintness, or lightheadedness when getting up from lying or sitting position
dry mouth
dysphoria
euphoria
fainting
frequent urge to urinate
hyperventilation
irregular heartbeats
irritability
lower back or side pain
paranoia
quick to react or overreact emotionally
rapidly changing moods
restlessness
seeing, hearing, or feeling things that are not there
severe sleepiness
shakiness in the legs, arms, hands, or feet
shortness of breath
trembling or shaking of the hands or feet
Rare
Attack, assault, or force
black, tarry stools
change in walking and balance
clumsiness or unsteadiness
cough
delusions
dementia
difficulty swallowing
dizziness
hives
itching
lack of feeling or emotion
pale skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
skin rash
sore throat
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
thoughts of killing oneself or changes in behavior
tightness in the chest
troubled breathing with exertion
uncaring
unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Drowsiness
headache
muscle aches
sleepiness or unusual drowsiness
stuffy or runny nose
Less common
Abdominal or stomach discomfort
acid or sour stomach
back pain
being forgetful
belching
body aches or pain
congestion
diarrhea
difficulty having a bowel movement (stool)
difficulty with moving
double vision
feeling of constant movement of self or surroundings
heartburn
hoarseness
indigestion
longer or heavier menstrual periods
loss of memory
muscle pain or stiffness
nausea
pain or tenderness around the eyes and cheekbones
seeing double
sensation of spinning
tender, swollen glands in the neck
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
voice changes
Less common or rare
Bad, unusual, or unpleasant (after) taste
breast pain
change in taste
changes in patterns and rhythms of speech
increased sweating
itching of the vagina or genital area
pain during sexual intercourse
paleness of the skin
slurred speech
thick, white vaginal discharge with no odor or with a mild odor
vomiting
Rare
Blemishes on the skin
blindness
blurred vision
change in near or distance vision
decreased interest in sexual intercourse
difficulty in focusing eyes
eye pain
feeling of warmth
frequent urge to defecate
inability to have or keep an erection
increased appetite
increased sensitivity of the skin to sunlight
lack or loss of strength
loss in sexual ability, desire, drive, or performance
pimples
redness of the face, neck, arms, and occasionally, upper chest
redness or other discoloration of the skin
severe sunburn
stomach upset
straining while passing stool
tearing
weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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