zolpidem AMBIEN

Class: Nonbenzodiazepine/​Imidazopyridine
FDA Indications: Short-term Treatment Of Insomnia
Off-Label Use: Jet Lag, Analgesia
FDA Schedule IV
Forms: 5, 10mg tablet; 6.25, 12.5mg CR tablet; 1.75, 3.5mg sublingual tab (Intermezzo)
Dose Range: 10-20 mg/day
Starting: 10 mg qhs; recommend start at 5 mg for women, elderly, patients with lower body weight. PDR lists maximum dose of 10 mg, but in practice many patients require and tolerate 20 mg QHS dosing.
Stopping: Taper to avoid rebound insomnia

NAMI drug fact sheet

Contraindications: None, other than patients with known hypersensitivity to zolpidem
Serious Side Effects: Anterograde amnesia; somnambulism (0.3-1%), sleep related eating and sleep-driving
Side Effects: daytime somnolence, dizziness, amnesia, amnesia, nausea
1° MOA: GABAAR α1 subunit agonist
Target: GABAA α1
t½: 2.5 (1.4-4.5)° TMAX: 1.5°
Absorption Rate: Rapid
Substrate of: 3A4, 2C9; 1A2
Inhibits: ∅ ; Induces:
Active Metabolites:
  • - preserves normal sleep architecture
  • - preferential binding of GABAAR α1 subunits > α23 subunits → sedation > anxiolysis
Special Populations

Category C—Crosses the placenta. No studies in pregnant women.

RID 4.7-19.1%; ∅ AE's have been reported in exposed infants

Start at 5mg to ↓ chances of motor and/or cognitive impairment

2019 BEE℞S Recommendation: Avoid. Nonbenzodiazepine benzodiazepine receptor agonist hypnotics (ie, Z drugs) have adverse events similar to those of benzodiazepines in older adults (eg, delirium, falls, fractures); increased emergency room visits/ hospitalizations; motor vehicle crashes; minimal improvement in sleep latency and duration.

No dosage adjustment necessary.

↓ dose to 5 mg qhs for hepatically impaired


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.