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Ambien CR (Oral)

Generic Name: zolpidem (Oral route)

zole-PI-dem

Medically reviewed on Oct 31, 2018

Commonly used brand name(s)

In the U.S.

  • Ambien
  • Ambien CR

Available Dosage Forms:

  • Tablet
  • Tablet, Extended Release
  • Spray

Therapeutic Class: Nonbarbiturate Hypnotic

Uses For Ambien CR

Zolpidem is used to treat insomnia (trouble sleeping). It belongs to the group of medicines called central nervous system (CNS) depressants, which slows 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 Ambien CR

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.

Pediatric

Use of zolpidem is not recommended in children. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of zolpidem in the elderly. However, elderly patients are more sensitive to the effects of this medicine (eg, confusion, dizziness, and falling) than younger adults.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with 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 not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Sodium Oxybate

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.

  • Alfentanil
  • Alprazolam
  • Amobarbital
  • Anileridine
  • Baclofen
  • Benzhydrocodone
  • Boceprevir
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Carbinoxamine
  • Carisoprodol
  • Ceritinib
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpromazine
  • Chlorzoxazone
  • Ciprofloxacin
  • Clarithromycin
  • Clobazam
  • Clonazepam
  • Clorazepate
  • Cobicistat
  • Codeine
  • Conivaptan
  • Cyclobenzaprine
  • Dexmedetomidine
  • Diacetylmorphine
  • Diazepam
  • Difenoxin
  • Dihydrocodeine
  • Diphenhydramine
  • Diphenoxylate
  • Doxylamine
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethylmorphine
  • Fentanyl
  • Flibanserin
  • Flumazenil
  • Flunitrazepam
  • Flurazepam
  • Fosnetupitant
  • Fospropofol
  • Halazepam
  • Hydrocodone
  • Hydromorphone
  • Hydroxyzine
  • Idelalisib
  • Indinavir
  • Itraconazole
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Levorphanol
  • Lofexidine
  • Lopinavir
  • Lorazepam
  • Loxapine
  • Meclizine
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Metoclopramide
  • Midazolam
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nefazodone
  • Nelfinavir
  • Netupitant
  • Nicomorphine
  • Nitrazepam
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Periciazine
  • Phenobarbital
  • Piritramide
  • Posaconazole
  • Prazepam
  • Primidone
  • Promethazine
  • Propofol
  • Quazepam
  • Ramelteon
  • Remifentanil
  • Ritonavir
  • Saquinavir
  • Secobarbital
  • Sufentanil
  • Tapentadol
  • Telaprevir
  • Telithromycin
  • Temazepam
  • Thiopental
  • Thioridazine
  • Tilidine
  • Tizanidine
  • Topiramate
  • Tramadol
  • Triazolam
  • Voriconazole
  • Zaleplon
  • Zolpidem
  • Zopiclone

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
  • Desipramine
  • Fluvoxamine
  • Rifampin
  • Sertraline
  • St John's Wort
  • Venlafaxine

Interactions with Food/Tobacco/Alcohol

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 is usually not recommended, 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

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, or 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.
  • Liver disease, severe—Use must be avoided in patients with this condition. May increase risk of developing encephalopathy (brain disease).

Proper Use of zolpidem

This section provides information on the proper use of a number of products that contain zolpidem. It may not be specific to Ambien CR. Please read with care.

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.

Take this medicine on an empty stomach.

Do not take this medicine if you have drank alcohol the same evening.

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. Take only 1 dose a night as needed.
      • Older adults—6.25 mg once a day at bedtime.
      • Children—Use is not recommended.
    • 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. Take only 1 dose a night as needed.
      • Older adults—5 mg once a day at bedtime.
      • Children—Use is not recommended.

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 Ambien CR

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.

Using this medicine while you are pregnant can harm your unborn baby, especially if you use this medicine while in your third trimester of pregnancy. Tell your doctor if you are pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away.

Zolpidem may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. 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, or severe injuries (eg, hip fractures, severe bleeding in the head). Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

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 any of these 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 serious breathing problems and unconsciousness. Some signs of an overdose include: 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 (eg, St. John's wort) or vitamin supplements.

Ambien CR Side Effects

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 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

Rare

  • Anxiety
  • attack, assault, or force
  • black, tarry stools
  • bladder pain
  • bloody or cloudy urine
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in walking and balance
  • chills
  • cold sweats
  • cough
  • crying
  • decreased awareness or responsiveness
  • deep or fast breathing with dizziness
  • delusions of persecution, mistrust, suspiciousness, or combativeness
  • difficult, burning, or painful urination
  • difficulty swallowing
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  • dry mouth
  • fainting
  • false beliefs that cannot be changed by facts
  • feeling of unreality
  • fever
  • frequent urge to urinate
  • hives, itching, or skin rash
  • irregular heartbeat
  • irritability
  • lack of feeling or emotion
  • light-colored stools
  • lower back or side pain
  • nausea
  • numbness of the feet, hands, and around the mouth
  • pale skin
  • poor insight and judgment
  • problems with memory or speech
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • quick to react or overreact emotionally
  • rapidly changing moods
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • sense of detachment from self or body
  • severe sleepiness
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain
  • swollen glands
  • thoughts of killing oneself or changes in behavior
  • tightness in the chest
  • trouble recognizing objects
  • trouble thinking and planning
  • trouble walking
  • troubled breathing with exertion
  • uncaring
  • unusual bleeding or bruising
  • vomiting
  • yellow eyes or skin
  • unease or dissatisfaction with life

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

  • Back pain
  • being forgetful
  • belching
  • body aches or pain
  • congestion
  • diarrhea
  • difficulty having a bowel movement
  • 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
  • pain or tenderness around the eyes and cheekbones
  • seeing double
  • sensation of spinning
  • stomach discomfort
  • tender, swollen glands in the neck
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • voice changes

Rare

  • Bad, unusual, or unpleasant (after) taste
  • blemishes on the skin
  • blindness
  • blurred vision
  • breast pain
  • change in near or distance vision
  • change in taste
  • changes in patterns and rhythms of speech
  • decreased interest in sexual intercourse
  • difficulty in focusing the 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
  • increased sweating
  • itching of the vagina or genital area
  • lack or loss of strength
  • loss in sexual ability, desire, drive, or performance
  • pain during sexual intercourse
  • paleness of the skin
  • pimples
  • redness of the face, neck, arms, and occasionally, upper chest
  • redness or other discoloration of the skin
  • severe sunburn
  • slurred speech
  • stomach upset
  • straining while passing stool
  • tearing
  • thick, white vaginal discharge with no odor or with a mild odor
  • 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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