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Intermezzo

Generic Name: zolpidem sublingual (zole PI dem)
Brand Names: Intermezzo

Medically reviewed by P. Thornton, DipPharm. Last updated on Dec 13, 2018.

What is Intermezzo?

Intermezzo (zolpidem) is a sedative, also called a hypnotic. It affects chemicals in your brain that may become unbalanced and cause sleep problems (insomnia).

Intermezzo sublingual tablets are used to treat insomnia characterized by middle-of-the-night waking followed by difficulty returning to sleep.

Intermezzo should only be used when a person has at least four hours of bedtime remaining. It should not be taken if alcohol has been consumed or with any other sleep aid.

Intermezzo is a class four federally controlled substance because it can be abused or lead to dependence. Keep this medicine in a safe place to prevent misuse and abuse.

Important Information

Intermezzo may cause a severe allergic reaction. Stop taking Intermezzo and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Do not share this medication with another person, even if they have the same symptoms you have. The recommended doses of zolpidem are not the same in men and women, and this drug is not approved for use in children. Misuse of this medication can result in dangerous side effects.

Intermezzo may impair your thinking or reactions. You may still feel sleepy the morning after taking this medicine, especially if you are a woman. Wait at least 4 hours or until you are fully awake before you do anything that requires you to be awake and alert.

Never take Intermezzo in larger amounts or for longer than prescribed.

Do not take this medicine if you have consumed alcohol during the day or just before bed.

Some people using Intermezzo have engaged in activity such as driving, eating, walking, making phone calls, or having sex and later having no memory of the activity. If this happens to you, stop taking this medicine and talk with your doctor about another treatment for your sleep disorder.

Before taking this medicine

You should not use Intermezzo if you are allergic to zolpidem.

Intermezzo is not approved for use by anyone younger than 18 years old.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

  • depression, mental illness, or suicidal thoughts;

  • drug or alcohol addiction;

  • lung disease or breathing problems;

  • sleep apnea (breathing stops during sleep); or

  • liver or kidney disease.

Taking zolpidem in the last 3 months of pregnancy may cause drowsiness or breathing problems in your newborn.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

How should I take Intermezzo?

Take Intermezzo exactly as prescribed by your doctor. Follow all directions on your prescription label. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Never take this medicine in larger amounts, or for longer than prescribed.

Do not swallow an Intermezzo tablet whole. Place the tablet under your tongue and allow it to dissolve in your mouth without water.

Do not take Intermezzo for middle-of-the-night insomnia unless you have 4 hours of sleep time left before being active.

Intermezzo is for short-term use only. Tell your doctor if your insomnia symptoms do not improve, or if they get worse after using this medication for 7 to 10 nights in a row. Do not take this medicine for longer than 4 or 5 weeks without your doctor's advice.

Do not stop using Intermezzo suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using the medicine.

Insomnia symptoms may also return after you stop taking this medicine. These symptoms may seem to be even worse than before you started taking the medication. Call your doctor if you still have worsened insomnia after the first few nights without taking zolpidem.

Store at room temperature away from moisture and heat. Do not freeze. Keep the medication in a place where others cannot get to it.

Intermezzo dosing information

Usual Adult Dose for Insomnia:
Intermezzo Sublingual Tablet: Initial and Maximum Dose: 1.75 mg (women) OR 3.5 mg (men)

Comments: The recommended initial doses for women and men are different due to the lower rate of drug clearance in females.
Use: as needed treatment of insomnia when a middle-of-the-night awakening is followed by difficulty returning to sleep.

Usual Geriatric Dose for Insomnia:
Intermezzo Sublingual Tablet: Men and women over the age of 65 years: 1.75 mg

What happens if I miss a dose?

Since Intermezzo is only taken if you awaken during the night and only if needed, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of zolpidem can be fatal, especially when it is taken together with other medications that can cause drowsiness.

Overdose symptoms may include sleepiness, confusion, shallow breathing, feeling light-headed, fainting, or coma.

What should I avoid while taking Intermezzo?

Avoid taking Intermezzo during travel, such as to sleep on an airplane. You may be awakened before the effects of the medicine have worn off. Amnesia (forgetfulness) is more common if you do not get a full 7 to 8 hours of sleep after taking zolpidem.

Avoid driving or hazardous activity until you know how zolpidem will affect you. You may still feel sleepy the morning after taking zolpidem, and your reactions could be impaired. Wait until you are fully awake before you drive, operate machinery, pilot an airplane, or do anything that requires you to be awake and alert.

Do not take this medicine if you have consumed alcohol during the day or just before bed.

Intermezzo side effects

Intermezzo may cause a severe allergic reaction. Stop taking Intermezzo and get emergency medical help if you have signs of an allergic reaction to zolpidem: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: depression, anxiety, aggression, agitation, confusion, unusual thoughts, hallucinations, memory problems, changes in personality, risk-taking behavior, decreased inhibitions, no fear of danger, or thoughts of suicide or hurting yourself.

Stop using Intermezzo and call your doctor at once if you have:

  • chest pain, fast or irregular heartbeat, feeling short of breath;

  • trouble breathing or swallowing; or

  • feeling like you might pass out.

The sedative effect of zolpidem may be stronger in older adults.

Dizziness or severe drowsiness can cause falls, accidents, or severe injuries.

Common Intermezzo side effects may include:

  • daytime drowsiness, dizziness, weakness, feeling "drugged" or light-headed;

  • tired feeling, loss of coordination;

  • stuffy nose, dry mouth, nose or throat irritation;

  • nausea, constipation, diarrhea, upset stomach; or

  • headache, muscle pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Intermezzo?

Using Intermezzo with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Many drugs can interact with zolpidem, making it less effective or increasing side effects. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Intermezzo only for the indication prescribed.

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

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