Ambien: 7 things you should know
Medically reviewed by C. Fookes, BPharm Last updated on Oct 15, 2019.
1. How it works
- Ambien is a brand (trade) name for zolpidem. Zolpidem causes sedative effects by enhancing the effects of GABA, a chemical transmitter in the brain. However, zolpidem's chemical structure is different from benzodiazepines.
- Ambien belongs to the class of medicines known as sedative-hypnotics. It may also be called a Z-drug.
- May be used for the short-term relief of insomnia.
- Ambien is available as an immediate-release tablet to help people who have trouble falling asleep and in an extended-release form, called Ambien CR, which has two layers. The first layer dissolves quickly to help people fall asleep, and the second layer dissolves slowly to help people to stay asleep.
- Ambien is available as a generic under the name zolpidem.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Drowsiness and unsteadiness on standing leading to an increased risk of falls, a drugged feeling, lightheadedness, and a headache, are the most commonly reported side effects.
- Ambien is intended as a sleep aid. People should not drive or operate machinery after taking Ambien. Alcohol can exacerbate the effects of Ambien and should be avoided.
- Only take Ambien or Ambien CR if you intend to stay in bed a full night (7 to 8 hours).
- Ambien can be habit-forming. Only take as recommended by your doctor and for the shortest time possible. Never share it with another person and keep it away from children or others who may misuse it. Selling or giving away this medicine is against the law. Ambien may not be suitable for people with a history of substance abuse or addictive disorders. Keep legitimate supplies of Ambien out of sight of potential drug seekers.
- There have been reports of withdrawal symptoms occurring on abrupt discontinuation of Ambien. Symptoms may include low mood, insomnia, tremor, abdominal and muscle cramps, vomiting, sweating, and rarely seizures. Ambien should be tapered off slowly on discontinuation.
- Reports of "sleep-driving” (driving while not fully awake), and other behaviors (such as eating, making phone calls, or having sex) after Ambien ingestion are documented. The risk may be exacerbated by large doses or alcohol. Seek medical advice if this occurs.
- May interact with several other medicines, including other drugs that have sedation as a side effect. See prescribing information for a full list of interactions.
- May not be suitable for some people including those with respiratory disease, kidney or liver disease, psychiatric illness, or those with a history of substance abuse or addictive disorders.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- Food delays the speed of Ambien's effect. Ambien will work faster if not taken with food.
- Take tablets immediately before going to bed, not sooner. Do not take Ambien if you have drunk alcohol that evening or before bed. Do not take Ambien if you are unlikely to stay in bed for the next seven to eight hours.
- Ambien CR may help you to stay asleep, as well as promoting sleep initiation. Do not cut, crush, or chew this formulation. Take only as directed by your doctor. Do not increase the dosage without your doctor's advice.
- Higher dosages and the CR formulation may impair next-day alertness and your ability to drive. Do not drive or perform other hazardous tasks if you still feel sleepy the next day.
- Ambien should not be given to children because its safety and effectiveness in children have not been demonstrated.
- Tell your doctor if your sleep worsens after taking Ambien.
- Only use Ambien for short periods of time to help with sleep (ideally no more than seven to ten days) as it can be habit-forming. Sleep disturbance can be a sign of some other underlying disorder. Call your doctor if your insomnia worsens or does not improve within seven to ten days.
- Ambien can increase your risk of falls, particularly if you need to get up in the middle of the night to go to the toilet. Remove any fall hazards from your house (such as loose rugs) and slowly get out of bed when getting up in the middle of the night.
- Seek immediate medical advice if you experience any unusual side effects from Ambien such as worsening of insomnia, aggressiveness, hallucinations, or bizarre behaviors.
- Talk to your doctor or pharmacist before buying other medications over the counter to check that they are compatible with Ambien.
6. Response and Effectiveness
- The time to Ambien's peak effect varies depending on whether the Ambien is immediate or controlled release (CR) but ranges from just over half an hour to 1.5 hours. Food delays the time Ambien takes to reach peak levels.
- Ambien CR has two layers: the first dissolves quickly to help you fall asleep, and the second layer dissolves slowly to help you stay asleep.
Medicines that interact with Ambien may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Ambien. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Ambien include:
- anti-anxiety medications, including benzodiazepines, such as diazepam and oxazepam
- anticonvulsants such as valproate
- antidepressants, such as amitriptyline, imipramine, nortriptyline
- antifungal medications, such as itraconazole, or ketoconazole
- antihistamines that cause sedation, such as diphenhydramine
- monoamine oxidase inhibitors, such as selegiline, isocarboxazid, or phenelzine
- opioid analgesics such as codeine, oxycodone and morphine
- muscle relaxants such as cyclobenzaprine
- sleeping pills, such as eszopiclone
- some medications used to treat mental illness, such as clozapine and thioridazine
- St. John's Wort
Alcohol may worsen the side effects of Ambien such as drowsiness and dizziness.
Note that this list is not all-inclusive and includes only common medications that may interact with Ambien. You should refer to the prescribing information for Ambien for a complete list of interactions.
Ambien (zolpidem). Revised: 08/2019. Sanofi-Aventis U.S. LLC https://www.drugs.com/pro/ambien.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ambien only for the indication prescribed.
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