Zolpidem Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Zolpidem Tablet (zolpidem tartrate) is a prescription hypnotic, or Z-drug, used for the short-term treatment of insomnia in adults. It helps people fall asleep faster and can reduce nighttime awakenings during short-term use. Because it can cause dependence, it is meant to be used only for brief periods, typically a couple of days up to 4 weeks, and only as prescribed.

What is Zolpidem Tablet

Zolpidem is a prescription sleep medicine that belongs to a group of medicines called hypnotics, also known as Z-drugs. It acts on the brain to help you sleep and is used only for short periods of time because it can cause dependence.

Zolpidem Tablet uses

• Difficulty falling asleep
• Waking in the middle of the night
• Waking too early
• Short-term treatment of insomnia in adults

Benefits of Zolpidem Tablet

• Helps you fall asleep faster
• Can help reduce nighttime awakenings and increase total sleep time during short-term use

How Zolpidem Tablet works

Zolpidem works by acting on the brain to help you sleep. It attaches to certain brain receptors and boosts the effect of a natural calming brain chemical called GABA, which lowers brain activity and helps you fall asleep faster.

Zolpidem Tablet dosage

Take this medicine by mouth and swallow the tablet whole with a drink of water. Take it as a single dose just before bedtime; do not take another dose during the same night. Only take it when you are able to stay in bed for a full 7 to 8 hours before you need to be active again. Do not take it with or right after a meal, since food can slow down how quickly it works.

If you forget a dose at bedtime, do not take it later in the night or day, and do not double up to make up for a missed dose. Treatment should be as short as possible, usually lasting from a couple of days up to 4 weeks. Do not stop taking it suddenly; your doctor will guide you on gradually lowering the dose over time.

Elderly patients and those with liver problems are usually given a lower dose. Do not give this medicine to anyone under 18 years old.

Available forms and strengths

• Tablet (film-coated, 5mg and 10mg strengths)

Side effects of Zolpidem Tablet

Common

• Poor memory (amnesia) and strange behaviour, more likely in the first hours after taking the tablet
• Sleeping problems that get worse after taking this medicine
• Seeing or hearing things that are not real (hallucinations)
• Diarrhoea
• Feeling sick (nausea) or being sick (vomiting)
• Abdominal pain
• Respiratory infection
• Headache
• Feeling tired or agitated
• Nightmares
• Depression
• Feeling dizzy
• Feeling sleepy or drowsy
• Back pain

Serious

• Severe allergic reaction: itchy lumpy rash, swelling of hands, feet, ankles, face, lips or throat, difficulty swallowing or breathing
• Sleep-driving, sleepwalking, or other complex activities done while not fully awake, with no memory of them afterward
• Falling, especially in the elderly
• Slower breathing (respiratory depression)
• Liver problems, including jaundice, dark urine, pale or bloody stools, severe itching, extreme weakness
• Thinking things that are not true (delusions)
• Becoming dependent on or addicted to zolpidem
• A feeling of being out of touch with reality (psychosis)
• Worsening depression or suicidal thoughts

Warnings and precautions

• Zolpidem can cause complex sleep behaviors such as sleepwalking, sleep-driving, preparing and eating food, or having sex while not fully awake, with no memory of it afterward. These can lead to serious injury or death.
• This medicine can cause dependence, tolerance, and addiction. Stopping it suddenly can cause withdrawal symptoms.
• Combining zolpidem with opioids increases the risk of severe drowsiness, breathing difficulties, coma, and can be life-threatening.
• Do not take zolpidem if you have sleep apnoea, myasthenia gravis, breathing difficulties, severe liver problems, psychosis, or are under 18.
• Severe allergic reactions, including anaphylaxis and swelling of the tongue or throat, have occurred with zolpidem.
• Zolpidem is not recommended during pregnancy. 
• If you find out you are pregnant or are planning a baby, talk to your doctor right away, since taking it late in pregnancy can affect the baby's breathing, temperature, feeding, and muscle tone, and may cause withdrawal symptoms in the newborn.
• Do not take zolpidem while breastfeeding or planning to breastfeed, because small amounts can pass into breast milk.
• People with liver problems are usually started on a lower dose. This medicine should not be used in people with severe liver problems.
• Do not drink alcohol while taking zolpidem, as it can increase the effects of the medicine and cause very deep sleep with breathing or waking difficulties.
• Do not drive or use machinery the day after taking zolpidem if you feel sleepy, dizzy or confused. Wait at least 8 hours after taking the medicine before doing activities that need full alertness.

Storage

• Keep this medicine out of the sight and reach of children.
• Do not use after the expiry date stated on the carton; the expiry date refers to the last day of that month.
• Store in a dry place below 30°C in the original packaging.
• Do not throw away any medicines via wastewater or household waste; ask your pharmacist how to dispose of medicines you no longer use.

When to see a doctor

• Stop taking zolpidem and get emergency medical help right away if you have signs of a severe allergic reaction, such as an itchy or lumpy rash, or swelling of your hands, feet, face, lips, or throat with difficulty breathing or swallowing.
• Get medical help immediately if you find out you have done activities like sleep-driving, sleepwalking, or other actions while not fully awake, and do not remember them.
• Contact your doctor as soon as possible if you have thoughts of harming yourself or suicidal thoughts.
• If you take more zolpidem than you should, tell a doctor or go to a hospital casualty department straight away, and take the medicine pack with you.
• Get emergency help right away if you develop breathing problems while taking this medicine.

Alternatives

• Eszopiclone
• Trazodone
• Melatonin