Ambien (zolpidem tartrate)

About Ambien

Ambien belongs to a new class of sleep medication prescribed for insomnia, frequent awakening, or persistent early waking. You should only take Ambien when you have time for 6-8 hours of sleep. This drug is usually prescribed for no more than a week or two, though if used infrequently and at lower doses, it may be used to correct sleep disturbances that do not respond to a short period of treatment. Ambien is metabolized much more quickly than other common sleep medications, so is far less likely to leave you feeling sleepy in the morning.

While Ambien works effectively to decrease the amount of time it takes to get to sleep, it's best to combine it with a 'sleep hygiene' regimen. Maintaining a regular bedtime, avoiding caffeine and heavy foods in the evening, and giving yourself time to relax before going to bed, are all ways to make your treatment as successful as possible.

Ambien is only available by prescription.

Ambien Side Effects

Ambien may interfere with some laboratory tests, consult your doctor or the test lab in advance for instructions. Notify your doctor if you experience any side effects at all on waking the next morning if you have had a full night's rest.

Normal Side Effects: Drowsiness. Take Ambien only on going to bed, not more than 5-15 minutes before actually lying down.

Consult your doctor about the best way to discontinue Ambien, as you will likely have difficulty sleeping for a night or two after you stop taking it. This is normal, but the effect can be minimized by slowly stepping off your treatment. If you continue to maintain a regular bedtime schedule, this will also help to minimize rebound sleeplessness.

Less Common Side Effects: amnesia (if taken on a plane), decreased appetite, drowsiness (daytime), dizziness, diarrhea, high blood sugar, migraine, nausea, water retention.

Rare Side Effects - Consult your doctor immediately if any of the following occur: agitation, blurred vision, confusion, glaucoma, hallucination, heart problems, high blood pressure, irritability, muscle spasm, muscle tremor, nightmares, rash, sleep walking, suicidal or abnormal thoughts.

Cautions: There are few cautions for Ambien use, and fewer absolute contraindications for this treatment. While the possibility exists that allergic reaction could occur, or that you may experience unpleasant side effects, this sleep medication is considered to be very safe.

Please inform your physician of any of the following circumstances, drug allergies, or medications you may be taking now. Be sure that your doctor clearly explains how to use this medication, and any special precautions you may need to take.

Allergy: An allergic reaction to this drug in the past, or during treatment, is a contraindication for continued use. This is very rare.
Depression or mental illness: Your doctor might consider another treatment, as Ambien may not be suitable in combination with all other medications for these conditions. The risk of unusual mental side effects may be increased, report any changes in thinking or behavior to your doctor.
Diabetes: Ambien may occasionally cause high blood sugar.
Glaucoma: In rare cases Ambien may cause this condition.
Heart problems: In rare cases Ambien may cause or worsen these conditions.
History of alcoholism or drug abuse: May increase your risk of dependence or of dangerous drug interactions, may be more likely to have some liver impairment.
Kidney or liver impairment: Your doctor may decrease your dose of Ambien, especially in cases of liver problems, by 50%.
Lung condition (serious): In rare cases Ambien has exacerbated respiratory problems.
Pregnancy or intention to become pregnant: Ambien is not considered safe for pregnant or nursing women.
Sleep Apnea (temporary suspension of breathing during sleep) - Ambien may worsen this condition. Individuals with sleep apnea should not generally use sedatives as sleep aids.

Ambien Interactions

Ambien is a central nervous system depressant, and may react strongly with other medication that has a similar effect. Be cautious about taking Ambien with any medication that warns it 'may cause drowsiness' or cautions you against driving or operating heavy machinery. Check the labels on over the counter medication, as these will not all mix safely with your treatment.

Alcohol - Ambien and alcohol can accelerate central nervous system depression. Avoid mixing the two, as this could increase side effects and possibly be dangerous. Drinking alcohol may also contribute to insomnia, decreasing the effectiveness of your treatment, even if you do not directly mix them. Ambien users are generally advised to avoid alcohol use.
Azole antifungals - Drugs like Diflucan (fluconazole), Nizoral (ketoconazole), and Sporanox (itraconazole), may lead to a toxic buildup of Ambien.
Benzodiazepines (a class of antidepressants, anti-panic agents, sleep medications, and muscle relaxants) such as Ativan (lorazepam), Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium (chlordiazepoxide), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, may increase the risk of side effects. The sleep medications of this class, Halcion and ProSom, should never be used at the same time as Ambien. Do not take multiple sleep medications together.
Caffeine - This stimulant may decrease the effectiveness of Ambien treatment, do not take it in the afternoon or evening while taking Ambien. Caffeine may be found in soda, coffee, tea (except herbal teas), some herbal diet formulas, and chocolate.
Desyrel (trazodone) - Risk of additive CNS depression.
Effexor (venlafaxine) may increase the risk of hallucinations when taken with Ambien, do not combine these treatments.
Ephedra - This herb may act as a stimulant, decreasing the effects of the medication.
Ginseng - This herb may act as a stimulant, decreasing the effects of the medication.
Kava kava - Do not take this herb while using Ambien, oversedation may result.
Kola nut - This herb may act as a stimulant, decreasing the effects of the medication.
Ma Huang - This herb may act as a stimulant, decreasing the effects of the medication.
Narcotic pain medication, like Codeine, Demerol (meperidine), Buprenex (buprenorphine), Darvon (propoxyphene), Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine, OxyContin (oxycodone), Percocet (oxycodone, acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine), Vicodin (hydrocodone, acetaminophen), or Vicoprofen (hydrocodone, ibuprofen) should not be mixed with Ambien, except under the direction of your physician. If your doctor gives you instructions concerning how long to wait between taking these medications, follow them exactly.
Norflex (orphenadrine) - Risk of oversedation.
Norvir (ritonavir) may lead to a toxic buildup of Ambien.
Nicotine - This stimulant may decrease the effectiveness of Ambien treatment.
Rifater (rifampin) may decrease the benefits of Ambien.
Sedatives like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal (butalbital, aspirin, and caffeine), Phenobarbitol, Seconal, or other barbiturates.
Selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline) may increase the risk of side effects from Ambien.
Skeletal muscle relaxants such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with Ambien.
Sleep medication like Sonata (zaleplon) or over the counter sleeping pills should not be used with Ambien.
St. John's Wort - Do not take this herb while using Ambien.
Tranquilizers like Haldol (haloperidol), Mellaril (thioridazine), or Thorazine (chlorpromazine) may cause oversedation in combination with Ambien.
Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the risk of side effects from Ambien.
Valerian - Do not take this herb while using Ambien.
Wellbutrin or Zyban (bupropion) - May increase risk of side effects.

If you are unsure about the safety of combining any medication with Ambien, consult your doctor or pharmacist.

Ambien Dosages

Ambien is available in 5 mg and 10 mg doses. A 10 mg dose is the most common, individuals are not advised to take more than 10 mg per day.

If you are being treated for a long term sleep disorder that responds slowly to treatment, your doctor may suggest lowering your Ambien dosage to 5 mg and take it only 2-4 times per week, or on nights when you can't sleep. Lower, less frequent doses of Ambien will decrease chances of tolerance, which would render treatment ineffective.

Ambien Directions

Take Ambien on an empty stomach right as you are going to bed. Food will slow absorption of this medication and delay sleep onset. The tablets may be broken or crushed. Do not take double doses; take only as much and only as often as your doctor suggests.

Ambien may make you sleepy very suddenly within 10-20 minutes of taking it; if you are not lying down, you may experience a decrease of coordination or find that it is difficult to think clearly. Ambien should be taken only at bedtime, and you should not attempt to drive or operate machinery for at least six hours after use. Take this medication only when you will have time for a full night's sleep, at least 6-8 hours for most people. If you have less time to sleep, it is much more likely that you will still feel sedated or lethargic when you get up. Be cautious if you plan to drive or perform dangerous tasks the next morning, avoid these activities if you find yourself feeling tired or experience slowed reactions.

Ambien may cause rebound sleeplessness if you stop taking it abruptly. Your doctor may advise you to cut your dose to 5 mg before stopping Ambien treatment to minimize this.

Store Ambien away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.

Keep Ambien away from children; both when storing it, and when discarding any unused medication.

Ambien is a trademark of Sanofi-Synthelabo, Inc.

This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. The dosages mentioned are general manufacturers guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. Dosage recommendations for children and seniors may vary significantly from standard dosages, and pregnant women should always speak to their OB/GYN before taking any medication. We have made every effort to ensure that the information presented is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.