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Ambien (Zolpidem)

Ambien (Zolpidem) is a non-benzodiazepine drug used mostly to treat insomnia.

Ambien: an overview and highlights

Ambien is branded name of zolpidem tartrate tablets manufactured by an American company Sanofi-Aventis. It comes in two forms, Ambien and Ambien CR.

CR is an abbreviation that stands for controlled release: it means that the formula and production process of the medication guarantee that it is released rationally and controllably in the body.

The active ingredient in both is still zolpidem tartrate, so we will be focusing on Ambien in this article. This material covers the key aspects of Ambien’s mechanism of action, indications, precautions, etc.

Availability

Ambien is a prescription-only medication. It is manufactured in 5 mg and 10 mg strength tablets to be taken orally (through the mouth).

Indications and usage

The main FDA-approved indication for Ambien is short-term insomnia treatment, in cases when the patient has trouble initiating sleep.

Additionally, zolpidem was researched as a potential treatment for other neurologic disorders. The research revealed off-label use and successful case studies, mostly related to motor function disorders and consciousness disorders. It shows that new treatment protocols for these conditions could be developed.

Mechanism of action

Zolpidem shares some pharmacological properties with benzodiazepines although it has a different chemical structure.

Just like with benzodiazepines, its sedative and hypnotic effects are caused by subunit modulation of the chloride channel of the GABA receptor.

However, zolpidem binding is much more selective which explains why the drug has relatively weak myorelaxant and anticonvulsant prosperity in comparison with BZs.

Potential side effects

The most serious adverse reactions to Ambien may include:

• Serious anaphylactic and anaphylactoid reactions (peak individual intolerance);
• Abnormal thinking, behavior changes, and complex behaviors (such as aggressiveness, hallucinations, sleep-driving);
• Withdrawal effects;
• CNS-depressant effects.

The most common side effects associated with Ambien are:

• Drowsiness in daytime;
• Dizziness;
• Drugged-feeling;
• Vertigo issues and falls;
• Nausea;
• Headache;
• Vomiting;
• Diarrhea;
• Muscle pain;
• Vision abnormalities.

There are also adverse reactions labeled as “infrequent”. Their occurrence rate is between 1 of 100 and 1 of 1000 patients. Some of them:

• Increased sweating;
• Postural hypotension;
• Fatigue;
• Tachycardia;
• Agitation;
• Anxiety;
• Constipation;
• Thirst;
• Respiratory infections;
• Eye pain and irritation.

Remember that if you have been prescribed Ambien and notice any negative changes in your physical or mental health that you connect to the medication, consult your doctor about this event. You may need another medication, dosage adjustment, or help in the alleviation of side effects.

A study of comparative effectiveness that various medications show in managing insomnia shows that zolpidem has a much higher dropout rate due to adverse reactions than placebo.

Warnings and precautions

There were no adequate studies on pregnant patients therefore safety of the drug was not established. Children whose mothers took sedatives and hypnotics during pregnancy can show withdrawal symptoms and neonatal flaccidity. The medication crosses the placenta and exerts in the breast milk.

To avoid possible negative impacts on a child, the use of Ambien is not recommended for pregnant women and nursing mothers. The safety and effectiveness of zolpidem have also not been established in children and teenage patients.

In a trial with 201 pediatric patients, aged 6 to 17, some patients stopped taking the medication due to adverse reactions, and others did not show a significant decrease in latency to persistent sleep, compared to a placebo. Patients who are allergic to zolpidem or other (inactive) constituents of Ambien, cannot take it.

Interactions

• CNS depressants: enhanced effects of combined medications.
• Imipramine: decreased alertness.
• Chlorpromazine: decreased alertness and worse motor function.
• Rifampin: decreased effectiveness of zolpidem.
• Ketoconazole: increased effectiveness of zolpidem.

Ambien demonstrated an addictive effect and causes psychomotor impairment when used with alcohol. Drinking while on Ambien therapy is prohibited. Also, due to possible drowsiness, decreased motor function, sleep-driving hazards, and decreased alertness, the patient should refrain from driving and operating machinery and vehicles when taking Ambien.

Dosage and administration

Ambien is taken once a day, before bedtime (specifically, when the patient is already in bed and ready to sleep).

The standard dose is 10 mg; however, the doctor decides individually for every particular patient. Some people may need dosage adjustment because of their age, chronic conditions, other medications they take, etc.

If the patient takes Ambien with food or immediately after, its absorption may slow down, therefore, the effect will not manifest as fast as expected.

Conclusion

Ambien is a sedative and hypnotic drug mainly used to treat insomnia. It also can be effective in the management of motor function and consciousness disorders.

The medication’s active ingredient is zolpidem tartrate which is a non-benzodiazepine hypnotic of the imidazopyridine class.

It works a bit similarly to BZs (modulates the same GABA receptors) but does so very selectively and in specific parts of the brain which determines the difference in pharmacological effect of the two.

FAQs

What is Ambien?

A non-benzodiazepine sedative and hypnotic drug used for short-term insomnia treatment.

Is Ambien an OTC drug?

No, it is a controlled and prescription-only medication that should be used strictly as prescribed.

Does Ambien cause side effects?

Yes, there are possible adverse reactions to Ambien rated from frequent to rare. If you suspect any, consult your healthcare provider.

Are there contraindications to Ambien?

People, allergic to zolpidem and auxiliary components of Ambien, cannot take it. It also is not recommended for pregnant and nursing persons. It is prescribed with great caution to people with a history of drug abuse and those on treatment with CNS depressants.

What you should remember when taking Ambien?

Alcohol and Ambien are incompatible so you should not drink. Also, avoid driving and operating complex machinery. Take the medication strictly following the doctor’s instructions, immediately before bedtime.