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Ambien Fact Sheet

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Medication Name (brand): 
Ambien
Medication Name (clinical): 
zolpidem
Manufacturer: 

Sanofi-Aventis; Ambien is available in generic form (patent expired in 2006); Ambien CR’s market exclusivity expires in 2009 (see “Ambien CR Fact Sheet”).

Indications: 

Indicated for both sleep initiation and sleep maintenance.

Mechanism: 

A so-called “non-benzodiazepine” in the chemical category called “imidazopyridines.” Binds to the GABA-benzodiazepine receptor complex, like benzodiazepines, but is more selective for the omega-1 receptor subtype than are BZs.

Dosing: 
  • Supplied as 5 mg pink and 10 mg white tablets (breakable).

  • Start at 5 mg QHS for elderly, 10 mg QHS otherwise. PDR lists maximum dose of 10 mg, but in practice many patients require and tolerate 20 mg QHS dosing.

Side Effects: 
  • Most common: drowsiness and dizziness.

  • Does not alter normal sleep stages.
  • Anecdotal: uncommonly, can cause black outs (loss of memory of activities) soon after ingested if the patient does not go right to sleep.
  • Classified as a Schedule IV drug, but abuse potential is likely somewhat less than BZs.
  • Pregnancy Category C

Drug-drug Interactions: 
  • Additive effect when combined with alcohol and other drugs or medications that have sedative effects.

  • Zoloft appears to increase Ambien concentrations by about 40%.

Pharmokinetics: 
  • Half life is 2.5 hours; duration of action about 10 hours.

  • Metabolized in the liver.
  • Works more slowly if taken after eating.
  • Cut dose in half in hepatic insufficiency. No adjustments needed in renal impairment.

Pearls: 

Good, solid sleeping pill for both sleep initiation and sleep maintenance. Generally just as effective as Ambien CR, but much cheaper because it is generic.

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