Zolpidem

What is zolpidem?

Zolpidem is a prescription-only medicine used to treat short-term insomnia. It belongs to a group of medications known as Z-drugs, which are sedative-hypnotics. It helps people fall asleep more quickly and reduces waking during the night or too early in the morning[1]. 

What is zolpidem used for?

Zolpidem is prescribed for short-term management of insomnia. It can be helpful for people experiencing[1]: 

• Difficulty falling asleep 

• Waking up in the middle of the night 

• Waking up too early and being unable to return to sleep 

It is not recommended for long-term use, as regular use can lead to dependence and reduced effectiveness over time[1]. 

How does zolpidem work?

Zolpidem increases the activity of gamma-aminobutyric acid (GABA), a natural chemical in the brain that slows down nervous system activity. This calming effect helps initiate sleep and maintain it for longer during the night[1]. 

Who can take zolpidem?

Zolpidem is suitable for adults aged 18 and over, but it is not suitable for children. Speak to your doctor first if you[1]: 

• Have liver disease or kidney problems 

• Have breathing disorders such as sleep apnoea or severe respiratory insufficiency 

• Have muscle weakness conditions like myasthenia gravis 

• Are pregnant, trying to get pregnant, or breastfeeding 

• Are allergic to zolpidem 

• Anyone with a history of alcohol or drug misuse, or mental health conditions 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2]. 

What is the typical dosage of zolpidem?

Zolpidem tablets come in 2 different strengths: 5mg and 10mg. The dosage of zolpidem depends on your age, health, and how you respond to the medicine. The standard adult dose is 10mg taken just before bedtime. A lower dose of 5mg is recommended for older adults or those with liver or kidney problems. You should not take more than one dose per night[1]. 

How do you take zolpidem?

To get the best results and reduce the risk of side effects[1]:

• Take zolpidem immediately before bedtime 

• Swallow the tablet whole with water – do not crush or chew 

• Make sure you can get 7 to 8 hours of uninterrupted sleep after taking it 

• Avoid drinking alcohol while using zolpidem 

• Follow your doctor’s instructions – they may ask you to only take zolpidem on two or three nights of the week, rather than nightly 

Can you stop taking zolpidem?

Yes, but care is needed if you’ve been taking it regularly for more than four weeks. Stopping suddenly can cause withdrawal symptoms such as anxiety, irritability, or rebound insomnia. Always speak to your doctor, who may recommend gradually reducing your dose[1]. 

What do you do if you take too much zolpidem?

An overdose of zolpidem can be dangerous and requires urgent medical attention. Symptoms of taking too much include[1]: 

• Extreme drowsiness or confusion 

• Difficulty breathing 

• Loss of consciousness 

Call 111 immediately if you suspect an overdose. If you need to go to A&E do not drive, ask someone to take you or call an ambulance. 

What do you do if you forget to take zolpidem?

If you miss a dose[1]:

• Only take it if you can still get a full 7 to 8 hours of sleep 

• If there’s not enough time left in the night, skip the dose 

• Do not take a double dose the next day to make up for it 

What medicines can’t you take with zolpidem?

Zolpidem can interact with other medicines. Speak to your doctor before taking it with: [1]: 

• Other sleeping tablets or sedatives 

• Antidepressants, especially fluoxetine 

• Antipsychotic medications 

• Anti-anxiety medications 

• Epilepsy medications 

• Opioid painkillers 

• Alcohol 

• Ciprofloxacin 

• Fungal medications like ketoconazole or itraconazole 

• HIV medication like ritonavir 

• Herbal sleep remedies such as valerian 

These combinations can increase the risk of side effects like drowsiness, breathing difficulty, and overdose. 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2].

What are the side effects of zolpidem?

Zolpidem may cause both common and more serious side effects. 

Common side effects include[1]: 

• Drowsiness or dizziness the next morning 

• Bitter or metallic taste in your mouth 

• Dry mouth 

• Back pain 

• Headache 

• Nausea or diarrhoea 

• Vivid dreams or nightmares 

Serious side effects are less common but require immediate attention. These may include[1]: 

• Hallucinations, delusions, or confusion 

• Memory loss 

• Falling over (over 65s particularly) 

• Aggressive or unusual behaviour 

• Depression 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

 If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about zolpidem

Is zolpidem addictive? 
Yes. Long-term use can lead to dependence. It is only meant for short-term treatment. If you take it for less than 4 weeks, you are unlikely to become addicted to it[1]. 

Can I drink alcohol with zolpidem? 
No. Alcohol increases the risk of severe drowsiness and dangerous side effects[1]. 

Can I drive the next day after taking zolpidem? 
Only if you feel fully alert. Zolpidem can cause next-day drowsiness, especially if you haven’t had a full night’s sleep. It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive[1]. 

Can I take zolpidem every night? 
Only for a limited time – typically no more than 2 to 4 weeks. Your doctor may advise you only to use it 2-3 nights a week and not every night. Please follow their instructions carefully[1]. 

Is zolpidem safe in pregnancy? 
It is not recommended. Talk to your doctor or pharmacist if you are pregnant or planning a pregnancy[1]. 

For the official NHS guide to zolpidem, visit their website.