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Manufacturer of Ambien

sanofi-aventis

Also know under brand names: Ambien, Ambien CR

Active ingredient / generic name: zolpidem

Approximate US Retail Price for Ambien

5 mg (30 ea): $134.12
10 mg (30 ea): $135.99

Short leaflet

Ambien is a prescription medication used for the short-term treatment of insomnia, as well as some brain disorders. It is a short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to benzodiazepine receptors which are located on the gamma-aminobutyric acid receptors. It works quickly (usually within 15 minutes) and has a short half-life (2–3 hours). Some trade names of Ambien are Ambien, Hypnogen, Myslee. Nimadorm, Nitrest, Sanval, Stilnoct, Stilnox, Zolfresh, and Zolt.

Its hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is molecularly distinct from the classical benzodiazepine molecule and is actually classified as an imidazopyridine. Flumazenil, a benzodiazepine receptor antagonist, which is used for benzodiazepine overdose, can also reverse Ambien's sedative/hypnotic effects.

As an anticonvulsant and muscle relaxant, the beneficial effects start to emerge at 10 and 20 times the dose required for sedation, respectively. For that reason, it has never been approved for either muscle relaxation or seizure prevention. Such drastically increased doses are more inclined to induce one or more negative side effects, including hallucinations and/or amnesia. (See below.)

The patent 4382938 in the United States on Ambien was held by the French pharmaceutical corporation Sanofi-Aventis. On April 23, 2007 the U.S. FDA approved 13 generic versions of Ambien tartrate. Ambien is available from several generic manufacturers in the UK, as generic from Sandoz in South Africa, as well as from other manufacturers such as ratiopharm.

Recently, Ambien has been cited in various medical reports mainly in the United Kingdom as waking persistent vegetative state (PVS) patients, and dramatically improving the conditions of people with brain injuries.

Ambien is approved for the short-term (usually two to six weeks) treatment of insomnia, and it has been studied for nightly use up to six months in a single-blind trial published in 1991, an open-label study lasting 180 days published in 1992 (with continued efficacy in patients who had kept taking it as of 180 days after the end of the trial), and in an open-label trial lasting 179 days published in 1993.

The United States Air Force uses Ambien as a substitute for temazepam, under trade name Ambien, as "no-go pills" to help pilots sleep after a mission; the main drug used for the purpose is temazepam (Normison/Restoril). (Cf. the "go-pills" dextroamphetamine, served under the name Dexedrine, or its recent modafinil (Provigil) replacement, act as a stimulant for the same pilots, the effects of which are reversed by the aforementioned "no-go pills")

Ambien is also used off-label to treat restless leg syndrome and, as is the case with many prescription sedative/hypnotic drugs, it is sometimes used by stimulant users to "come down" after the use of stimulants such as amphetamines (including methamphetamine), cocaine, or MDMA (ecstasy).

Recently, the drug has been reported anecdotally to have positive effects for patients in persistent vegetative state. Results from phase IIa trials are expected in June 2007. The trials are being conducted by Regen Therapeutics of the UK, who have a patent pending on this new use for Ambien.

A clinical trial on a single patient performed at the Toulouse University Hospital using PET shows that Ambien repeatably improves brain function and mobility of a patient immobilized by akinetic mutism caused by hypoxia.

Ambien binds with high affinity to the α₁ containing GABA_A receptors, about 10-fold lower affinity for those containing the α₂, α₃-GABA_A receptor subunits, and with no appreciable affinity for α₅ subunit containing receptors.

Like the vast majority of benzodiazepine like molecules, Ambien has no affinity for α₄ and α₆ subunit containing receptors. Ambien positively modulates GABA_A receptors, probably by increasing the GABA_a receptor complexes apparent affinity for GABA, without affecting desensitization or peak current. Ambien increases slow wave sleep and caused no effect on stage 2 sleep in laboratory tests.

A meta-analysis of the randomised controlled clinical trials which compared benzodiazepines against Z drugs has shown that there are few consistent differences between Ambien and benzodiazepines in terms of sleep onset latency, total sleep duration, number of awakenings, quality of sleep, adverse events, tolerance, rebound insomnia and daytime alertness.

Ambien has recently been very strongly related to certain instances of patients in a minimally conscious coma state being brought to a fully conscious state. While it was initially given to these supposed permanent coma patients to put them to sleep, it actually brought them to a fully conscious state in which they were capable of communicating and interacting for the first time in years. CAT scans have shown that the use of the drug actually does dramatically increase the activity in the frontal lobe of the brain in some patients in a minimally conscious state. Large scale studies are currently being done to see if it has the same universal effect on all or most patients in a minimally conscious state. It may be that Ambien's ability to stimulate the brain, particularly in the semi-comatose, may be related to one of its side effects, which sometimes causes sleepwalking and other activity while asleep, that appears to observers to be fully conscious activity.

The transition from medicinal use to recreational use of Ambien can occur when the drug is used without the doctor's recommendation to continue using it, in high doses (more than the usual 5mg or 10 mg), when consumed other than orally (snorting or injecting), or when taken for purposes other than as a sleep aid. Abuse is more prevalent in those who have been dependent on other drugs, tobacco, or alcohol in the past. Ambien effects can increase and intensify if mixed with other substances like alcohol and cannabis.

In the U.S., recreational use of this drug is becoming more common in young people. Recreational users claim that "fighting" the effects of the drug by forcing themselves to stay awake will sometimes cause vivid visuals and a body high (see side-effects below). However, others who are already in an anxious state, claim it is not hard to fight the main effect of sedation, experiencing the side-effect of euphoria more than the sedation itself. Thus some users report decreased anxiety, and even mild euphoria, as well as perceptual changes, visual distortions, and light-based hallucinations. It is also not uncommon for one who has developed a tolerance to the drug to eventually feel such a decrease in the sedation effect that only the euphoric, perceptual, and anxiety decreasing side effects remain.

With regular use at high dosage, there can be a risk of a severe physical dependence on Ambien with cases being reported in the medical literature of epileptic seizures forming part of the withdrawal syndrome. One case involved a woman detoxing off a high dose of Ambien experiencing a generalized seizure. The clinical withdrawal and dependence effects were reported to be similar to those of benzodiazepines in this case report.

Ambien and other sedative hypnotic drugs are detected frequently in cases of people suspected of driving under the influence of drugs. Other drugs including the benzodiazepines and zopiclone are also found in high numbers of suspected drugged drivers. Many drivers have blood levels far exceeding the therapeutic dose range suggesting a high degree of excessive-use potential for benzodiazepines, Ambien and zopiclone.

As Ambien's patent expired April 21, 2007, new generic versions were approved, which do not have the "protective cover" present on the Sanofi name-brand Ambien they once previously had to prevent users from crushing, snorting, or injecting the drugs.

Alcohol has cross tolerance with GABAa receptor positive modulators such as the benzodiazepines and the nonbenzodiazepine drugs. For this reason alcoholics or recovering alcoholics may be at increased risk of physical dependency on Ambien. Also, alcoholics and drug abusers may be at increased risk of abusing and or becoming psychologically dependent on Ambien. Ambien should be avoided in those with a history of Alcoholism, drug misuse (illicit or prescription misuse), or in those with history of physical dependency or psychological dependency on sedative-hypnotic drugs.

Overdose of Ambien may present with excessive sedation, pin-point pupils, depressed respiratory function, which may progress to coma and possibly death. Ambien combined with alcohol, opiates or other CNS depressants may be even more likely to lead to fatal overdoses. Ambien overdosage can be treated with the benzodiazepine receptor antagonist flumazenil which displaces Ambien from its binding site the benzodiazepine receptor and therefore rapidly reverses the effects of Ambien.

An extensive review of the medical literature regarding the management of insomnia and the elderly found that there is considerable evidence of the effectiveness and durability of non-drug treatments for insomnia in adults of all ages and that these interventions are underutilized. Compared with the benzodiazepines, the nonbenzodiazepine (including Ambien) sedative-hypnotics appeared to offer few, if any, significant clinical advantages in efficacy or tolerability in elderly persons. It was found that newer agents with novel mechanisms of action and improved safety profiles, such as the melatonin agonists, hold promise for the management of chronic insomnia in elderly people. Long-term use of sedative-hypnotics for insomnia lacks an evidence base and has traditionally been discouraged for reasons that include concerns about such potential adverse drug effects as cognitive impairment (anterograde amnesia), daytime sedation, motor incoordination, and increased risk of motor vehicle accidents and falls. In addition, the effectiveness and safety of long-term use of these agents remain to be determined. It was concluded that more research is needed to evaluate the long-term effects of treatment and the most appropriate management strategy for elderly persons with chronic insomnia.

Some users take Ambien recreationally for these side effects. However, it may be less common than benzodiazepine abuse. In the United States, recreational use may be less common than in countries where the drug is available as a less expensive generic (or in countries, such as the UK, where prescriptions are free or heavily subsidised). It is not yet known whether there is a link between the cost and availability of Ambien and the level at which it is abused. Ambien can become addictive if taken for extended periods of time, due to dependence on its ability to put one to sleep or to the euphoria it can sometimes produce. Like most addictive drugs, a tolerance in the Ambien user develops and increases all the more quickly the longer the user has been regularly taking it. Under the influence of the drug it is common to take more Ambien than is necessary due to either forgetting that one has already taken a pill (elderly users are particularly at risk here), or knowingly taking more than the prescribed dosage. Users with a predilection for abuse are advised to keep additional Ambien in a safe place that is unlikely to be remembered or accessed while intoxicated to avoid this risk. A trustworthy friend or relative is the best defense if such people are available; otherwise, a box or cupboard locked with a combination padlock is a good defense against this tendency, as the above-mentioned side-effects can easily prevent a user from operating such a lock while under the drug's influence. The recent release of Ambien CR (Ambien tartrate extended release) in the United States renewed interest in the drug among recreational drug users.

Before a user becomes fully acclimated to these effects (or if the user does not become acclimated), these symptoms can be severe enough to be deemed as drug-induced psychosis. Incidentally, antipsychotics like ziprasidone (Geodon) or quetiapine (Seroquel) may be prescribed alongside Ambien to both combat these side effects and to aid in sleep-induction, as both of them contain mild hypnotic properties. However, because some antidepressants are known for being mildly sedating (i.e., paroxetine), it may be inadvisable to use Ambien and an antidepressant simultaneously. Some Ambien users (especially those suffering from chronic insomnia), however, commonly use these drug combination due to the relative ease with which the user gains no benefit from one or the others of these drugs, while both together can assist sufferers of insomnia in getting to sleep.

Some users have reported unexplained sleepwalking while using Ambien, and a few have reported driving, binge eating, sleep talking, and performing other daily tasks while sleeping. The sleepwalker can sometimes perform these tasks as normally as they might if they were awake. They can sometimes carry on complex conversations and respond appropriately to questions or statements so much so that the observer may believe the sleepwalker to be awake. This is similar to, but unlike typical sleep talking, which can usually be identified easily and is characterised by incoherent speech that often has no relevance to the situation or that is so disorganised as to be completely unintelligible. These statements bear a strong resemblance to that of schizophasia, one of many symptoms commonly seen in individuals suffering from schizophrenia. A person under the influence of this medication may seem fully aware of their environment even though they are still asleep. This can bring about concerns for the safety of the sleepwalker and others. These side effects may be related to the mechanism that also causes Ambien to bring some semi-comatose people back to consciousness.

Driving while under the drug's influence is generally considered several orders of magnitude more dangerous than the average drunk driver, due to the diminished motor controls and delusions that may affect the user. It is unclear if the drug is responsible for the behavior, but a class-action lawsuit was filed against Sanofi-Aventis in March 2006 on behalf of those who reported symptoms. Residual 'hangover' effects such as sleepiness, impaired psychomotor and cognitive after nighttime administration may persist into the next day which may impair the ability of users to drive safely, increase risks of falls and hip fractures.

More recently, the Sydney Morning Herald in Australia reported on 4 March 2007 that a man who fell 30 metres to his death from a high-rise unit balcony may have been sleepwalking under the influence of Stilnox. The coverage prompted over 40 readers to contact the newspaper with their own accounts of Stilnox related automatism and the drug is now under review by the Adverse Drug Reactions Advisory Committee.

On 6 April 2007 Australia's Therapeutic Goods Administration ordered the manufacturer to upgrade its warning about mixing the pills with alcohol. There are also plans to move the drug to a tougher class of medicines (Schedule 8 status) in Australia because of its susceptibility to abuse and addiction. This would place the drug in the same class as opioids (eg. morphine), psychostimulants (eg. methylphenidate, dexamphetamine), and flunitrazepam (Rohypnol, Hypnodorm).

There are many unsubstantiated reports on the internet of people who have had issues with this medication.

On March 14, 2007, the US Food and Drug Administration ordered stronger warnings on 13 prescription sleep-hypnotic drugs including Ambien and eszopiclone. The dangers of allergic reactions and driving while intoxicated, while serious, are not thought to be sufficient to withdraw the drugs from the market.

In April 2007, Slovenian serial killer Silvo Plut committed suicide by consuming a large quantity of Ambien, sold under the brandname Sanval.

The media reports of side effects of Ambien have caused them to become referred to in popular culture. In the Simpsons episode Crook and Ladder, Homer Simpson becomes addicted to an insomnia pill known as Nappien and starts experiencing strange side effects. To this, Lisa Simpson says "I've read that people do strange things in their sleep when they've taken Ambien... I mean Nappien."

Actor Heath Ledger was taking Ambien in the weeks prior to his death on 22 January 2008. In addition, early reports state that a bottle of Ambien was found near his body.[1] The drug has been the subject of much controversy in his native Australia, where it is available as Stilnox brand.[2]

Actor Jack Nicholson told reporters in London that he almost drove off a cliff once while under the influence of Ambien.

Ambien: Patient Education

Zolpidem may cause a severe allergic reaction. Stop taking zolpidem and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Zolpidem will make you fall asleep. Never take this medication during your normal waking hours, unless you have a full 7 to 8 hours to dedicate to sleeping.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking zolpidem and talk with your doctor about another treatment for your sleep disorder.

Zolpidem can cause side effects that may impair your thinking or reactions. You may still feel sleepy the morning after taking the medication. Until you know how this medication will affect you during waking hours, be careful if you drive, operate machinery, pilot an airplane, or do anything that requires you to be awake and alert.

Do not drink alcohol while you are taking zolpidem. It can increase some of the side effects of zolpidem, including drowsiness.

Zolpidem may be habit-forming and should be used only by the person it was prescribed for. Zolpidem should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

It is dangerous to try and purchase zolpidem on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of zolpidem purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

Zolpidem is a sedative, also called a hypnotic. It affects chemicals in your brain that may become unbalanced and cause sleep problems (insomnia).

Zolpidem is used to treat insomnia. This medication causes relaxation to help you fall asleep and stay asleep.

Zolpidem may also be used for purposes other than those listed in this medication guide.

Zolpidem will make you fall asleep. Never take this medication during your normal waking hours, unless you have a full 7 to 8 hours to dedicate to sleeping.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking zolpidem and talk with your doctor about another treatment for your sleep disorder.

Do not use this medication if you are allergic to zolpidem. Zolpidem tablets may contain lactose. Use caution if you are sensitive to lactose.

Before taking zolpidem, tell your doctor if you are allergic to any drugs, or if you have:

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Zolpidem can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The sedative effects of zolpidem may be stronger in older adults. Accidental falls are common in elderly patients who take sedatives. Use caution to avoid falling or accidental injury while you are taking zolpidem.

Do not give this medicine to anyone younger than 18 years of age.

It is dangerous to try and purchase zolpidem on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of zolpidem purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Zolpidem comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Take zolpidem only if you are able to get a full night's sleep before you must be active again. Never take this medication during your normal waking hours, unless you have a full 7 to 8 hours to dedicate to sleeping.

Take zolpidem with a full glass of water.

Zolpidem is for short-term use only. Tell your doctor if your insomnia symptoms do not improve, or if they get worse after using this medication for 7 to 10 nights in a row. Do not take zolpidem for longer than 4 or 5 weeks without your doctor's advice.

You may have withdrawal symptoms if you stop taking zolpidem after taking it over several days in a row. Do not stop taking zolpidem suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Withdrawal symptoms include behavior changes, stomach pain, muscle cramps, nausea, vomiting, sweating, anxiety, panic, tremors, and seizure (convulsions). Insomnia symptoms may also return after you stop taking zolpidem. These symptoms may seem to be even worse than before you started taking the medication. Call your doctor if you still have worsened insomnia after the first few nights without taking zolpidem.

Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Store zolpidem at room temperature away from moisture and heat.

Since zolpidem is usually taken as needed, you may not be on a dosing schedule. Never take this medication if you do not have a full 7 to 8 hours to sleep before being active again. Do not take extra medicine to make up a missed dose.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of zolpidem can be fatal when it is taken together with other medications that can cause drowsiness.

Symptoms of a zolpidem overdose may include sleepiness, confusion, shallow breathing, feeling light-headed, fainting, or coma.

Zolpidem can cause side effects that may impair your thinking or reactions. You may still feel sleepy the morning after taking the medication. Until you know how this medication will affect you during waking hours, be careful if you drive, operate machinery, pilot an airplane, or do anything that requires you to be awake and alert.

Do not drink alcohol while you are taking zolpidem. It can increase some of the side effects of zolpidem, including drowsiness.

Do not take other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxants, and medicine for depression or anxiety).

Avoid taking zolpidem during travel, such as to sleep on an airplane. You may be awakened before the effects of the medication have worn off. Amnesia (forgetfulness) is more common if you do not get a full 7 to 8 hours of sleep after taking zolpidem.

Take zolpidem only if you are able to get a full night's sleep before you must be active again.

Zolpidem may cause a severe allergic reaction. Stop taking zolpidem and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using zolpidem and call your doctor at once if you have any of these serious side effects:

Before taking zolpidem, tell your doctor if you are using any of the following drugs:

There may be other drugs not listed that can affect zolpidem. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Your pharmacist has information about zolpidem written for health professionals that you may read.

Ambien: Dosing

insomnia, short-term tx:

sleep onset: Dose: 5-10 mg PO qhs; Max: 10 mg PO qd; Info: give on empty stomach; in elderly or debilitated pts start 5 mg PO qhs

hepatic dosing:

adjust dose amount: hepatic impairment: start 5 mg qhs

Ambien: Drug Interactions

Ambien vs sodium oxybate: contraindicated: combo may incr. risk of CNS and resp. depression, other adverse effects and additive effects

Ambien vs dexmedetomidine: caution advised, consider dose reduction: combo may incr. risk of CNS depression, adverse effects and additive effects

Ambien vs acetaminophen/butalbital: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs acetaminophen/caffeine/CNS depressant combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Acetaminophen/caffeine/CNS depressant combos: also know as acetaminophen/butalbital/caffeine, acetaminophen/butalbital/caffeine/codeine, acetaminophen/caffeine/dihydrocodeine

Ambien vs acetaminophen/opiate combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Acetaminophen/opiate combos: also know as acetaminophen/codeine, acetaminophen/hydrocodone, acetaminophen/oxycodone, acetaminophen/pentazocine

Ambien vs acetaminophen/propoxyphene: caution advised: combo w/ propoxyphene may incr. risk of CNS depression, psychomotor impairment and additive effects. Acetaminophen/propoxyphene: also know as acetaminophen/propoxyphene HCl, acetaminophen/propoxyphene napsylate

Ambien vs acetaminophen/tramadol: caution advised: combo w/ tramadol may incr. risk of CNS and respiratory depression, psychomotor impairment and additive effects

Ambien vs antihist/decongest/DM combos: caution advised: combo of antihistamines and CNS depressants may incr. risk of CNS depression, psychomotor impairment and additive effects. Antihist/decongest/DM combos: also know as brompheniramine/dextromethorphan/pseudoephedrine, chlorpheniramine/phenylephrine/dextromethorphan

Ambien vs antihist/decongestant combos: caution advised: combo of antihistamines and CNS depressants may incr. risk of CNS depression, psychomotor impairment and additive effects. Antihist/decongestant combos: also know as acrivastine/pseudoephedrine, brompheniramine/phenylephrine, chlorpheniramine/phenylephrine, chlorpheniramine/pseudoephedrine, pseudoephedrine/triprolidine

Ambien vs antihistamines, sedating: caution advised: combo may incr. risk of CNS depression and additive effects. Antihistamines, sedating: also know as brompheniramine, carbinoxamine, chlorpheniramine, clemastine fumarate, cyproheptadine, dimenhydrinate, diphenhydramine, hydroxyzine, meclizine

Ambien vs antipsychotics: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Antipsychotics: also know as aripiprazole, clozapine, haloperidol, haloperidol decanoate, haloperidol lactate, loxapine, molindone, olanzapine, paliperidone, quetiapine, risperidone, thiothixene, ziprasidone

Ambien vs apomorphine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive/synergistic effects

Ambien vs aspirin/caffeine/CNS depressant combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Aspirin/caffeine/CNS depressant combos: also know as aspirin/butalbital/caffeine, aspirin/butalbital/caffeine/codeine, aspirin/caffeine/dihydrocodeine

Ambien vs aspirin/caffeine/orphenadrine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs aspirin/muscle relaxant combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Aspirin/muscle relaxant combos: also know as aspirin/carisoprodol

Ambien vs aspirin/opiate combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Aspirin/opiate combos: also know as aspirin/carisoprodol/codeine, aspirin/codeine, aspirin/oxycodone

Ambien vs azelastine nasal: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs azole antifungals: caution advised, consider lower zolpidem dose: combo may incr. zolpidem levels, adverse effects and hepatic metab. inhibited. Azole antifungals: also know as fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole

Ambien vs barbiturates: caution advised: combo may decr. sedative/hypnotic efficacy; incr. risk of CNS depression and hepatic metab. induced; additive effects. Barbiturates: also know as butabarbital, methohexital, pentobarbital, phenobarbital, primidone, secobarbital, thiopental

Ambien vs BZDs, all: caution advised: combo may incr. risk of CNS depression and additive effects. BZDs, all: also know as alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, diazepam rectal, estazolam, flurazepam, lorazepam, midazolam, oxazepam, temazepam, triazolam

Ambien vs cannabinoids: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Cannabinoids: also know as dronabinol, nabilone

Ambien vs central alpha 2 agonists: caution advised: combo may incr. risk of CNS depression and additive effects. Central alpha 2 agonists: also know as clonidine, clonidine transdermal, guanabenz, guanfacine, methyldopa

Ambien vs cetirizine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Cetirizine: also know as cetirizine, cetirizine/pseudoephedrine

Ambien vs chlorpheniramine/hydrocodone: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs dantrolene: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs decongest/opiate combos: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Decongest/opiate combos: also know as guaifenesin/hydrocodone/phenylephrine

Ambien vs droperidol: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs ethanol: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs ethosuximide: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs hydrocodone/ibuprofen: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs ibuprofen/oxycodone: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs levocetirizine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs lopinavir/ritonavir: caution advised: combo may incr. zolpidem levels, adverse effects and hepatic metab. inhibited

Ambien vs maprotiline: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs meperidine/promethazine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs meprobamate: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs methadone: caution advised, consider opioid dose reduction: combo may incr. risk of CNS and resp. depression, psychomotor impairment and additive effects

Ambien vs metoclopramide: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs mirtazapine: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs mitotane: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs morphine liposomal: caution advised: combo may incr. risk of CNS and resp. depression, profound sedation, hypotension, other adverse effects and additive effects

Ambien vs muscle relaxants: caution advised: combo may incr. risk of CNS depression and additive effects. Muscle relaxants: also know as baclofen, baclofen intrathecal, carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, orphenadrine, tizanidine

Ambien vs nefazodone: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs nevirapine: caution advised: combo may decr. ziprasidone levels, efficacy and hepatic metab. induced

Ambien vs olanzapine/fluoxetine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs opiate agonist/antagonists: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Opiate agonist/antagonists: also know as buprenorphine, buprenorphine/naloxone, butorphanol, butorphanol nasal, nalbuphine, pentazocine lactate, pentazocine/naloxone

Ambien vs opiates: caution advised, consider opioid dose reduction: combo may incr. risk of CNS and resp. depression, psychomotor impairment and additive effects. Opiates: also know as alfentanil, codeine phosphate, codeine sulfate, codeine/guaifenesin, fentanyl, fentanyl buccal, fentanyl oral transmucosal, fentanyl transdermal, guaifenesin/hydrocodone, hydrocodone/homatropine, levorphanol, meperidine, morphine sulfate, oxycodone, oxymorphone, remifentanil, sufentanil

Ambien vs oxcarbazepine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs phenothiazines: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Phenothiazines: also know as chlorpromazine, fluphenazine, fluphenazine decanoate, perphenazine, prochlorperazine edisylate, prochlorperazine maleate, prochlorperazine rectal, promethazine, promethazine rectal, thioridazine, trifluoperazine

Ambien vs pimozide: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs pramipexole: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs pregabalin: caution advised: combo may incr. risk of CNS depression, psychomotor impairment, adverse effects and additive effects

Ambien vs promethazine/codeine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs propoxyphene: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Propoxyphene: also know as propoxyphene HCl, propoxyphene napsylate

Ambien vs ritonavir: caution advised: combo may incr. zolpidem levels, adverse effects and hepatic metab. inhibited

Ambien vs ropinirole: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs rotigotine transdermal: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs thalidomide: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs tiagabine: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien vs tipranavir: caution advised: combo may incr. zolpidem levels, adverse effects and hepatic metab. inhibited

Ambien vs tramadol: caution advised, consider lower tramadol dose: combo may incr. risk of CNS and resp. depression, psychomotor impairment and additive effects

Ambien vs trazodone: caution advised: combo may incr. risk of CNS depression and additive effects

Ambien vs tricyclic antidepressants: caution advised: combo may incr. risk of CNS depression and additive effects. Tricyclic antidepressants: also know as amitriptyline, amitriptyline/chlordiazepoxide, amitriptyline/perphenazine, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline, trimipramine

Ambien vs valproic acid derivatives: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects. Valproic acid derivatives: also know as divalproex sodium, valproate sodium, valproic acid

Ambien vs ziconotide intrathecal: caution advised: combo may incr. risk of confusion, dizziness, other CNS adverse effects and additive effects

Ambien vs zonisamide: caution advised: combo may incr. risk of CNS depression, psychomotor impairment and additive effects

Ambien: Adverse Reactions

depression, worsening

suicidal ideation

aggressive behavior

complex sleep-related behavior

hallucinations

amnesia

anaphylactic/anaphylactoid rxns (rare)

withdrawal if abrupt D/C

headache

drowsiness

dizziness

lethargy

drugged feeling

back pain

allergic reactions

diarrhea

sinusitis

pharyngitis

dry mouth

lightheadedness

flu-like sx

palpitations

depression

rash

Did you know?

Yes, Ambien today sold under many names; here is only few:

→ Zolpidem
→ Stilnox
→ Hypnogen
→ Myslee
→ Nimadorm
→ Nitrest
→ Sanval
→ Stilnoct
→ Zoldem
→ Zolfresh
→ Zolt

Buy any from these brand names you receice medicine contain same active ingredient as contain original Ambien

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