Adult Dosing
Short-term management of insomnia
zolpidem, Ambien, Ambien CR
- Immediate release
- Recommended dose: 10 mg PO qhs; Max: 10 mg/day
- Elderly/debilitated patients: 5 mg PO qhs
- Extended release
- Recommended dose: 12.5 mg PO qhs; Max: 12.5 mg/day
- Elderly/debilitated: 6.25 mg PO qhs
Note:- Dose should not be administered with or immediately after meal
- Swallow them whole; do not crush, chew, or divide the tablet
- Recommended initial dose: Women - 5 mg PO qhs and Men - 5 or 10 mg PO qhs, Max: 10 mg/day
- Blood levels may remain high in morning following nighttime usage of 10 mg dose to impair activities that require alertness, including driving and is more prevalent in women because of their slower elimination compared with men
Edluar
- Sublingual
- Recommended dose: 10 mg PO qhs; Max: 10 mg/day
- Elderly/debilitated patients: 5 mg PO qhs
Note:
- Should not be given with or immediately after meal
- Tablet should be placed under the tongue, where it will disintegrate; do not swallow or take with water
- Recommended initial dose: Women - 5 mg PO qhs and Men - 5 or 10 mg PO qhs, Max: 10 mg/day
- Blood levels may remain high in morning following nighttime usage of 10 mg dose to impair activities that require alertness, including driving and is more prevalent in women because of their slower elimination compared with men
Intermezzo
- Sublingual
- Men: 3.5 mg/night PRN; Max: 1 dose/night
- Women: 1.75/night PRN; Max: 1 dose/night
- Recommended dose for men and women who are taking concomitant CNS depressants and in patients >65 years is 1.75 mg/night PRN
Note:
- Indicated for middle-of-the-night waking with difficulty returning to sleep
- Admister only if >4 hours before planned time of waking
- Reevaluate if insomnia persists after 7-10 days of treatment
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Treatment of insomnia should be started after careful evaluation of the patient. If insomnia persists after 7 to 10 days of treatment, reevaluate the patient for a primary psychiatric and/or medical illness
- Angioedema involving the tongue, glottis and larynx have been reported after taking the first or subsequent doses of zolpidem, which may lead to airway obstruction that could be fatal. Additional symptoms such as dyspnea, nausea, throat closing, and vomiting that suggest anaphylaxis have been reported in some patients receiving zolpidem. Do not re-challenge with the drug if such reactions develop after treatment with zolpidem
- Abnormal thinking and behavior changes including decreased inhibition, visual and auditory hallucinations, bizarre behavior, agitation, depersonalization, and sleep-driving have been reported with the use of zolpidem. Avoid using alcohol and other CNS depressants concomitantly with zolpidem, as the risk of developing such behaviors is increased
- In primarily depressed patients, exacerbation of depression including suicidal thoughts and actions has been reported during therapy. Emergence of any new behavioral sign or symptom of concern requires careful evaluation
- Rapid dose reduction or abrupt discontinuation of therapy may lead to signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs
- Advise patients to take the tablet immediately prior to going to bed, and not to engage in hazardous occupations requiring complete mental alertness or motor coordination such as operating machinery or driving a vehicle after ingesting the drug
- Zolpidem should be given in lower doses in elderly/debilitated patients due to the risk of impaired motor and/or cognitive performance after repeated exposure or unusual sensitivity to the drug
- Use cautiously in patients with diseases or conditions that could affect metabolism or hemodynamic responses, compromised respiratory function, sleep apnea syndrome, myasthenia gravis, and hepatic impairment
- Use with caution in patients exhibiting signs or symptoms of depression. The lowest possible effective dose should be prescribed
Cautions: Use cautiously in
- History of alcohol or drug abuse
- Psychiatric disorder
Supplemental Patient Information
- Advice patients about the risk of sleep-driving and other complex behaviors associated with zolpidem use; inform them to report any such events to the physician
- Instruct patients not to drive or perform any hazardous activities after taking zolpidem until they feel fully awake
- Advise patients not to drink alcohol during therapy because of the potentially additive effects
Pregnancy Category:C
Breastfeeding: Zolpidem is excreted in breastmilk in small amounts; however, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 12 April 2011). This drug is considered compatible with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 12 April 2011). Manufacturer advises caution.
US Trade Name(s)
- Ambien
- Ambien CR
- Edluar
- Intermezzo
- Zolpimist
US Availability
zolpidem (generic)
- TABS: 5, 10 mg
- ETABS: 6.25, 12.5 mg
Ambien
Ambien CR
Edluar
Intermezzo
Zolpimist
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
zolpidem (generic)
Stilnoct
Australian Trade Name(s)
- Dormizol
- Somidem
- Stildem
- Stilnox
- Stilnox-CR
- Zolpibell
Australian Availability
zolpidem (generic)
Dormizol, Somidem, Stildem, Stilnox, Zolpibell
Stilnox-CR
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Ambien CR 6.25 MG TBCR [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $193.99
90 mg = $555.97 - Edluar 10 MG SUBL [Box] (MEDA PHARMACEUTICALS)
30 mg = $179.99
90 mg = $525.99 - Ambien CR 12.5 MG TBCR [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $190.99
90 mg = $549.97 - Edluar 5 MG SUBL [Box] (MEDA PHARMACEUTICALS)
30 mg = $179.99
90 mg = $519.96 - Ambien 5 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $203.64
90 mg = $582.16 - Ambien 10 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $209.98
90 mg = $599.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
