Ambien (Zolpidem): Insomnia Treatment Option, Side Effects, and Dosage

The pharmaceutical drug zolpidem - sold under the brand names of Ambien, Ambien CR, and Intermezzo - is a commonly prescribed hypnotic medication used to initiate sleep and to treat insomnia. What are the common side effects and dosage of Ambien? Learn about this medicine and important safety precautions and whether it is right for you to relieve difficulty sleeping.

A prescription bottle of Ambien sleeping pills
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Ambien is a hypnotic drug that has direct effects on the central nervous system, specifically the brain. It causes drowsiness and is safe and effective for initiating and maintaining sleep. It is used to treat insomnia or acute insomnia.

You may be prescribed a standard or controlled-release (CR) formulation of the drug. There is also a fast-acting form that is taken under the tongue (sublingually). These vary slightly in how long it takes the body to metabolize them, but their effects are the same.

Available Dosages

Depending on the formulation used, there are different dosages of Ambien. Women, in particular, are advised by the U.S. Food and Drug Administration (FDA) to use lower doses due to the potential risks of morning hangover effects that may impact safe driving. 

The doses of the various formulations of zolpidem include the following:

  • Ambien: 5 mg or 10 mg
  • Ambien CR: 6.25 mg or 12.5 mg
  • Intermezzo (sublingual): 1.75 mg or 3.5 mg

Any decision regarding the proper dose should be discussed with your prescribing physician and consideration of your entire list of medications should occur.

How Does It Work?

Ambien promotes the activity of GABA receptors, a special type of neurotransmitter. Neurotransmitters are chemicals that serve as messengers between nerve cells (neurons). The additional activity of the GABA receptors inhibits neuron activity that contributes to insomnia.

Who Should Not Use It?

Fortunately, the risk of tolerance or dependence with extended use of Ambien is less than with other benzodiazepines. The medication should not be taken with alcohol or with other drugs that suppress the central nervous system or respiratory system, as it may slow or stop your breathing.

It may not be the best drug to use if you have a history of alcohol abuse, drug abuse, depression, psychiatric disorders, lung, or liver problems. It should be used with caution in the elderly or debilitated.

Common Side Effects

There are many potential side effects of any drug. At high doses, Ambien may cause amnesia (memory loss), suppression of REM sleep, or breathing difficulties. Abrupt cessation of the medication at higher doses may also cause rebound insomnia. Although an individual likely won't experience most side effects associated with the drug - and may indeed not have any of them - some that commonly occur include:

  • Headache
  • Drowsiness, lethargy, or a "drugged" feeling
  • Dizziness, lightheadedness
  • Constipation or diarrhea
  • Back pain
  • Allergic reactions
  • Sinusitis (sinus infection)
  • Pharyngitis (sore throat)
  • Dry mouth
  • Flu-like symptoms
  • Palpitations (irregular heartbeat)
  • Depression
  • Rash

Potential Serious Reactions

With the use of any drug, there are also risks of serious side effects. These occur more rarely, but include:

  • Worsening depression
  • Suicidal thoughts
  • Aggressive behavior
  • Complex sleep-related behaviors (such as doing activities while asleep)
  • Hallucinations
  • Amnesia (memory loss)
  • Anaphylaxis (allergic reaction such as throat swelling and difficulties breathing)
  • Withdrawal after stopping the drug abruptly

Safety Precautions

Ambien should be avoided in pregnancy and with breastfeeding. Certain individuals, as mentioned above, should use the medication with caution or not at all. There is no monitoring necessary with Ambien's use.

If you experience any difficulties with the use of Ambien, you should be in close contact with your primary health provider.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Monti JM, Spence DW, Buttoo K, Pandi-perumal SR. Zolpidem's use for insomnia. Asian J Psychiatr. 2017;25:79-90. doi:10.1016/j.ajp.2016.10.006

  2. Wisden W, Yu X, Franks NP. GABA Receptors and the Pharmacology of Sleep. Handb Exp Pharmacol. 2019;253:279-304. doi:10.1007/164_2017_56

  3. Wong CK, Marshall NS, Grunstein RR, et al. Spontaneous Adverse Event Reports Associated with Zolpidem in the United States 2003-2012. J Clin Sleep Med. 2017;13(2):223-234. doi:10.5664/jcsm.6452

Additional Reading
  • Cooper, D.H. et al. The Washington Manual of Medical Therapeutics. 32nd edition, 2007. 14. Lippencott, Williams & Wilkins. New York.
  • Katzung, B.G. Basic & Clinical Pharmacology. 9th edition, 2004. 134-140. The McGraw-Hill Companies, Inc. New York.
  • “Ambien.” Epocrates Rx Pro. Version 16.3, 2016. Epocrates, Inc. San Mateo, California.

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.