Ambien (Zolpidem) - Oral

Warning:

Some people who take Ambien may sleep-walk or participate in other activities—like sleep-driving—during their sleep (i.e., "complex sleep behaviors"). This side effect can lead to serious injuries. If you suspect that you're experiencing this side effect, immediately inform your healthcare provider, and stop using the medication.

What Is Ambien?

Ambien (zolpidem) is a controlled, prescription sedative-hypnotic medication approved by the Food and Drug Administration (FDA) for short-term use in insomnia (sleep difficulty), specifically for falling asleep (sleep initiation). It's unclear though whether Ambien may help people stay asleep (sleep maintenance).

Ambien is available in a tablet form. It works mainly by preventing excitability in the brain's neurons.

Ambien has a boxed warning for complex sleep behaviors. Some people who take Ambien may sleep-walk or participate in other activities—like sleep-driving—during their sleep. This side effect can lead to serious injuries. If you suspect that you're experiencing this side effect, immediately inform your healthcare provider, and stop using the medication.  

Drug Facts

Generic Name: Zolpidem

Brand Name(s): Ambien

Drug Availability: Prescription

Therapeutic Classification: Sedative-hypnotic

Available Generically: Yes

Controlled Substance: Schedule IV

Administration Route: Oral

Active Ingredient: Zolpidem

Dosage Form(s): Tablet

What Is Ambien Used For?

The FDA approved Ambien as a short-term treatment option to help people who have trouble falling asleep.

In the United States, one-third of adults do not get the recommended amount of sleep. Adults typically need seven hours of sleep on a nightly basis for good health. Having little sleep is linked to other medical conditions, including depression, diabetes type 2, heart disease and obesity.

How to Take Ambien

Take Ambien by mouth once nightly immediately before bedtime without food. Make sure that you will have at least seven to eight hours of sleep for the night before taking Ambien.

Storage

Since Ambien is a controlled prescription medication, your healthcare provider will likely only provide you with a limited number of refills.

After picking up your Ambien from the pharmacy, store it at room temperature - between 68 degrees and 77 degrees Fahrenheit (F). Store this medication in a safe place—like a locked cabinet, and out of the reach of children and pets.

If you plan on bringing Ambien on your travels, be sure to get familiar with your final destination’s regulations first. In general, however, make a copy of your Ambien prescription. Also, ask your healthcare provider for a note of medical necessity in a letter with an official letterhead. You should also try to keep the medication in its original container—with your name on it—from the pharmacy.

How Long Does Ambien Take to Work?

Ambien works very quickly. The medication effects usually occur within 90 minutes.

What Are the Side Effects of Ambien?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

If Ambien is used for a short period of time—less than 10 nights, then the following are some common side effects of this medication.

Severe Side Effects

Get medical help right away if you experience the following serious side effects.

  • Changes in behavior or mood
  • Difficulty concentrating or focusing
  • Extremely slow breathing
  • Insomnia that worsens or doesn’t go away
  • Severe allergic reaction
  • Sleeping-walking or other complicated activities while asleep
  • Unsteady muscle movements
  • Worsening mood conditions

Long-Term Side Effects

If you take Ambien for long periods of time (more than 28 nights), you may experience dizziness, which is a common side effect. Some people, however, might also feel drugged.

If you’ve taken Ambien for a long time, then don’t abruptly stop taking it. Suddenly stopping Ambien can lead to the following withdrawal side effects:

Report Side Effects

Ambien may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Ambien Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treatment of insomnia:
    • For oral dosage form (extended-release tablets):
      • Adults—6.25 milligrams (mg) (for women) or 6.25 or 12.5 mg (for men) once a day at bedtime. Your doctor may increase your dose as needed. However, do not take more than 12.5 mg per day. Take only 1 dose a night as needed.
      • Older adults—6.25 mg once a day at bedtime.
      • Children—Use is not recommended.
    • For oral dosage form (tablets):
      • Adults—5 milligrams (mg) for women and 5 or 10 mg for men once a day at bedtime. Your doctor may increase your dose as needed. However, do not take more than 10 mg per day. Take only 1 dose a night as needed.
      • Older adults—5 mg once a day at bedtime.
      • Children—Use is not recommended.

Modifications

Older Adults

To prevent side effects of confusion and fall risk, the manufacturer recommends a nightly Ambien dose of 5 milligrams (mg) for adults over 65 years.

People Assigned Female Sex at Birth

People assigned female at birth get rid of zolpidem from their bodies slower than those assigned male at birth. Therefore, the manufacturer recommends a nightly Ambien dose of 5 milligrams for people assigned female at birth.

People Who Take Other Sleep-Inducing Medications

If you take another medication that can cause drowsiness or sleepiness, you might need to lower the dose of zolpidem or the other medication to prevent worsening side effects.

People With Liver Impairment

The manufacturer recommends a nightly zolpidem dose of 5 milligrams for people with mild to moderate liver issues. If you have severe liver issues though, the manufacturer recommends avoiding Ambien altogether.

Pregnant or Nursing Parents

Taking zolpidem in the third trimester of pregnancy is linked to reports of drowsiness, sleepiness and a slow breathing rate in newborn babies. Therefore, your healthcare provider will monitor your fetus and newborn for these side effects as well as low muscle tone. 

As for nursing parents, there is little safety information about zolpidem in nursing babies.  Although experts don’t recommend zolpidem while nursing, the low amount of zolpidem in breast milk is unlikely to cause negative effects in older nursing babies.

If you are taking Ambien while nursing, your healthcare provider will closely monitor the nursing baby for side effects of drowsiness, sleepiness, slow breathing rate, and low muscle tone. If you want to limit exposing your nursing baby to Ambien, one option is to pump and then dispose of your breast milk while taking zolpidem and 23 hours after taking this medication—before nursing your baby again.

Missed Dose

If you take Ambien as needed for only a short period of time, then missing a dose shouldn’t lead to worrisome side effects.

If you forget to take Ambien at your usual scheduled dosing time, you can take it as soon as you remember—as long as you will still have at least seven to eight hours of sleep. If you will have less than seven to eight hours of sleep, then skip this missed dose. 

If you’ve taken zolpidem for a long time, however, then missing too many doses in a row might cause withdrawal side effects. If you don’t want to take zolpidem anymore, talk with your healthcare provider who will help you stop the medication by slowly lowering the dose.

Overdose: What Happens If I Take Too Much Ambien?

Overdose on Ambien is linked to the following serious side effects.

  • Coma
  • Drowsiness
  • Problems with awareness
  • Slow breathing or trouble breathing
  • Slow heart rate

If you accidentally took too many Ambien tablets, seek immediate medical attention.

What Happens If I Overdose on Ambien?

If you think you or someone else may have overdosed on Ambien, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Ambien, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

Using this medicine during the last 3 months of pregnancy can harm your newborn baby. Check with your doctor right away if your baby has pale or blue lips, fingernails, or skin, difficult or troubled breathing, excessive sleepiness, or limpness. Tell your doctor right away if you are pregnant or if you think you have become pregnant while using this medicine.

If you think you need to take zolpidem for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem.

Zolpidem may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hives, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

This medicine may cause you to do things while you are still asleep that you may not remember the next morning. It is possible you could drive a car, sleepwalk, have sex, make phone calls, or prepare and eat food while you are asleep or not fully awake. Tell your doctor right away if you learn that any of these has happened.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally, which may lead to falls. Even though zolpidem is taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Also, this medicine may cause double vision or other vision problems, or severe injuries (eg, hip fractures, severe bleeding in the head). Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

If you develop any unusual and strange thoughts or behavior while you are using zolpidem, be sure to discuss it with your doctor. Some changes that have occurred in people using this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

Do not change your dose or stop using it without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of zolpidem or taking alcohol or other CNS depressants with zolpidem may lead to serious breathing problems and unconsciousness. Some signs of an overdose include: severe drowsiness, severe nausea or vomiting, staggering, and troubled breathing.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Ambien?

Avoid taking Ambien if you experienced the following:

  • Complicated sleep behaviors: If you’ve ever experienced sleep-walking or other complex sleep activities after taking Ambien, avoid this medication.
  • Severe allergic reaction: If you’re allergic to Ambien or anything in it, don’t take this medication.
  • Severe liver impairment: If you have severe liver issues, the manufacturer recommends against taking zolpidem.

What Other Medications Interact With Ambien?

Take the following with caution.

  • Alcohol: Alcohol can potentially worsen zolpidem’s side effects.
  • Chlorpromazine: Chlorpromazine is usually used to treat a mood condition called schizophrenia. When taken with Ambien, there've been reports of trouble staying alert and unsteady muscle movement. 
  • CYP3A4-inducing medications: CYP3A4 is a type of protein in the liver that breaks down zolpidem. If you take medications—like St. John’s wort for mood—that encourage CYP3A4 to work faster, then these medications can lower the effectiveness of zolpidem.
  • Imipramine: Imipramine is a treatment option for depression. Combining imipramine and zolpidem is linked to a lower ability to stay alert. 
  • Ketoconazole: Ketoconazole is an antifungal medication. Combining this medication with zolpidem might raise the risk of side effects.
  • Sleep-inducing medications: If you take another medication that causes drowsiness or sleepiness, then you are more likely to have serious side effects with zolpidem.

If you have any questions about these drug interactions, talk with your pharmacist or healthcare provider.

What Medications Are Similar?

In addition to Ambien, some other medication options to help with sleep include:

With all of these medications used for sleep, they are typically not taken together. If you have questions, talk with your healthcare provider. 

Since there are a number of options, the decision to choose one medication over the other is usually based on the following.

  • Are you having trouble with falling asleep?
  • Are you having problems with staying asleep?
  • Do you have both?

If you have problems with falling asleep, staying asleep or both, then Ambien is a potential choice for you.

Frequently Asked Questions

  • What if Ambien doesn’t work for me?

    If your sleeping troubles aren’t better or get worse within seven to 10 days of starting treatment, let your healthcare provider know. Another medical condition could be the cause of your sleeping troubles.

    Once your healthcare provider determines that your insomnia is not due to another medical condition, your healthcare provider can help you with next steps—like choosing another medication option.

  • Will Ambien affect my ability to drive?

    Ambien can affect your ability to drive due to the following side effects:

    • Drowsiness
    • Sleepiness
    • Slower reaction time
    • Trouble staying alert
    • Vision changes

    These effects might happen the morning after taking zolpidem. To limit the risks of these side effects, only take Ambien when you can have at least seven to eight hours of sleep. Additionally, don’t try to immediately drive in the morning. Take time to make sure that you are fully awake before driving.

  • Can I drink with Ambien?

    Mixing alcohol and Ambien can raise the risk of serious side effects. In fact, the manufacturer recommends skipping your nightly Ambien dose if you already had an alcoholic beverage during the same evening.

  • Can I develop an addiction with Ambien?

    Similar to many other sleep medications, Ambien is also linked to substance use disorder (SUD). With Ambien being a schedule IV controlled substance, its likelihood of causing SUD is less than schedule I through III medications—but more than a schedule V controlled substance.

    If you had a previous history of SUD, discuss with your healthcare provider. Please also inform your healthcare provider if you notice the following SUD-like symptoms:

    • Agitation
    • Appetite changes
    • Changes in mood and behavior
    • Irritability
    • Less attention to personal hygiene
    • Low performance at school, work, or home
    • Relationship problems
    • Sleeping habit changes
    • Tremors
    • Unsteady muscle movement
    • Weight changes

How Can I Stay Healthy While Taking Ambien?

While Ambien might help your sleeping troubles for a short-period of time, experts recommend good sleep hygiene to help create healthier sleep habits overall. Consider the following tips to help you get better sleep and to help avoid negatively impacting sleep:

  • Schedule a time to go to bed and wake up every day.
  • Don’t eat large meals before going to bed.
  • Don’t drink coffee or alcohol before bed.
  • Avoid intense exercise before bed.
  • Don’t smoke before bed.
  • Use your bed only for sleep and sex.
  • Avoid watching TV or reading in bed.
  • Adjust your sleep environment to make sure it's not too cold, hot, or loud.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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