Ambien, Ambien CR, Tovalt ODT
Classifications: anxiolytic; sedative-hypnotic, non-benzodiazepine; Therapeutic: sedative-hypnotic; antianxiety
Pregnancy Category: C
Controlled Substance: Schedule IV
5 mg, 10 mg tablets; 6.25 mg, 12.5 mg extended release tablets; 5 mg, 10 mg orally disintegrating tablets
An agonist that binds to the BZD1 subunit on the gamma-aminobutyric acid (GABA)-A receptor chloride channel, thus inhibiting
the action potential.
Sedative, anticonvulsant, and antianxiety effects thought to be due to GABA-A agonism.
Short-term treatment of insomnia.
Suicidal ideation; labor or obstetric delivery; pregnancy (category C), children <18 y.
Depressed patients, hepatic/renal impairment, older adults, alcohol or drug abuse; patients with compromised respiratory
status, COPD, sleep apnea; chronic depression.
Route & Dosage
|Short-Term Treatment of Insomnia
Adult: PO 10 mg (immediate release/ODT) OR 12.5 mg (extended release) at bedtime
Geriatric: PO 5 mg (immediate release) or 6.25 mg (extended release) at bedtime
5 mg (immediate release) or 6.25 mg (extended release) at bedtime
- Give immediately before bedtime; for more rapid sleep onset, do NOT give with or immediately after a meal.
- Extended release tablets should be swallowed whole. Ensure that they are not crushed or chewed.
- Use reduced dosage of 5 mg in older adult or debilitated patients.
- Store at room temperature, 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
Headache on awakening, drowsiness or fatigue
, lethargy, drugged feeling, depression
, anxiety, irritability, dizziness, double
vision. Confusion and falls reported in elderly. Doses >10 mg may be associated with anterograde amnesia or memory impairment.
Dyspepsia, nausea, vomiting. Other:
InteractionsDrug: cns depressants
, alcohol, phenothiazines
by augmenting CNS depression
Extent and rate of absorption of zolpidem are significantly decreased.
Readily from GI tract. 70% reaches systemic circulation. Food decreases rate and extent of absorption. Onset:
727 min. Peak:
0.52.3 h. Duration:
68 h. Distribution:
Highly protein bound. Lowest concentrations in CNS
, highest concentrations in glandular tissue
and fat. Crosses placenta,
very small amounts (<0.02%) distributed into breast milk. Metabolism:
In the liver to 3 inactive metabolites. Elimination:
7996% of dose appears as metabolites in the bile, urine, and feces. Half-Life:
Assessment & Drug Effects
- Assess respiratory function in patients with compromised respiratory status. Report immediately to physician significantly
depressed respiratory rate (<12/min).
- Monitor patients for S&S of depression (see Appendix F); zolpidem may increase level of depression.
- Monitor older adult or debilitated patients closely for impaired cognitive or motor function and unusual sensitivity to
the drug's effects.
Patient & Family Education
- Avoid taking alcohol or other CNS depressants while on zolpidem.
- Do not drive or engage in other potentially hazardous activities until response to drug is known.
- Report vision changes to physician.
- Note: Onset of drug is more rapid when taken on an empty stomach.