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20Mg of ambien: High-dose zolpidem dependence – Psychostimulant effects? A case report and literature review

How Much Ambien Can I Take Safely?

Written by
Juhi Modi

Medically reviewed by
HaVy Ngo-Hamilton, Pharm.D.
| Jun 21, 2022

Ambien is the brand name of the generic medication zolpidem tartrate. It is a prescription sedative-hypnotic medication usually used for the short-term treatment of insomnia. However, extended use of Ambien is not uncommon, depending on the patient’s medical history and the prescriber’s clinical judgment. This medication helps you fall asleep faster, stay asleep longer, and reduce the number of awakenings during sleep. However, like with any other medication, zolpidem treatment carries some risks.

This article will provide information about Ambien, including the recommended dose, adverse effects, and the associated risks of Ambien.

How does Ambien make you sleep?

Ambien (zolpidem tartrate) affects the brain’s chemistry. Specifically, Ambien binds to a specific site of the GABA receptors in the brain. Ambien’s mechanism of action slows down brain activity, in turn, helping you fall asleep faster while improving sleep quality.

What is the recommended dose of Ambien?

Ideally, doctors prescribing Ambien (zolpidem tartrate) use the lowest effective dose for the shortest possible time to treat insomnia.

Please keep in mind that this dose recommendation is specifically for the immediate-release Ambien, and not for other dosage forms such as extended-release tablets or oral spray.

The recommended initial dose is 5 or 10 mg per day for men and 5 mg for women. The maximum dose of Ambien is 10 mg daily. 

The recommended dose for elderly patients and patients with liver disease is 5 mg daily. Lower doses of Ambien may be necessary for people taking other drugs and CNS depressants such as opioids and alcohol.

If insomnia does not respond to Ambien after 7 to 10 days, you may need to be evaluated for other underlying psychiatric or physical conditions.

What’s the difference between Ambien and Ambien CR?

Ambien is the brand name of the generic drug zolpidem tartrate. An Ambien tablet comes in 5-mg and 10-mg strengths and is available in immediate-release and extended-release forms. 

Ambien is the immediate-release tablet, and Ambien CR is the extended-release tablet. The immediate-release tablets are used to treat insomnia in people who have trouble falling asleep. Ambien CR extended-release tablets are the long-acting form, and they are helpful for people who have trouble falling asleep and staying asleep. 

Zolpidem tartrate is also available under other brand names and dosage forms, such as sublingual tablets (Intermezzo, Edluar) and oral spray (Zolpimist).

What are some precautions before starting Ambien?

Before starting Ambien, give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, supplements, and herbal products. This can help avoid dangerous drug interactions.

Tell your doctor if you are pregnant. Also, tell your doctor if you have a history of substance abuse, depression, other mental illnesses, sleep apnea (heavy snoring), breathing problems, lung disease, kidney disease, or liver disease

Ambien is not approved for use in patients under the age of 18.

How to take Ambien?

  • Follow the instructions on your prescription label and take the Ambien dose exactly as instructed by your healthcare professional. Do not take it more frequently or for longer than prescribed. Ambien has habit-forming properties. Misuse of this medication can increase the risk of dependence, addiction, overdose, and even death.
  • You should take a single dose of Ambien as needed for sleep at bedtime; do not take it more than once in 24 hours.
  • Take the Ambien oral tablet immediately before bedtime. You will probably feel sleepy very quickly after taking this medication. This medication is designed to give you a full night’s sleep; therefore, if you take Ambien, you should plan to have at least 7- 8 hours of sleep before your planned waking-up time. Intermezzo, the sublingual tablets, has a shorter duration of action; therefore, only 4 hours until the planned wake-up time is required with this specific product. Ask your pharmacist if you are not sure which Ambien you are taking.
  • After taking Ambien, you may experience extreme drowsiness and decreased alertness if you wake up too soon. 
  • Avoid taking Ambien with a meal or immediately after eating food because this can slow down the effects of the medication. 
  • Swallow Ambien CR (extended-release tablets) whole. Do not chew, crush, or split these tablets. 
  • Taking another dose of Ambien in the middle of the night is not recommended. Also, you should not take more than one type of sleeping pill on the same night.

Can Ambien be taken long-term?

Ambien is used for the short-term treatment of insomnia. You should not take Ambien for longer than two weeks. Taking Ambien for more than two weeks can increase your risk of physical dependence and tolerance, meaning Ambien will not work as well as initially. You should discuss the risks of taking Ambien for longer than two weeks and other long-term treatment options. 

Call your doctor if your sleep problems do not improve within 7-10 days of starting Ambien.

How to safely come off Ambien?

Do not discontinue Ambien without talking to your doctor first, especially if you have been taking it for over two weeks. Abrupt discontinuation of Ambien can lead to unpleasant symptoms due to withdrawal effects. You might experience difficulties falling or staying asleep for the first few nights after discontinuing Ambien, however,  this will improve over time.

What are the common side effects of Ambien?

Ambien can cause drowsiness, dizziness, fatigue, headache, and a “drugged feeling” with poor balance and unsteady walking. It can also cause gastrointestinal side effects such as nausea, gas, diarrhea, constipation, stomach pain, heartburn, and changes in appetite. Other possible side effects of Ambien include dry mouth, ringing in the ears, numbness and tingling in the hands or feet, muscle cramps, joint pain, memory loss, and heavy menstrual bleeding.

Rarely Ambien can lead to a more serious adverse reaction, such as an allergic reaction. You should seek emergency medical care if you have signs and symptoms such as rash, hives, swelling of the face, or difficulty breathing or swallowing.

What are the risks of taking Ambien?

Ambien is a Schedule IV controlled substance due to its low potential for abuse and low-risk physical dependence. It is possible to overdose on Ambien with deadly consequences. 

This medication causes a slowing down of brain activity (CNS depressant effects). Ambien can, therefore, lead to extreme drowsiness and impaired driving ability. A lack of complete mental alertness can lead to serious injuries and accidents. These risks  increase with higher doses of Ambien.

Withdrawal from Ambien can lead to uncomfortable symptoms if the medication is discontinued suddenly. 

Other potentially dangerous drug effect includes an increased risk of complex sleep behaviors such as sleep-driving. Clinical trials found that the risk of these abnormal behaviors was higher in people who drank alcohol or took other CNS depressants along with Ambien. Other activities such as sleep-eating, walking, or having sex have occurred with people taking Ambien who do not have any memory of these activities later on. If this ever happens to you or someone you know, Ambien must be discontinued immediately and you should discuss other treatment options for insomnia with your doctor.

Ambien can cause worsening depression and/or suicidal thinking. 

Lastly, Ambien should be used with caution in patients with compromised lung function, breathing disorders, and compromised liver function.  

What happens in an Ambien overdose?

A drug overdose with Ambien can be lethal. Possible symptoms of an Ambien overdose may include extreme drowsiness, loss of consciousness, dangerously low heartbeat, and low breathing rate. In case of a suspected or known Ambien overdose, call 911 without delay for immediate medical attention, especially if a person has collapsed, is unconscious, has trouble breathing or a seizure, or can’t be awakened. If it is certain that the Ambien overdose is not severe and the patient is drowsy but still conscious, contact the poison control helpline at 1-800-222-1222, then seek medical attention afterward if needed.

Seeking addiction treatment

Taking more Ambien than prescribed, i.e., taking higher doses, more frequent doses, or using Ambien for a longer duration than recommended by a healthcare provider, can lead to a physical dependence addiction. If you or a loved one is struggling with Ambien misuse or abuse, seeking addiction treatment can help.  

Though the risks of potential for abuse and misuse of Ambien are relatively low, if you are still worried about the abuse potential of Ambien, talk to your doctor about other pharmacological and non-pharmacological treatment options for insomnia treatment. 

References:

  1. https://medlineplus.gov/druginfo/meds/a693025.html
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019908s037lbl.pdf

Ambien Dosage Guide – Drugs.com

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Generic name: ZOLPIDEM TARTRATE 5mg
Dosage form: tablet, film coated
Drug class: Miscellaneous anxiolytics, sedatives and hypnotics

Medically reviewed by Drugs.com. Last updated on Feb 2, 2023.

Dosage in Adults

Use the lowest effective dose for the patient. The recommended initial dose is 5 mg for women and either 5 or 10 mg for men, taken only once per night immediately before bedtime with at least 7–8 hours remaining before the planned time of awakening. If the 5 mg dose is not effective, the dose can be increased to 10 mg. In some patients, the higher morning blood levels following use of the 10 mg dose increase the risk of next-day impairment of driving and other activities that require full alertness [see Warnings and Precautions (5.2)]. The total dose of AMBIEN should not exceed 10 mg once daily immediately before bedtime. AMBIEN should be taken as a single dose and should not be readministered during the same night.

The recommended initial doses for women and men are different because zolpidem clearance is lower in women.

​Long-term use of AMBIEN is not recommended. Treatment should be as short as possible. Extended treatment should not take place without re-evaluation of the patient’s status because the risk of abuse and dependence increases with the duration of treatment [see Drug Abuse and Dependence (9.3)].

Special Populations

Elderly or debilitated patients may be especially sensitive to the effects of zolpidem tartrate. The recommended dose of AMBIEN in these patients is 5 mg once daily immediately before bedtime [see Warnings and Precautions (5.2), Use in Specific Populations (8.5)].

Patients with mild to moderate hepatic impairment do not clear the drug as rapidly as normal subjects. The recommended dose of AMBIEN in these patients is 5 mg once daily immediately before bedtime. Avoid AMBIEN use in patients with severe hepatic impairment as it may contribute to encephalopathy [see Warnings and Precautions (5.8), Use in Specific Populations (8.7), Clinical Pharmacology (12.3)].

Use with CNS Depressants

Dosage adjustment may be necessary when AMBIEN is combined with other CNS-depressant drugs because of the potentially additive effects [see Warnings and Precautions (5.2, 5.7)].

Administration

The effect of AMBIEN may be slowed by ingestion with or immediately after a meal.

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Zolpimist, Edluar, Intermezzo

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Zolpidem: side effects, dosage, usage and more

content

  • Zolpidem oral tablets are also available as generics and medicines under the name. Trade names: Ambien (immediate release tablet), Ambien CR (extended release tablet), Edluar (under the tongue tablet), Intermezzo (under the tongue tablet).
  • Zolpidem is also available as an oral spray.
  • Zolpidem oral tablets are used to treat insomnia (sleep problems). I can help you fall asleep or stay asleep.
  • Zolpidem is a prescription drug available as oral tablets and oral spray.

    Oral tablets are available in three forms: immediate release, extended release and sublingual. The instant release form releases the drug into your body immediately. The extended-release form of the drug is slowly released into the body. The sublingual tablet dissolves under your tongue.

    These forms are available as the following brand-name drugs:

    • Ambien (instant release tablet)
    • Ambien CR (prolonged release tablet)
    • Edluar (sublingual tablet)
    • Intermezzo (sublingual tablet)

    900 02 All oral tablet forms of zolpidem are also available as generics. Generics usually cost less than branded versions. In some cases, they may not be available in all dosages and forms as a protected drug.

    Why it is used

    Zolpidem oral tablets are used to treat insomnia. Insomnia causes difficulty sleeping or staying asleep.

    If you have trouble falling asleep, Edluar instant release and subluxation tablets are used. Extended release tablets are used if you have trouble falling or staying asleep.

    Low dose sublingual tablets (1.75 mg and 3.5 mg) are used when you wake up in the middle of the night and have difficulty sleeping.

    How it works

    Zolpidem belongs to the class of sedatives. A drug class is a group of drugs that work in a similar way. These drugs are often used to treat these conditions.

    Zolpidem increases GABA activity. GABA is the chemical in your body that makes you sleepy. Increasing its activity helps you fall asleep.

    Zolpidem may cause mild or severe side effects. The following list lists some of the key side effects you may experience while taking zolpidem. This list does not include all possible side effects.

    For more information about possible side effects of zolpidem or advice on how to deal with a worrisome side effect, talk to your doctor or pharmacist.

    More common side effects

    More common side effects of zolpidem may include: dry mouth

  • chest pain
  • palpitations (fast, strong, or irregular heartbeat or feeling like your heart is skipping)
  • lethargy
  • dizziness
  • muscle pain
  • If these effects are mild, they may disappear within a few days or a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.

    Serious side effects

    Call your doctor if you have serious side effects. Call 911 if your symptoms seem life-threatening or if you think you need emergency medical attention. Serious side effects and their symptoms may include the following:

    • Allergic reactions. Symptoms may include:
      • swelling of the tongue or face
      • trouble breathing
    • New or more severe symptoms of depression. Symptoms may include:
      • thoughts of suicide or harm
      • loss of interest in activities you normally enjoy
      • feelings of guilt or worthlessness
      • lack of energy
      • trouble thinking or concentrating
      • weight loss or weight gain
    • Abnormal thoughts or behavior. Symptoms may include:
      • anxiety
      • more sociable than usual
      • thinking things are not real or that you are seeing yourself outside of your body
      • hallucinations (seeing or hearing things that are not there)
    • Doing things sometime while you sleep and don’t remember this event. Maybe:
      • travel
      • cooking and eating
      • talking on the phone
      • sex
    • Trouble breathing. Symptoms may include:
      • slow breathing
      • shallow breathing
      • humor
      • decreased oxygen in the blood
    • Amnesia (memory loss)
    • Hallucinations (seeing or hearing something that is not there) )

    Zolpidem oral tablet may interact with some other medicines. Different interactions can cause different effects. For example, some may interfere with the drug’s action, while others may increase the side effects.

    The following is a list of medicines that can affect zolpidem. This list does not include all medicines that may work with zolpidem.

    Before taking zolpidem, be sure to tell your doctor and pharmacist about all prescriptions, over-the-counter medicines, and other medicines you are taking. Tell them about all the vitamins, herbs, and supplements you use. Providing this information may help you avoid potential interactions.

    If you have any questions about drug interactions that may affect you, ask your doctor or pharmacist.

    Increased side effects of both zolpidem and other drugs

    Taking zolpidem with certain drugs increases the risk of side effects. This is because zolpidem and other medicines can cause the same side effects. As a result, these side effects may be exacerbated. Examples of such drugs include:

    • Anti-vigilance drugs such as imipramine and chlorpromazine. If you are taking any of these medicines with zolpidem, you may have more sedation and drowsiness.

    Increased side effects of zolpidem

    Taking zolpidem with certain drugs increases the risk of side effects of zolpidem. This is because the amount of zolpidem in the body may increase. Examples of such drugs include:

    • Antibiotics such as clarithromycin and erythromycin
    • Drugs used to treat fungal infections such as ketoconazole, itraconazole and voriconazole.
    • Ritonavir and atazanavir

    Interactions that may make substances less effective

    When zolpidem is used with certain medicines, it may not work to treat your condition. This is because the amount of zolpidem in the body can be reduced. Examples of such drugs include:

    • Antibiotics such as rifampin, rifabutin and rifapentine
    • Anticonvulsants such as carbamazepine, phenobarbital and phenytoin
    • St. Ivana

    The dosage of zolpidem prescribed by the doctor depends on several factors. This includes:

    • the type of insomnia you are using zolpidem for
    • your age or gender
    • the form of zolpidem you are taking
    • other health conditions they may have, such as liver damage

    Your doctor will usually Means you small doses and adjusts them over time to achieve the correct dose. In the end, you will be prescribed the lowest dose that gives you the desired effect.

    The following information describes the dosage commonly used or recommended. However, be sure to take the dose prescribed by your doctor. Your doctor will determine the best dosage for your needs.

    Forms and strengths

    Generic: Zolpidem

    • Presentation: tablets for oral administration with immediate release.
    • Strengths: 5mg, 10mg
    • Composition: extended release oral tablet.
    • Strength: 6.25mg, 12.5mg
    • Form: sublingual tablet
    • Strength: 1.75mg, 3.5mg, 5mg, 10mg

    Trademark: Ambien

    900 16

  • Presentation: tablets for oral administration with immediate release.
  • Strengths: 5mg, 10mg
  • Brand: Ambien CR

    • Presentation: sustained release tablet for oral administration.
    • Strengths: 6.25 mg, 12.5 mg

    Brand: Edluar

    • Form: sublingual tablet
    • Strengths: 5mg, 10mg

    Brand: Intermezzo

      9000 4 Form: sublingual tablet
    • Strengths: 1.75mg, 3.5mg

    Dose for insomnia that has trouble sleeping

    Dose for adults (18-64 years old)

    Ambien, Edluar and generics: 9000 3

    • Initial dose: 5 mg for women and 5 mg or 10 mg for men taken just before bedtime. You should only take a dose if you have at least 7-8 hours before waking up.
    • Increased dosage: Your doctor may increase your dose to 10 mg per day if the 5 mg dose is not effective.
    • Maximum dose: 10 mg once daily at bedtime.

    Pediatric dose (age 0-17 years)

    This drug has not been studied in children. Should not be used by people under 18 years of age.

    Higher dose (age 65 and older)

    An older person’s liver may not work as well as it used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects. Your doctor may prescribe a reduced dosage or a different treatment schedule for you. This can help keep levels of this medication from building up too much in the body.

    • Ambien, Edloir and generics: 5 mg once daily at bedtime.

    Special dosage recommendations for people with liver disease

    • Ambien, Edluar and generics: Take 5 mg once daily just before bed for people with mild to moderate liver disease. Avoid this medication if you have severe liver disease.

    Dose due to sleep or sleep problems

    Dose for adults (18-64 years old)

    Ambien CR and generic extended release oral tablets only:

    • Starting dose: 6.25 mg for women and 6.25 mg or 12. 5 mg for men taken just before bed. Take it only when you have at least 7-8 hours before waking up.
    • Increased dosage: Your doctor may increase your dose to 12.5 mg per day if the 6.25 mg dose is not effective.
    • Maximum dose: 12.5 mg once daily at bedtime.

    Pediatric dose (age 0-17 years)

    This drug has not been studied in children. Should not be used by people under 18 years of age.

    Higher dose (age 65 and older)

    An older person’s liver may not work as well as it used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects. Your doctor may prescribe a reduced dosage or a different treatment schedule for you. This can help keep levels of this medication from building up too much in the body.

    • Ambien CR and generic extended release oral tablets: 6.25 mg once daily taken at bedtime.

    Special dosage recommendations for people with liver disease

    • Ambien CR and extended-release generic oral tablets: 6. 25 mg once daily taken at bedtime for people with mild to moderate liver disease. Avoid this medication if you have severe liver disease.

    Dosage for post-sleep troubles

    Dose for adults (18-64 years old)

    Intermezzo and generic low dose sublingual tablets:

    • Starting dose: 1.75 mg for women and 3.5 mg for men, take once a day as needed. Take this medicine only when you have trouble sleeping after waking up in the middle of the night. Also, take this medicine only when you have at least 4 hours before you need to wake up.
    • Dosage increase: if you are a man and you started at 1.75 mg, your doctor may increase your dose to 3.5 mg per day.
    • Maximum dose: 1.75 mg per day for women and 3.5 mg per day for men.

    Pediatric dose (age 0-17 years)

    This drug has not been studied in children. Should not be used by people under 18 years of age.

    Higher dose (age 65 and older)

    An older person’s liver may not work as well as it used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects. Your doctor may prescribe a reduced dosage or a different treatment schedule for you. This can help keep levels of this medication from building up too much in the body.

    • Intermezzo and generics: 1.75 mg once a day only as needed. Take it when you have trouble sleeping after waking up in the middle of the night. Also, take this medicine only if you have at least 4 hours left before you need to wake up.

    Special dosage recommendations for people with liver disease

    • Intermezzo and generics: 1.75 mg once daily as needed. Take it only when you find it difficult to get back to sleep after waking up in the middle of the night. Also, take this medicine only if you have at least 4 hours left before you need to wake up.

    Zolpidem oral tablets have several caveats.

    Decreased awareness and reaction time warning

    If you take zolpidem and stay up all night, you may have decreased consciousness and a slow reaction the next day. This may cause driving problems. You should not drive a car or do any other activity that requires alertness while you are taking this medicine and stay up all night.

    If you are taking Intermezzo, you should not drive or do activities that require you to be awake after taking the drug for at least four hours of sleep.

    Abnormal Behavior Warning

    This medicine may cause behavioral changes such as increased anxiety. You can act differently. You may act distant, hallucinate (see or hear things that are not real), or feel like you are watching yourself outside of your body. You can also drive a car in your sleep or do other things in your sleep that you don’t remember later.

    Tell your doctor if any of these happen to you.

    Withdrawal warning

    Do not stop taking this medicine without talking to your doctor. If you have been taking this medicine for a while and suddenly stop taking it, you may have a withdrawal syndrome.

    Symptoms may include muscle spasms, vomiting, sweating, erythema (reddening and warming of the skin) and emotional changes. These may include feelings of nervousness, panic attacks, and uncontrollable crying.

    Allergy Alert

    Zolpidem may cause a severe allergic reaction. Symptoms may include:

    • trouble breathing
    • swelling of the throat or tongue

    If you have an allergic reaction, call your doctor or local poison control center right away. If you have severe symptoms, call 911 or go to the nearest emergency room.

    Do not take this medicine again if you have ever had an allergic reaction to it. Repeated use may be lethal (lead to death).

    Food Interaction Warning

    Eating with zolpidem may take longer to work. You must take this medicine on an empty stomach.

    Alcohol Interaction Warning

    Drinking alcohol may increase the risk of sedation and drowsiness from zolpidem. You should not take this medication at night while drinking alcohol. If you drink alcohol, talk to your doctor. You may need to monitor side effects more closely.

    Warnings for people with certain medical conditions

    For people with depression: This medicine may make symptoms of depression worse. Ask your doctor if this medicine is safe for you.

    For people with myasthenia gravis: this medicine may make your breathing slow or shallow. This can decrease the amount of oxygen in the blood. If you have myasthenia gravis, you may already have lower oxygen levels. Ask your doctor if this medicine is safe for you.

    For people with sleep apnea: This medicine may make your breathing slow or shallow. This can decrease the amount of oxygen in the blood. If you have sleep apnea, you may already have lower oxygen levels. Ask your doctor if this medicine is safe for you.

    For people with liver disease: If you have liver problems or a history of liver disease, you may not be able to handle this medicine well. This can increase the level of the drug in the body and cause more side effects. It can also cause a serious condition called hepatic encephalopathy. In this disease, poor liver function causes brain problems. Symptoms may include confusion, forgetfulness, and annoying speech. If you have severe liver damage, you should not use zolpidem.

    Warnings for other groups

    For pregnant women: there are not enough human studies to determine how the drug may affect the fetus. Animal studies have shown adverse effects on the fetus when the mother takes zolpidem. But animal studies don’t always predict how people will react.

    Studies have shown that when mothers take this medicine at the end of the third trimester, their newborns may have slow breathing and excessive sleepiness. Your doctor will monitor your newborn closely if you have been exposed to zolpidem during pregnancy.

    This drug should only be used if the potential benefit justifies the potential risk. Talk to your doctor if you are pregnant or planning to become pregnant. And call your doctor immediately if you become pregnant while taking this medicine.

    For lactating women: zolpidem may pass into breast milk and cause side effects in nursing infants. Talk to your doctor about breastfeeding your baby. You may need to decide if you want to stop breastfeeding or stop taking this medicine.

    For older people: An older person’s liver may not work as well as it used to. This can cause your body to process medications more slowly. As a result, more drugs stay in your system for longer. This increases the risk of side effects such as sedation and reduced alertness. You may also be more sensitive to these effects. If you are over 65, your doctor may prescribe a lower dose of this medicine for you.

    For children: This medicine has not been tested in children. It should not be used by people under 18 years of age.

    Zolpidem oral tablets are used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

    If you suddenly stop taking this medicine or don’t take it at all: If you don’t take this medicine, you will still have trouble falling or staying asleep. If you have been taking this medicine for a while and suddenly stop taking it, you may have withdrawal symptoms.

    Withdrawal symptoms may include muscle spasms, vomiting, sweating, flushing (reddening and warming of the skin) and emotional changes. These may include nervousness, panic attacks, or uncontrollable crying. Never stop taking this medicine without talking to your doctor.

    If you miss a dose or don’t take your medicine as scheduled: The medicines may not work properly or may stop working completely.

    If you take too much: You may have dangerous levels of the drug in your body. Overdose symptoms with this medicine may include:

    • extreme drowsiness
    • fainting
    • eating
    • trouble breathing

    If you think you have taken too much of this medicine, call your doctor or contact the American Association of Poison Control Centers for help by phone 800-222-1222 or through their online tool, but if you have severe symptoms, call 911 or go to the nearest emergency room right away.

    What to do if you miss a dose:

    • For instant-release tablets, extended-release tablets and Edluar: take the dose as soon as you remember, but only if there are 7-8 hours left before waking up.
    • For Intermezzo: Do ​​not take your dose if you are less than 4 hours away from waking up.

    How to find out if the medicine is working: You should be able to fall asleep more easily and stay asleep.

    Important considerations for taking this medicine

    Keep this in mind if your doctor prescribes zolpidem oral tablets for you.

    Basic information

    • You must not take this medicine with food. It may take longer to take this drug with food.
    • Take immediate release tablets, extended release tablets and Edluar just before bed. Take these forms only if you have 7-8 hours of sleep before you have to wake up.
    • Take only one dose of Ambien each night. Do not take it a second time during the same night.
    • Take Intermezzo when you wake up at night. Only take it if you have 4 hours of sleep left before you need to wake up.
    • Instant release tablets may be cut or crushed. Do not cut or crush extended-release tablets.
    • Store immediate release tablets (Ambien) and sublingual tablets (Edluar and Intermezzo) at room temperature. Store them at 68°F to 77°F (20°C to 25°C).

    Storage

    • Store extended release tablets (Ambien CR) at (59°C and 77°C) 15°F to 25°F. Keep away from the world.
    • Do not store this medicine in damp or damp places such as bathrooms.

    tapping

    The prescription for this medicine can be refilled. Because zolpidem is a scheduled, controlled intravenous injection, your doctor may add this medicine up to five times over a 6-month period. Your doctor will write the number of refills on your prescription.

    Travel

    When traveling with medication:

    • Always carry your medication with you. Never put it in your checked bag while flying. Keep it in your bag.
    • Don’t worry about air devices at the airport. I can’t hurt drugs.
    • You may need to show the pharmacy label for your medicines to the airport staff. Always carry the original prescription container with you.
    • Do not put this medicine in the glove compartment of your car or leave it in your car. Be sure to avoid this when the weather is very hot or very cold.

    Clinical follow-up

    You and your doctor must monitor certain health problems during treatment. This may help keep you safe while you are taking this medicine. These problems include:

    • Mental health and behavioral problems. You and your doctor should watch for any changes in your behavior and mood. This medication may cause new mental health and behavioral problems. It can also exacerbate problems you already have.
    • Liver function. Your doctor will monitor your liver function while you are taking this medicine. If the liver is not working well, your doctor may reduce the dose of this medicine.

    availability

    Not every pharmacy stocks this medicine. When filling out a prescription, be sure to call in advance and make sure that it is in the pharmacy.

    Insurance

    Many insurance companies require prior approval for this drug. This means your doctor may need approval from your insurance company before your insurance company will pay for the prescription.

    There are other medicines available to treat your condition. Some may suit you better than others. Talk to your doctor about other treatment options that may help you.

    Disclaimer: Healthline has made every effort to ensure that all information is correct, complete, and up-to-date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. Always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, instructions, precautions, warnings, drug interactions, allergic reactions, or side effects.