Ambien and Ambien CR dosage: Form, strengths, and more

Ambien and Ambien CR (zolpidem) are brand-name prescription medications. The Food and Drug Administration (FDA) has approved Ambien and Ambien CR for use in adults. They’re approved to treat insomnia that involves trouble falling asleep. Ambien CR is also approved to treat insomnia that involves difficulty staying asleep.

Ambien and Ambien CR come as oral tablets. They belong to a class of drugs called sedative-hypnotics. Generic forms of Ambien and Ambien CR are available.

For information about the dosage of Ambien and Ambien CR, including strengths and how to take them, keep reading. For a comprehensive look at Ambien and Ambien CR, see this article.

This article describes typical dosages for Ambien and Ambien CR provided by the drugs’ manufacturer. When taking Ambien or Ambien CR, always follow the dosage prescribed by your doctor.

Below, you’ll find information on Ambien and Ambien CR’s form, strengths, and typical dosages.

Ambien and Ambien CR form

Ambien and Ambien CR come as oral tablets. You’ll take either medication by mouth.

Ambien and Ambien CR strengths

Ambien is available in the following strengths:

• 5 milligrams (mg)
• 10 mg

Ambien CR is available in the following strengths:

• 6.25 mg
• 12.5 mg

Ambien CR is an extended-release form of the drug. Unlike Ambien, it’s released into the body over time rather than all at once.

Typical dosages

Typically, a doctor will start you on a low dosage of Ambien or Ambien CR. If you’re still experiencing insomnia, your doctor may increase the Ambien or Ambien CR dosage strength prescribed. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Doses of this drug should be taken just before bedtime. Plan to have at least 7 to 8 hours available for sleeping after you take a dose.

Ambien dosage for insomnia

Recommended dosages of Ambien vary between males and females.*

The starting Ambien dosage for females is 5 mg once daily. The starting Ambien dosage for males is 5 mg or 10 mg once daily.

If the starting dosage is not effective, your doctor may increase your dosage. A 10-mg dose is the highest dose of Ambien per day that’s typically prescribed.

*Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

Ambien CR dosage for insomnia

Recommended dosages of Ambien CR also vary between males and females.*

The recommended starting dosage of Ambien CR for females is 6.25 mg once daily. For males, it’s 6.25 mg or 12.5 mg once daily. If the starting dosage is not effective, your doctor may increase your dosage.

A 6.25-mg dose is the lowest dose of Ambien CR per day that’s typically prescribed. A 12.5-mg dose is the highest dose of Ambien CR per day that’s typically recommended.

*Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

Long-term treatment

Ambien and Ambien CR are not meant to be used as long-term treatments. Instead, they are each used short term to treat insomnia.

If you take more Ambien or Ambien CR than your doctor prescribes, you may develop serious side effects.

It’s important that you do not take more Ambien or Ambien CR than your doctor advises.

Symptoms of an Ambien or Ambien CR overdose

Overdose symptoms for Ambien or Ambien CR can include:

• loss of consciousness
• extreme sleepiness
• breathing problems
• very low blood pressure or heart rate
• coma

In rare cases, an overdose could lead to death.

If you take more than the recommended amount of Ambien or Ambien CR

Call your doctor right away if you believe you’ve taken too much Ambien or Ambien CR. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Below are some frequently asked questions about Ambien and Ambien CR.

What is the maximum Ambien dosage? Is there a ‘normal’ dose of Ambien?

The maximum dosage of Ambien that’s approved by the Food and Drug Administration (FDA) is 10 milligrams (mg), taken once daily. The maximum recommended dosage of Ambien CR is 12.5 mg, taken once daily.

There isn’t a “normal” dose of either drug. However, there are typical recommended doses for both medications. To learn more, see the “Ambien and Ambien CR dosage” section above. Your doctor will prescribe a dosage of Ambien or Ambien CR that’s right for you.

If you have additional questions about dosages for these medications, talk with your doctor or pharmacist.

How do Ambien dosages compare between males and females?

Typically, doctors prescribe a higher dosage of Ambien or Ambien CR to treat insomnia in males compared with females.*

That’s because Ambien’s clearance has a higher rate in males. (Clearance describes how the body processes and removes a drug after a person takes it.)

Ambien’s clearance tends to have a lower rate in females. So, they may need a smaller dose of the drug to have the same effect as males.

If you’d like to learn more about this, ask your doctor or pharmacist.

*Sex and gender exist on spectrums. In this article, use of the terms “male” and “female” refers to sex assigned at birth.

Is there a 2.5-mg dosage of Ambien?

No, this isn’t a recommended dosage of Ambien or Ambien CR. There also isn’t a “low dose” of Ambien for sleep problems. To learn about typical recommended doses for insomnia, see the “Ambien and Ambien CR dosage” section above.

Ambien comes in 5-mg tablets. However, its manufacturer has not stated whether it’s safe to cut the tablets in half.

Ambien CR is an extended-release tablet. It should not be cut, crushed, or chewed. This is because the drug may be released all at once instead of over a period of time as intended.

If you have questions about low doses of Ambien or Ambien CR, ask your doctor or pharmacist.

Does Ambien have an extended-release form and dosage?

Yes, Ambien CR is an extended-release (ER) form of the medication. Unlike Ambien, Ambien CR is released into the body over time rather than all at once.

The recommended Ambien CR dosage is 6.25 mg or 12.5 mg, taken once just before bedtime.

For more information, see the “Ambien and Ambien CR dosage” section above.

The Ambien or Ambien CR dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of insomnia you’re using either medication to treat
• your age
• other medications you may take
• your liver function and other medical conditions

Dosage adjustments

Your doctor may recommend a lower dosage than usual of Ambien or Ambien CR. This may be the case if you’re age 65 years or older or if you have liver problems.

Ambien and Ambien CR come as oral tablets. Unlike Ambien, Ambien CR is released into the body over time rather than all at once.

You’ll take one Ambien tablet or one Ambien CR tablet once daily, just before bedtime. Plan to have at least 7 to 8 hours for sleeping after you take a dose.

Be sure to take Ambien or Ambien CR on an empty stomach. Doing so allows the drug to work quickly, which can help you fall asleep faster. Do not take the tablets with food or right after you’ve eaten.

It may be helpful to take Ambien or Ambien CR at the same time each day, just before going to sleep. This helps you maintain a regular sleep schedule, which may also help the medication work effectively to improve your sleep.

If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.

ACCESSIBLE DRUG LABELS AND CONTAINERS

If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

If you’re having trouble opening medication bottles, ask your pharmacist about putting Ambien and Ambien CR in an easy-open container. They also may recommend tools that can make it easier to open bottles.

People who’ve misused drugs or alcohol may have a higher risk of misusing or becoming addicted to Ambien or Ambien CR.

Misuse means taking a drug in a way other than how a doctor prescribes it. Addiction means taking a drug even if it’s causing harmful outcomes.

Talk with your doctor if you have concerns about misuse or addiction with Ambien or Ambien CR. Let them know if you’ve misused drugs or alcohol in the past. If your doctor recommends that you take Ambien or Ambien CR, they’ll likely monitor you closely during treatment.

It’s possible to develop dependence on Ambien or Ambien CR. Dependence means your body needs a drug in order to function like usual.

This risk may be greater for people who’ve:

• taken Ambien or Ambien CR long term
• taken higher doses of either drug
• misused drugs or alcohol in the past

Misuse means taking a drug in a way other than how a doctor prescribes it.

Withdrawal symptoms can occur if you stop taking Ambien or Ambien CR abruptly. These are symptoms that can happen when you stop taking a drug your body is dependent on.

Possible withdrawal symptoms for Ambien or Ambien CR can include:

• flushing
• uncontrolled crying
• fatigue
• nausea, vomiting, and stomach cramps
• lightheadedness
• nervousness or panic attacks

Typically, these symptoms go away after a few days.

If you’re interested in stopping Ambien or Ambien CR, talk with your doctor first. They may have you taper your dosage slowly over a few days. This can help decrease possible withdrawal symptoms from the medication.

The dosages presented in this article are typical dosages provided by the drugs’ manufacturer. If your doctor recommends Ambien or Ambien CR for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Ambien or Ambien CR without your doctor’s recommendation. If you have questions about the dosage of Ambien or Ambien CR that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Ambien and Ambien CR. These additional articles might be helpful:

• More about Ambien and Ambien CR. For information about other aspects of Ambien and Ambien CR, refer to this article.
• Drug comparison. To find out how Ambien and Ambien CR compare with Lunesta, read this article.
• Interactions. For details about what substances Ambien and Ambien CR interact with, see this article.
• Details about insomnia. For details about your condition, see our science of sleep hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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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Medical Disclaimer

Sleep and wakefulness. Insomnia and sleeping pills

In all living beings (from protozoa to humans), all organs and systems of the body function in accordance with circadian (from the Latin words “circa” – about and “dies” – day) or circadian rhythms. Fluctuations in circadian rhythms are most pronounced during the transition of the body from sleep to wakefulness, and they also appear during sleep. The physiological significance of circadian rhythms in humans and animals lies not only in the regulation of the rhythmic activity of physiological functions and metabolism, but also in the interaction of the body with the environment.

A waking person actively interacts with the environment. In the state of sleep, this interaction does not disappear, but has a number of physiological differences.

Physiological (normal) sleep proceeds in several stages. In a healthy person, it starts from the so-called “relaxed wakefulness” (stage A), which corresponds to the transition from wakefulness to sleep. The person is in bed and getting ready for bed. Alpha waves are recorded on the encephalogram. Then comes the latent period of sleep (stage B, falling asleep and the most superficial sleep), characterized by the appearance of delta waves on the encephalogram. This is followed by superficial sleep (stage C), when the sleeping person no longer responds to weak external stimuli. On the encephalogram, high-amplitude “vertex teeth” lasting 3-5 s appear, as well as spindle-shaped bursts of rhythm – beta waves (“sleepy spindles”). Stage D (moderately deep sleep) is characterized by the appearance of fast beta waves on the encephalogram. In stage E (deep sleep), slow beta waves are episodically superimposed by slow alpha waves. In stages D and B, there is a complete loss of consciousness, a significant decrease in pain sensitivity and tone of the striated muscles, as well as a lack of response to strong stimuli.

Before awakening, a sleeping person usually goes through another, special phase of sleep, characterized by desynchronization of the encephalogram, as well as episodes of rapid eye movements with atony of the remaining striated muscles.

It must be emphasized that during the night there are four cycles of changes in sleep phases.

Another feature of the physiology of sleep has been established – during sleep, some centers of the brain are in a state of rest (inhibition), while others are in a state of excitation.

It is well known that sleep is a physiological state of the body and vital for a person. During sleep, a person rests, restores his strength, just during sleep, the processes of growth and normalization of metabolism are accelerated. There is a relationship between growth and sleep of a child. During sleep, growth hormone is released. The longer the baby sleeps, the better he grows. If we add to this that a person spends a third of his life in a dream, then the vital need for sleep becomes clear.

Studies conducted on animals have shown that depriving them of sleep for three days or more leads not only to dysfunction of the nervous, cardiovascular, urinary systems, digestive organs, metabolism, but also to the development of degenerative (necrotic) changes in the structure of nerve cells.

Insomnia negatively affects the general condition of the human body, reduces its ability to work, causes fatigue, increased irritability, mental imbalance, leads to the development of a state of constant stress, slows down the healing process in diseases of internal organs. Insomnia is one of the risk factors for the development of hypertension or ischemic disease, hypertensive crisis, angina attack. Without a doubt, insomnia reduces the ability to work, the mental activity of a person, and negatively affects the communication of a person in a team.

Therefore, sleep disorders are so difficult for patients to endure, and this requires the use of hypnotic drugs that are capable of inducing normal physiological sleep.

Restoration of physiological sleep is the main purpose of sleeping pills. Insomnia remedies can not only normalize a patient’s sleep, but also improve a person’s general condition.

Scientists around the world have long been searching for effective and safe sleeping pills. The first synthetic hypnotic drug was chloral hydrate, which began to be used from the middle of the 19th century. The drug, in addition to sleeping pills, has a calming effect. Chloral hydrate induces sleep close to physiological, lasting 6–8 hours. However, a pronounced irritant effect on the skin and mucous membranes, as well as the development of a state of drug dependence, sharply reduces the value of chloral hydrate as a hypnotic. This drug is currently not used for this purpose.

A significant success in the search for sleeping pills was the synthesis in 1902 by the German chemist E. Fischer of barbituric acid derivatives – barbital and phenobarbital, which had a pronounced hypnotic effect. This was no doubt a significant achievement in the search for new drugs for insomnia. Therefore, already in 1904, E. Fischer received the Nobel Prize for this discovery. Then they began to synthesize new derivatives not only of barbituric acid, but also of other chemical groups.

Unfortunately, the first success was somewhat overshadowed by the side effects caused by barbiturates. In the morning, a person did not feel vivacity, freshness, there was a general (albeit insignificant) fatigue, a decrease in working capacity, a deterioration in mood. Research began to study the mechanism of such action.

One of the disadvantages of the action of barbiturates on the human body was that the sleep caused by these drugs does not “fit” into the phases of normal sleep. If we add to this that drug dependence develops due to the use of barbiturates, it becomes clear why these drugs have not been practically used in the treatment of insomnia in recent years.

At the end of the 60s, a new group of hypnotics appeared – benzodiazepine derivatives (diazepam, phenazepam, chlordiadepoxide, etc.), which have not only hypnotic, but also a calming (tranquilizing) effect. The hypnotic effect of benzodiazepine derivatives is more physiological and resembles natural normal sleep, so they have become widely used to treat various forms of insomnia.

However, the use of benzodiazepines may also cause undesirable effects, such as: slight daytime sleepiness, fatigue, headache, incoordination, muscle weakness. They should not be prescribed to pregnant women due to an adverse effect on the fetus (mental retardation, muscle hypotension). Unfortunately, it turned out that drugs of this group can cause even more pronounced drug dependence than barbiturates. This has significantly limited the use of benzodiazepine derivatives for insomnia.

Imidazopyridine derivatives include zolpidem hemisuccinate. In addition to the hypnotic effect, the drug has a sedative, as well as a slightly pronounced anxiolytic, anticonvulsant and central muscle relaxant effect. Zolpidem hemisuccinate is prescribed at a dose of 10-20 mg for situational, short-term and chronic sleep disorders, including difficulty falling asleep, nocturnal and early awakenings. In a review article on the pharmacotherapy of insomnia, J.L. Goren et al (1999), note that zolpiden, interacting with benzodiazepine receptors, can cause drug dependence.

In recent years, a new hypnotic drug, an ethanolamine derivative, DONORMIL (doxylamine succinate) has been used in medical practice.

DONORMIL is available in the form of coated tablets and effervescent tablets. One tablet, both effervescent and coated, contains 15 mg of doxylamine succinate.

DONORMIL is widely used in the countries of Western and Central Europe, the Middle East, etc., and in most countries DONORMIL is included in the group of over-the-counter drugs.

The pharmacokinetic properties of DONORMILA are characterized by the fact that the active substance, doxylamine succinate, is well absorbed from the intestine. Its plasma half-life is comparable to that of benzodiazepines. Biotransformation of doxylamine succinate is carried out in the liver only partially. The main part of the drug (about 60%) is excreted unchanged in the urine, partly in the feces.

In the pharmacodynamics of DONORMILA, one can distinguish: 1) features of the mechanism of action; 2) the physiological nature of the hypnotic effect.

1. A feature of the mechanism of the hypnotic action of DONORMILA is that the active substance of the drug, doxylamine succinate, acts simultaneously on M-cholinergic (which resembles central anticholinergics) and N ₁ -histamine (which resembles the antihistamine drug – dimedrol (diphenylhydramine)) receptors in the central nervous system (CNS). Such a combined effect on receptors in the central nervous system enhances the hypnotic effect, as well as the development of the sedative effect of the drug.

2. Unlike other hypnotic drugs, DONORMIL not only increases the duration and improves the quality of sleep, but also does not disturb the physiological phases of normal sleep and circadian rhythms. This is one of the most important features of the new hypnotic drug DONORMIL.

Indications for its use are sleep disorders and insomnia of various origins in patients aged 15 years and older.

Usually the drug is prescribed in a dose of 1/2-1 tablet 15-30 minutes before bedtime. However, depending on the individual response of the patient, the dose of the drug can be reduced to 1/4 tablet or increased to 2 tablets. The effervescent tablet is dissolved in 150 ml of water, and the film-coated tablet is washed down with water. At the same time, the patient should know that the duration of sleep will be at least 7-8 hours, if the expected period of sleep is less, then after waking up for a short time, a decrease in psycho-emotional activity is possible. The drug is prescribed in courses: the first course lasting 10 days. This is enough to normalize sleep. If necessary, repeat 10-day courses are carried out with a break of 10-15 days.

At the Department of Dermatology and Venereology of the National Medical University, clinical studies were conducted to study the effectiveness of DONORMILA as a sleeping pill. The study compared the effects of DONORMILA and Dimedrol in patients with dermatological profile (eczema, pemphigus, mycosis, psoriasis) suffering from insomnia. The results of the study convincingly indicate that DONORMIL is significantly superior to Diphenhydramine in terms of the effectiveness of hypnotic action, and at the same time, it has practically no antihistamine effect.

At the Center for Somnological Research of the Russian Federation (Moscow) and at the Department of Nervous Diseases of the Moscow Medical Academy (headed by Corresponding Member of the Russian Academy of Medical Sciences, Prof. A.M. Vein), the hypnotic effect of DONORMILA was studied in patients with various types of insomnia. We studied the effect of the drug on the duration of sleep and its latent period. The duration of various stages of sleep was determined in accordance with international requirements according to the data of the encephalogram, electrooculogram, electromyogram, as well as on the basis of subjective and objective data. The results of the study convincingly indicate that DONORMIL has a pronounced hypnotic effect and normalizes the structure of sleep, usually without causing the development of side effects. At the same time, the effective therapeutic effect of Donormil on patients with severe sleep disorders was noted. DONORMIL reduced the duration of falling asleep, the duration of sleep, and also increased the duration of non-REM sleep phases.

In 1996, Schadeck B. et al. completed a multicenter, randomized, double-blind study involving 338 patients, comparing the hypnotic effect and safety of doxylamine succinate and zolpidem. The study revealed high activity of both drugs without significant differences in their safety and efficacy. However, side effects in the group of patients taking doxylamine succinate were observed less frequently. Thus, the results of the study indicate that doxylamine succinate is an effective and safe non-addictive drug that, due to its pharmacological properties, does not require special accounting and storage conditions and is available to the widest range of people with sleep disorders.

Side effects are noted only when the drug is used in high doses, in these cases, daytime drowsiness, dry mouth may occur, accommodation disturbances and constipation are even more rarely observed.

Contraindications to prescription: glaucoma, age under 15 years, hypersensitivity to the drug, lactation period.

It should be remembered that with the simultaneous use of DONORMILA with barbiturates, benzodiazepines, clonidine, opiate analgesics, neuroleptics, tranquilizers, there is an increase in the inhibitory effect on the central nervous system.

While taking DONORMILA with atropine or other blockers of M-cholinergic receptors, the risk of developing anticholinergic side effects increases: dry mouth, urinary retention is possible. Alcohol enhances the sedative effect of DONORMILA. As already noted, after taking DONORMILA, you should take 7-9 hours to sleep, if the duration of sleep is insufficient, then attention may be weakened, which can complicate driving or working with various mechanisms.

Overdose is possible only when taking the drug in very high doses.

Symptoms: mydriasis, flushing of the facial skin, hyperthermia, impaired coordination of movements, tremor, convulsions are possible. In the absence of treatment, severe hypotension may occur, accompanied by the development of collapse. The phase of excitation and development of seizures may be preceded by a state of CNS depression.

Treatment: symptomatic. It is necessary to wash the stomach, prescribe sorbents, saline laxatives. According to indications, anticonvulsants are used.

Thus, DONORMIL has the following characteristic features of pharmacological action in clinical use:

1. DONORMIL causes a long and sound sleep without disturbing its physiological phases (sleep structure), awakening is not accompanied by drowsiness, which contributes to active and productive activity during the day, as well as improving the quality of life.

2. DONORMIL is effective in almost all forms of sleep disorders, as it eliminates various pathological processes that lead to insomnia.

3. After taking DONORMILA in therapeutic (recommended) doses, patients do not experience an aftereffect (headache, weakness, general weakness, etc.).

4. The drug is well tolerated by patients. When DONORMILA is used in therapeutic doses, side effects are extremely rare.

5. DONORMIL does not cause drug dependence and withdrawal syndrome.

Thus, an effective hypnotic drug, DONORMIL, has appeared in the arsenal of doctors, which can be widely used in clinical practice to treat various forms of insomnia. An ethanolamine derivative – Donormil is one of the most effective and safe hypnotics, the use of which restores normal physiological sleep in a person suffering from insomnia.

Ivan Chekman, Corresponding Member
NAS and AMS of Ukraine, Honored Worker of Science and Technology of Ukraine, Professor, Head of the Department of Pharmacology with the Course of Clinical Pharmacology of the National Medical University. A.A. Bogomolets