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Active Ingredient: Zolpidem

Zolpidem, sold under the brand name Ambien® (or Ambien CR®), among others, is a medication primarily used for the short term treatment of sleeping problems.

The drug Ambien is a drug that has a sedative effect. It is available in tablets in a shell, a dosage of 10 mg. It belongs to the group of agonists that have a selective effect on omega-1-benzodiazepine receptors.

Recommendations before using sleep medications

Let's just say that there is no need to take sleeping pills medications for single insomnia. Talk to your doctor before taking sleeping pills. Discuss with them whether you should use medications or whether you can do with other methods of normalizing sleep.

Pharmacological action

The drug has a hypnotic effect, but in normal doses is not able to cause neuroleptic and anticonvulsant effects, muscle relaxation. Ambien excites benzodiazepine receptors localized in the receptor complexes of the inhibitory mediator-gamma-amino-butyric acid, located in the motor-sensory zone, the black substance, the bridge and other parts of the brain.

Zolpidem promotes rapid falling asleep, reduces the number of wakes up at night, allows you to increase the overall duration of sleep and its quality. It extends all phases of sleep, except the first, without causing fatigue and drowsiness during the day.

The drug is quickly absorbed from the digestive tract. The maximum plasma concentration occurs 30-180 minutes after administration. Metabolism occurs in the liver, the components of the drug are excreted by the kidneys and intestines. The half-life is up to 4 hours. In patients with liver tissue pathology, it is excreted in 8-12 hours.

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Indications and contraindications for use

The drug is used for:

  • sleep disorders, when it is difficult to fall asleep;
  • the presence of multiple awakenings at night;
  • anxiety state.

It is forbidden to use it in case of respiratory disorders – shortness of breath, hypoxia, severe respiratory failure. Also, Ambien is not used for decompensated liver failure, cirrhosis and hepatitis due to impracticality. This is due to destructive changes in the liver, which is unable to metabolize this medication.

It is strictly forbidden to use it when:

  • stopping breathing during sleep;
  • pregnancies;
  • childhood;
  • breast-feeding;
  • lactose intolerance, lactase that has a genetic character;
  • hypersensitivities.

In some cases, with caution, under the supervision of medical personnel, Ambien is prescribed for:

  • depressive syndrome;
  • chronic liver and kidney failure in the compensated phase;
  • chronic alcoholism, drug addiction.

Instruction for use

The drug is taken once, orally, in the amount of one tablet (10 mg). Persons of advanced age or weakened patients, with pathologies of the liver and bile ducts, are prescribed 5 mg. With weak effectiveness and normal tolerability of the drug, the dosage can be increased.

The maximum daily amount of 10 mg. the duration of treatment should be less than 4 weeks. Transient insomnia (causes of insomnia) is stopped within 3-5 days, situational-up to 21 days.

With short-term courses of therapy, there is no gradual step-by-step withdrawal of the drug. With a long period of treatment to avoid the phenomenon of rebound, manifested by insomnia, the drug is canceled gradually, reducing the amount of daily intake to zero.

Rules of reception and dosage

Take the medicine inside just before going to bed.

  1. A single dosage is 10 mg of the active substance.
  2. If the patient is weakened or there are liver disorders, a single dosage is 5 mg. If the clinical effect of taking 5 mg is insufficient and the patient tolerates the drug well, the dosage can be increased to 10 mg.
  3. The duration of the therapeutic course should not exceed 4 weeks. If insomnia is transient, it is recommended to take the drug for 3-5 days. In the case of situational insomnia, the course is from 2 to 3 weeks.
  4. If the course of treatment takes several days, there is no need to gradually cancel the drug. If the course of treatment was several weeks, the cancellation may cause the development of so-called ricochet insomnia. To avoid this, you must cancel Ambien gradually-the dosage is initially gradually reduced until complete cancellation.

Side effects of Ambien

Side effects are rare. The most pronounced adverse effects from the nervous system. Occur:

  • drowsiness;
  • pain in various parts of the head;
  • insomnia;
  • forgetfulness to the point of amnesia;
  • appearance of illusions and hallucinations;
  • sudden feelings of aggression, irritation;
  • sleepwalking (see Somnambulism);
  • sedative dependence.

If you abruptly cancel or stop taking the drug, you may experience:

  • rebound insomnia;
  • suppression of appetite, sexual desire.
  • change in gait, loss of balance.

From the digestive tract: stool disorders in the form of diarrhea, dyspepsia, epigastric pain, increased liver enzymes. From other organs and systems: fatigue, double vision, skin rashes, excessive sweating, myalgia.

Overdose is manifested by a confusion of consciousness to the point of blurring. This can lead to the development of inhibition, in some cases to a comatose state. In the case of poisoning, it is necessary to provoke vomiting or perform gastric lavage. After using adsorbents (Activated carbon, Enterosgel).

Special information

What do you need to know about the drug "Ambien"? Instructions for use (in tablets, this tool is sold in almost all pharmacies) States that with long-term treatment (about 20-30 days), the patient may develop a mental or physical dependence on the drug.

This reaction is particularly susceptible to those who have previously been observed to be dependent on alcoholic beverages and other substances. In this regard, such a group of patients should be kept under constant control, as well as periodically monitor their mental and physical condition.

It should be particularly noted that the risk of developing an addiction is significantly increased if the drug in question is combined with other benzodiazepines.

When taking "Zolpidem", the patient should take into account that within 8 hours after using the tablet, he should be in a comfortable environment for sleeping, otherwise he may develop anterograde amnesia.

If after several weeks of treating insomnia has not passed, the patient needs to reassess the condition. Most likely, this paradoxical reaction is a consequence of primary mental disorders.

In the course of treatment with the drug in question, a person should refrain from performing actions that require an increased concentration of attention, as well as from driving a car.

Some people may develop unusual behavioral disorders and mental reactions while taking Ambien (especially in the elderly). In this case, you should immediately stop taking the drug.

In the presence of liver disease, the active substance of the drug can accumulate in the body, and subsequently lead to undesirable effects.

With extreme caution, this drug should be prescribed to the elderly. This is because they have a high risk of developing sedative and muscle relaxant effects, which can lead to falls and injuries.

Principle of operation

The sleeping drug Ambien or Ambien CR® (zolpidem tartrate) belongs to the group of imidazopyridines. Due to its mechanism of action, it produces a sedative effect. The use of small doses of the drug does not cause an anticonvulsant effect, does not eliminate especially pronounced fear, anxiety, anxiety. The drug excites omega-receptors, which provokes the opening of neuronal channels for chlorine ions.

When using a drug under the trade name Ambien significantly reduces the time of falling asleep. Patients taking the drug note that their sleep becomes stronger, there are no frequent awakenings in the middle of the night. The quality of night rest increases, and in the morning a person does not feel tired and depressed.

After taking the tablets, the maximum concentration of the active substance in the blood is reached in 30 minutes (maximum in 3 hours, which depends on the individual characteristics of the human body). The components of the drug are processed by the liver, after which they are excreted together with urine and feces.

The opinion of a neurologist

Ambien tablets are good medicine that normalizes the process of falling asleep and sleep itself. But the cost is so high that patients simply refuse to buy this drug. Only those who have already fallen into despair from insomnia agree. I do not recommend Ambien to elderly patients, as they often develop adverse behavioral reactions. Young people and middle-aged patients well tolerated the treatment with Zolpidem and note its effectiveness. After a week of taking pills, the period of falling asleep is much shorter, and the sleep itself becomes stronger and calmer.

By: Dr. Peter Bernad | 02.04.2020



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