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Zolpidem

Zolpidem ("ZOL-pi-dem") can be used to treat sleep problems

This page will give you general information about zolpidem. It is not medical advice. Always talk to your doctor about your situation and whether this medication is for you.

What's it for?

Zolpidem is licensed to treat the following conditions:

Name: zolpidem ("ZOL-pi-dem")

Medication type: non-benzodiazepine hypnotic medicine (also sometimes called a ‘Z drug’)

Other names: Stilnoct® ("STIL-nokt")

What can it be used for?
If you are 18 or over, the doctor can prescribe zolpidem for you as a licensed medicine if you have sleep problems.

There is less research about its use and effectiveness in young people under 18. Even so, specialists might prescribe it ‘off-label’ if they believe it is the best medicine for you.

Ways to take it:
Tablets: 5mg and 10mg strengths are available

NICE provide guidelines on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia.

N.B. since publication, zaleplon has been discontinued.

How it works

What does zolpidem do?

Zolpidem boosts the effectiveness of a chemical in the brain called gamma-aminobutyric acid (GABA) by attaching to the receptor sites in the brain where GABA normally works.

GABA is a chemical that calms nerve excitability in the brain. If the action of GABA in the brain is boosted, then sleep is improved.

How long does zolpidem take to start working?

Zolpidem starts to work very quickly in your body.

You should start to feel sleepy soon after taking it.

How long will I need to take zolpidem?

You should not take zolpidem for more than four weeks at a time.

You and your doctor should talk about how long you need to take zolpidem before you start treatment with the medication.

People can become dependent on the effects of zolpidem if they take it for more than a month, and then when they stop, they are more likely to get withdrawal symptoms.

Some people take zolpidem for a very short time (two to five days).

You may take zolpidem for two to four weeks, to get you into a new sleep routine, and then stop it so that you do not get hooked on it.

Your doctor needs to know if...

You need to talk to your doctor or pharmacist before starting treatment with zolpidem if any of the following apply to you:

  • you have myasthenia gravis (a problem that causes severe muscle weakness)
  • your lungs do not work properly (respiratory disease)
  • you have sleep apnoea (a problem where you stop breathing for short periods at night)
  • you have serious liver problems

You also need to talk to your doctor or pharmacist if any of the following apply to you:

  • you have any liver problems
  • you have ever been dependent on alcohol or drugs
  • you have ever experienced psychosis, or have had other mental health problems like depression
  • you have recently taken zolpidem or other similar medicines for more than four weeks

Taking zolpidem

You should only take zolpidem as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

Zolpidem should be taken at the lowest dose possible for the shortest possible time.

Your doctor might suggest ways to improve sleep naturally by changing some habits such as:

  • stopping daytime naps
  • reducing the intake of caffeine and alcohol
  • having a regular sleep-wake routine
  • making sure your sleeping area is as comfortable and quiet as possible

This is called the 'sleep hygiene approach' and you can talk about it with your doctor.

You should take zolpidem just before you go to bed.

If you can make sure that you get seven to eight hours of uninterrupted sleep, you will get fewer side effects like drowsiness the next day.

You can take it before or after food.

What if I miss a dose?

If you forget to take it by bedtime, just start again on the next night.

Do not take a forgotten dose during the day.

Do not take a double dose.

What will happen if I forget to take my zolpidem?

You could get your old symptoms back and have difficulty getting to sleep.

You could get withdrawal symptoms.

Stopping the use of zolpidem

Zolpidem may give you withdrawal symptoms if you stop taking it all at once.

You might get any of the following symptoms:

  • rebound sleeplessness
  • muscle pain or aches or cramps
  • feeling anxious, restless, irritable or confused
  • fast or uneven heartbeat
  • feeling strange or having nightmares or hallucinations (sensing things that are not there)
  • uncomfortable feelings in your stomach and gut
  • feeling unreal in yourself, like a puppet
  • feeling apart from reality
  • numbness and tingling in hands and feet
  • being more sensitive to light, noise and physical contact than normal
  • having seizures (fits)

Your doctor will help you to reduce zolpidem slowly over a few days at the end of your treatment.

If you suffer from any of these symptoms, go back to your doctor for advice.

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

CMHP
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