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Zolpidem 10mg

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What is zolpidem?

Zolpidem, sold under the brand name Ambien, among others, is a medication primarily used for the short-term treatment of sleeping problems. Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and behavioral changes, such as sleep hygiene, have been tried.

It decreases the time to sleep onset by about fifteen minutes and at larger doses helps people stay asleep longer. It is taken by mouth and is available in conventional tablets, sublingual tablets, or oral spray.

Common side effects include daytime sleepiness, headache, nausea, and diarrhea. More severe side effects include memory problems and hallucinations.

The previously recommended dose was decreased in 2013, by the US Food and Drug Administration (FDA), to the immediate-release 10 mg for men, and 5 mg for women, in an attempt to reduce next-day somnolence.

Newer extended-release formulations include the 6.25 mg for women, and 12.5 mg or 6.25 mg for men, which also cause next-day somnolence when used in higher doses.

Additionally, driving the next morning is not recommended with either higher doses or the long-acting formulation.

While flumazenil, a GABAA–receptor antagonist, can reverse zolpidem’s effects, usually supportive care is all that is recommended in overdose.

Zolpidem is a nonbenzodiazepine or Z-drug which acts as a sedative and hypnotic. Zolpidem is a GABAA receptor agonist of the imidazopyridine class.

 It works by increasing GABA effects in the central nervous system by binding to GABAA receptors at the same location as benzodiazepines. It generally has a half-life of two to three hours. This, however, is increased in those with liver problems.

Zolpidem was approved for medical use in the United States in 1992. It became available as a generic medication in 2007.

Ambien is a Schedule IV controlled substance under the Controlled Substances Act of 1970 (CSA). More than ten million prescriptions are filled each year in the United States, making it one of the most commonly used treatments for sleeping problems.

 In 2020, it was the 47th most commonly prescribed medication in the United States, with more than 14 million prescriptions.

Take zolpidem tartrate just before going to bed, when you are ready to go to sleep or when you are having trouble falling asleep. This medicine works very quickly to put you to sleep.

Dosing
  1. Adults—6.25 milligrams (mg) (for women) or 6.25 or 12.5 mg (for men) once a day at bedtime.
  2. Older adults—6.25 mg once a day at bedtime.
  3. Mechanism of ActionThe selective binding of zolpidem on the BZ1 receptor may explain the relative absence of myorelaxant and anticonvulsant effects. Overall, zolpidem is not recommended for the general population as a first-line treatment because of its high potential for abuse.

Zolpidem belongs to a class of medications called sedative-hypnotics.

Medical uses of zolpidem.

Zolpidem 10mg is labelled for short-term (usually about two to six weeks) treatment of insomnia at the lowest possible dose. It may be used for both improving sleep onset, sleep onset latency, and staying asleep.

Guidelines from NICE, the European Sleep Research Society, and the American College of Physicians recommend medication for insomnia (including possibly zolpidem) only as a second line treatment after non-pharmacological treatment options have been tried (e.g. cognitive behavioral therapy for insomnia).

 This is based in part on a 2012 review which found that zolpidem’s effectiveness is nearly as much due to psychological effects as to the medication itself.

A lower-dose version (3.5 mg for men and 1.75 mg for women) is given as a tablet under the tongue and used for middle-of-the-night awakenings.

It can be taken if there are at least 4 hours between the time of administration and when the person must be awake.

Adverse Effects of Ambien.

The most common adverse effects of short-term use include headache (reported by 7% of people in clinical trials), drowsiness (2%), dizziness (1%), and diarrhea (1%); the most common side effects of long-term use included

drowsiness (8%), dizziness (5%), allergy (4%), sinusitis (4%), back pain (3%), diarrhea (3%), drugged feeling (3%), dry mouth (3%), lethargy (3%), sore throat (3%), abdominal pain (2%), constipation (2%), heart

palpitations (2%), lightheadedness (2%), rash (2%), abnormal dreams (1%), amnesia (1%), chest pain (1%), depression (1%), flu-like symptoms (1%), and sleep disorder (1%).

Zolpidem

Zolpidem sleeping tablet increases risk of depression, falls and bone fracture, poor driving, suppressed respiration, and has been associated with an increased risk of death.

Upper and lower respiratory infections are also common (experienced by 1–10% of people).

Residual ‘hangover’ effects, such as sleepiness and impaired psychomotor and cognitive function, may persist into the day following nighttime administration.

Such effects may impair the ability of users to drive safely and increase risks of falls and hip fractures. Around 3% of people taking zolpidem are likely to break a bone as a result of a fall due to impaired coordination caused by the drug.

Some users have reported unexplained sleepwalking while using zolpidem, as well as sleep driving, night eating syndrome while asleep, and performing other daily tasks while sleeping.

Research by Australia’s National Prescribing Service found these events occur mostly after the first dose taken, or within a few days of starting therapy.

Overdose effects of zolpidem.

Overdose can lead to coma or death. When overdose occurs, there are often other drugs in the person’s system.

Zolpidem overdose can be treated with the GABAA receptor antagonist flumazenil, which displaces zolpidem from its binding site on the GABAA receptor to rapidly reverse the effects of the zolpidem. It is unknown if dialysis is helpful

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