Experiences with
Zolpidem

Zolpidem is a sleeping pill that can be taken for short-term treatment of severe insomnia.

It helps you fall asleep more quickly and makes you less likely to wake up during the night. It works by affecting a calming chemical in your brain called gamma-aminobutyric acid (GABA).

Zolpidem comes as tablets. It's only available on prescription.

Who can take zolpidem

Most adults aged 18 and over can take zolpidem.

Who may not be able to take zolpidem

Zolpidem is not suitable for some people. To make sure it's safe for you, tell a doctor if you:

have ever had an allergic reaction to zolpidem or any other medicine
have liver or kidney problems
have myasthenia gravis, a condition that causes muscle weakness
have breathing problems or sleep apnoea, where you stop breathing for short periods while sleeping
have ever had mental health problems
have ever had issues with alcohol or drugs
are trying to get pregnant, already pregnant, or breastfeeding

Dosage and strength

Zolpidem tablets come in 2 different strengths: 5mg and 10mg.

The usual dose is one 10mg tablet, taken just before you go to bed. It takes around 30 minutes to work.

If you're 65 years old or over, or if you have kidney or liver problems, your doctor may start you on a lower dose of 5mg.

Do not take more than your prescribed dose of zolpidem.

It's important to take zolpidem exactly as your doctor tells you. Your doctor might ask you to take a tablet on only 2 or 3 nights of the week, rather than every night.

Swallow the tablet whole with a drink of water. Do not crush or chew it.

You can take zolpidem with or without food.

How long to take it for

You'll usually be prescribed zolpidem for 2 days to 4 weeks.

It's only prescribed for a short period because your body gets used to this medicine quickly. After taking it for a few weeks, it's unlikely to have the same effect. Your body can also become dependent on it.

If you still have problems sleeping after you finish your course of zolpidem, try lifestyle changes for insomnia such as taking a warm bath before bed and not napping during the day. See your doctor again if these changes do not help.

If you forget to take it

If you forget to take your zolpidem, leave out the missed dose. Start again the next night and take your zolpidem at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you take too much

Taking more than your prescribed dose of zolpidem can be dangerous. You may get symptoms including:

feeling drowsy, feeling confused, sleeping deeply and possibly going into a coma
feeling dizzy, light-headed or faint due to low blood pressure
floppy muscles
falling over or losing your balance
shallow breathing or difficulty breathing

you take more than your prescribed dose of zolpidem – even if you do not feel any different

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the zolpidem packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of zolpidem happen in more than 1 in 100 people. There are things you can do to help cope with them:

Using a mouthwash before bedtime may help. Ask a pharmacist to recommend one that's good for a dry mouth, as some can make a dry mouth worse. You can also try taking sips of water and keep some water by your bed at night.

Do not drive, cycle or use tools or machinery if you're feeling this way. Do not drink any alcohol as it will make you feel more tired.

Make sure you rest and drink plenty of fluids. Do not drink alcohol. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if headaches last longer than a week or are severe.

Stop what you're doing and sit or lie down until you feel better. Drink plenty of fluids, especially water. Do not drink alcohol. Avoid coffee, cigarettes and drugs. Do not drive, cycle or use tools or machinery until you feel better.

Stick to simple meals and do not eat rich or spicy food. Get plenty of fresh air and take regular sips of a cold drink such as water. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take contraceptive pills and you're being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you the combined pill or the progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Try to stay active and continue with your daily activities. Do not stay in bed for long periods of time. Try doing some exercises and stretches for back pain. Ask your pharmacist to recommend a painkiller.

Talk to your doctor if the back pain is severe, or stopping you from doing your day-to-day activities, or if it does not get better after a few weeks, or it's getting worse over time.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Some people can get serious side effects with zolpidem.

Stop taking zolpidem and call a doctor or call 111 as soon as possible if you:

develop memory loss (amnesia)
see or hear things that are not real (hallucinations)
fall over – particularly if you're over the age of 65
think things that are not true – these are called delusions
feel low or sad – this could be a sign of depression

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to zolpidem.

Meds New IA (H4) - serious allergic reaction

These are not all the side effects of zolpidem. For a full list, see the leaflet inside your medicines packet.

Zolpidem and pregnancy

Zolpidem is not usually recommended in pregnancy because little is known about its effect on the baby.

If you become pregnant while taking zolpidem, speak to your doctor. They will help you decide what to do and may switch you to a medicine that is more suitable for pregnancy.

Zolpidem may cause drowsiness or withdrawal symptoms such as agitation in newborn babies. Taking zolpidem at the end of pregnancy increases the chances of your baby having these problems. Your baby may need to stay in hospital for extra monitoring for a few days after they're born.

Zolpidem and breastfeeding

If you're having problems sleeping, it's best to try some practical steps to help you sleep first. You can also talk to your doctor or pharmacist as there may be other ways of improving sleep without taking zolpidem.

But if your doctor or health visitor says your baby is healthy, you can take zolpidem while breastfeeding. It's better to only take occasional doses, and only for a short time. The side effects of taking zolpidem could make you feel too tired to breastfeed and look after your baby.

There is not much information about taking zolpidem while breastfeeding, but information shows that zolpidem passes into breast milk in very small amounts. There is a very small risk that it might make your baby sleepy too.

Do not share a bed with your baby if you're taking zolpidem.

If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to a health visitor, midwife, pharmacist or doctor as soon as possible.

Zolpidem and fertility

There's no evidence to suggest that taking zolpidem will reduce fertility in either men or women.

Speak to a pharmacist or doctor if you're trying to get pregnant. They may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

Some medicines and zolpidem can affect each other and increase your chance of having side effects. Certain medicines may increase the drowsy (sedating) effects of zolpidem.

Speak to a doctor or a pharmacist before starting to take zolpidem if you take any of these medicines:

drowsy antihistamines such as chlorphenamine or promethazine
medicines to treat schizophrenia or bipolar disorder
medicines to treat depression
medicines for epilepsy
medicines to calm or reduce anxiety
medicines for sleep problems
ciprofloxacin, an antibiotic to treat bacterial infections
medicines used to treat fungal infections, such as ketoconazole or itraconazole
ritonavir, a medicine used to treat HIV infections
strong painkillers such as codeine, methadone, morphine, oxycodone, pethidine or tramadol

Mixing zolpidem with herbal remedies and supplements

Do not take any herbal remedies that make you feel sleepy while taking zolpidem.

These can increase the drowsy (sedating) effects of your medicine.

There's not enough information to say that other complementary medicines, herbal remedies and supplements are safe to take with zolpidem. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert