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.
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Trade names | Ambien and Ambien CR, others |
AHFS/Drugs.com | Monograph |
MedlinePlus | a693025 |
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Dependence liability | Physical: High Psychological: Low–moderate |
Routes of administration | By mouth, sublingual, oromucosal (spray), rectal |
Drug class | Nonbenzodiazepine, sedative-hypnotic |
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Pharmacokinetic data | |
Bioavailability | 70% (by mouth) |
Protein binding | 92% |
Metabolism | Liver through CYP3A4 (~60%), CYP2C9 (~20%), and CYP1A2 (~14%) |
Metabolites | (ZCA) zolpidem 6-carboxylic acid; (ZPCA) zolpidem phenyl-4-carboxylic acid |
Onset of action | ≤ 30 Minutes |
Elimination half-life | 2.0 - 3 hours |
Duration of action | 3 hours |
Excretion | Kidney (56%) fecal (34%) |
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ECHA InfoCard | 100.115.604 |
Chemical and physical data | |
Formula | C19H21N3O |
Molar mass | 307.397 g·mol−1 |
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Melting point | 193–197 °C (379–387 °F) |
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Common side effects include daytime sleepiness, headache, nausea, and diarrhea. More severe side effects include memory problems and hallucinations. 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. Zolpidem 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 2021, it was the 63rd most commonly prescribed medication in the United States, with more than 10 million prescriptions.