Zolpidem

Anxiolytic and Hypnotic Drugs

Drug class: Hypnotic

Zolpidem (STILNOX)（中文：唑吡坦）

Pronunciation

Zolpidem 10mg

Common Strengths of Zolpidem

Zolpidem are available in the following strengths:

• Tablet:
  • 10 mg
• Extended-Release Tablets:
  • 6.25 mg
  • 12.5 mg

Drug Trade Names of Zolpidem

Stilnox

Drug Usage

Zolpidem is used for:

• Short-term treatment of insomnia

Mechanism of Action

Zolpidem binds to the benzodiazepine site on GABA-A receptors, enhancing the effects of GABA (gamma-aminobutyric acid), which leads to sedative and anxiolytic effects.

Route of Administration

Oral

Dosages

• The usual dose is 10 mg taken just before bedtime.
• Elderly or Debilitated Patients:
  • A lower starting dose of 5 mg may be recommended.

Side Effects

Frequency	Adverse reactions
Common Side Effects	Drowsiness which may persist till the next day
	Dizziness
	Headache
	Nausea
	Dry mouth
	Diarrhea
	Nightmares
Serious Side Effects	Allergic Reactions: Symptoms may include swelling of the face, lips, tongue, or throat, diificulty breathing, and hives.
	Hallucinations: Seeing or hearing things that are not there.
	Severe Mood Changes: New or worsening symptoms of depression, uicidal thoughts, or unusual changes in behavior.
	Respiratory Depression: Slowed or shallow breathing, particularly when combined with other CNS depressants.
	Amnesia: Memory loss, especially related to events that occurred after taking the medication.
	Complex sleep-related behaviours such as sleepwalking, sleep driving, eating, and making phone calls while still sleeping.

Pharmacokinetics

• Absorption: Rapidly absorbed after oral administration; peak plasma concentrations occur within 1 to 2 hours.
• Half-Life: Approximately 2.5 hours.
• Metabolism: Primarily hepatic
• Excretion: Mainly renal

Drug Precautions

Pregnancy

Potential risks to the fetus.

Breastfeeding

Excreted in breast milk; caution is advised.

Contraindication

Patients with obstructive sleep apnoea, acute or severe respiratory depression, unstable myasthenia gravis, and psychotic illness.

Withdrawal Symptoms

Rebound insomnia may occur on withdrawal of therapy.

Children and Elderly

Not recommended for use in children. The elderly may require lower doses due to increased sensitivity.

Monitoring Requirements

Monitor for signs of dependence, withdrawal symptoms, and respiratory function.

Drug Interactions

Avoiding alcohol and other CNS depressants (such as opioids, benzodiazepines, fluoxetine, and sertraline) significantly increases the risk of sedation, respiratory depression, and impairment of psychomotor performance.

FAQ

How Should I Take the Tablet?

Take zolpidem at night, just before bed. Swallow the tablet whole with water; do not crush or chew it.

What Should I Avoid While Taking?

Avoid alcohol and other CNS depressants; do not drive or operate machinery until you know how zolpidem affects you.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember, but skip it if it is close to the next dose. Do not double up.