Ambien possesses sedative action. This drug improves the intervals of falling asleep, decreases the number of nocturnal awakenings and improves the entire duration of sleep and its quality. It extends the second stage of sleep and the stage of deep sleep (third and fourth). Ambien doesn’t produce sleepiness during the day.
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- Acute and/or severe respiratory impairment;
- Severe or chronic liver failure;
- Nocturnal sleep apnea;
- Lactose intolerance;
- Patients under the age of 18;
- Hypersensitivity to Ambien or any other components of the drug.
It is necessary to prescribe Ambien therapy with caution to patients with respiratory failure, hepatic insufficiency, depressive disorder, alcoholism, drug and other addictions.
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Dosage and Administration
Ambien is administered right before bed time in a single take of 10 mg.
Treatment should begin with a dose of 5 mg for those patients who experience problems with liver or for elderly patients. If there is insufficient effect and the patient has good tolerability of Ambien, the dosage can be increased to 10 mg. The maximum daily dose is 10 mg. The period of treatment should not go above 4 weeks. With transient insomnia, the recommended period of treatment is 2-5 days, with a situational course – 2-3 weeks.
Short duration of treatment doesn’t call for a slow withdrawal of the drug. When the drug is being used for a long period of time, the risk of development insomnia increases, in which case the withdrawal should be carried out slowly (a gradual decrease in the daily dosage).
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Adverse Effects of Ambien
The most commonly experienced side effects for patients who are using Ambien include:
- Impaired vision;
- Taste distortion;
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Some of the less common adverse effects include:
- Increased sweating;
- Cardiovascular diseases (hypertension, tachycardia);
- Decreased cognitive ability;
- Difficulty concentrating;
Adverse effects which have the minimal rate of occurrence include:
- Allergic reaction;
- Abdominal pain;
- Face swelling;
- Restless legs syndrome;
- Weight loss;
- Circulatory disorders;
- Varicose veins;
- Hostile behavior;
- Decreased libido;
- Panic attacks;
- Suicidal behavior;
- Frequent urination;
- Acne dermatitis.
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Preservation of insomnia within 7-14 days of treatment indicates the presence of primary mental disorders and/or disorders of the nervous system. Therefore, in order to identify these disorders, the patient’s condition must be reassessed on a regular basis.
When Ambien is used, mental and behavioral reactions may occur. The risk of developing such responses is higher in elderly patients. If such reactions occur, the drug has to be discontinued. After the course of treatment that lasts for several weeks, there may be observed reduction in the sedative and hypnotic action of the drug.
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The use of Ambien (especially for a long time) can lead to the formation of physical and/or mental dependence, the chances of which increase in proportion to the dosage and length of treatment, as well as in patients with a history of alcohol abuse or other drugs and non-medicinal substances. Such patients should be closely monitored during the treatment period. However, dependence (extremely rare) can occur with the use of therapeutic doses and/or in patients without individual risk factors.
The combination with benzodiazepines increases the risk of drug dependence.
In elderly patients or with a violation of liver function, a significant increase in the half-life of Ambien may occur, which may lead to cumulation of the drug when it is repeated. Based on the peculiarities of Ambien pharmacokinetics, in case of chronic renal failure, cumulation of the drug is not expected.
When elderly people are using Ambien, care must be taken in connection with the chance of development of severe sedative and/or muscle relaxant effects.
During the treatment period, one should refrain from engaging in potentially dangerous activities that require increased concentration of attention (driving, working with mechanisms), and the speed of psychomotor reactions.
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Interaction with Other Drugs
Alcohol enhances the sedative action of Ambien, and it is not recommended to use at the same time during treatment.
Drugs that possess a depressive effect on the CNS (neuroleptics, barbiturates, other sleeping pills, anxiolytics/sedatives, antidepressants with sedative action, narcotic analgesics, antitussive of central action), antiepileptic drugs, general anesthetics, antihistamines with sedative effect, antihypertensive central action; baclofen; thalidomide; Pizotifen, when combined, there is an intensification of the oppressive action on the CNS and the chance of respiratory depression increases;
- Buprenorphine increases the chance of respiratory depression;
- Ketoconazole reduces the clearance of zolpidem, in connection with which it is possible to increase its sedative effect;
- Itraconazole produces a slight, clinically insignificant change in the pharmacokinetics and pharmacodynamics of Ambien.
Rifampicin accelerates metabolism, reduces the concentration and effectiveness of Ambien.
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