| Drug Name: | Ambien (Generic) | Ambien (Generic) |
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Ambien belongs to the group of imidazopyridines and has hypnotic, anxiolytic and sedative effects, as well as minor anticonvulsant and central muscle relaxant activities.
Clinical effects: Ambien decreases sleep latency, reduces the number of night awakenings and increases total sleep time and improves its quality.
Indications for use
Ambien is indicated for the short-term treatment of sleep disorders (such as difficulties with sleep onset and frequent awakenings).
Routes of administration
Ambien should be taken by mouth before going to bed. Avoid taking a pill during the meal, as in this case, it will not work as quickly.
The recommended dose of Ambien is 10 mg per day. The dose can be increased to 15 mg per day as needed. The maximum recommended dose of Ambien is 20 mg per day.
Dosage adjustment may be necessary when Ambien is combined with other CNS depressants.
Weakened and elderly patients need lower doses of Ambien.
Side effects
During the treatment with Ambien, the incidence of side effects depends directly on the drug dosage. Women experience adverse reactions more often than men.
CNS: vertigo, cranialgia, worsening insomnia, nightmares, memory disorders, increased excitability, hallucinations, ataxia and emotional lability; peripheral nerve disorders (such as paresthesia and tremor). Elderly patients often experience behavioral disorders (including unreasonable anger, delusions and psychosis).
GI tract: diarrhea, dyspepsia, abdominalgia and flatulence.
Liver: elevated liver enzymes.
Musculoskeletal system: myalgia, arthritis, peripheral edema, decreased performance, gait disturbances and fever.
Contraindications
Ambien is contraindicated in patients with glucose-galactose malabsorption, lactose intolerance and lactase deficiency. Other contraindications include severe and/or acute or chronic liver failure; first trimester of pregnancy; breastfeeding; age under 18 years; sleep apnea; myasthenia gravis; hypersensitivity to the drug ingredients. Patients with minor to moderate liver/respiratory failure, mental disorders, depression, alcohol, drug and other types of addiction, as well as pregnant patients (during II and III trimester) should take Ambien with caution.
Drug interactions
Co-administration of Ambien with CNS depressants enhances its hypnotic and sedative effects.
A combination of zolpidem with antidepressants (such as bupropion, desipramine, venlafaxine and fluoxetine derivatives) can cause hallucinations.
Ketoconazole impairs the clearance of Ambien, while co-administration of these drugs may increase the blood levels of the latter.
Ritonavir may enhance the sedative effect of Ambien (up to respiratory distress).
Precautions
Ambien should be prescribed by the doctor after determining the cause of sleep disturbance (for example, mental or CNS disorder). Dosage adjustment (including prescription of additional drugs) is required in patients who don’t notice any clinical effects within 7–14 days after the beginning of treatment with Ambien. Central nervous system adverse effects are often individual and dose-dependent. Therefore, to reduce their intensity, patients (especially elderly ones) should take them just before going to bed. Zolpidem should not be used alone to treat mental disorders and depression.