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AMBIEN
AMBIEN ONLINE
Before Using This Medicine
Sleep medicines may cause a special type of memory loss or
``amnesia''. When this occurs, a person does not remember what has
happened during the several hours between use of the medicine and
the time when its effects wear off. This is usually not a problem
since most people fall asleep after taking the medicine. In most
instances, memory problems can be avoided by taking zolpidem only
when you are able to get a full night's sleep (7 to 8 hours)
before you need to be active again. Be sure to talk to your doctor
if you think you are having memory problems.
In deciding to use a medicine, the risks of taking the medicine
must be weighed against the good it will do. This is a decision
you and your doctor will make. For zolpidem, the following should
be considered:
Allergies—Tell your doctor if you have ever
had any unusual or allergic reaction to zolpidem. Also tell your
health care professional if you are allergic to any other
substances, such as foods, preservatives, or dyes.
Pregnancy—Zolpidem has not been studied in
pregnant women. However, studies in pregnant animals have shown
that zolpidem slows down the development of the offspring when
given to the mother in doses many times the human dose. Before
taking this medicine, make sure your doctor knows if you are
pregnant or if you may become pregnant.
Breast-feeding—Although zolpidem passes into
breast milk, it has not been reported to cause problems in nursing
babies.
Children—Studies on this medicine have been
done only in adult patients, and there is no specific information
comparing use of zolpidem in children with use in other age
groups.
Older adults—Confusion and falling are more
likely to occur in the elderly, who are usually more sensitive
than younger adults to the effects of zolpidem.
Other medicines—Although certain medicines
should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur.
In these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking zolpidem, it is
especially important that your health care professional know if
you are taking any of the following:
 | Other central nervous system (CNS) depressants (medicines
that cause drowsiness) or
| Tricyclic antidepressants (amitriptyline [e.g., Elavil],
amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil],
desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan],
imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl],
protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])—The
CNS depressant effects of either these medicines or zolpidem
may be increased, possibly leading to unwanted effects |
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Proper Use of This Medicine
Take this medicine only as directed by your doctor. Do
not take more of it, do not take it more often, and do not take it
for a longer time than your doctor ordered. If too much is taken,
it may become habit-forming (causing mental or physical
dependence).
Take zolpidem just before going to bed, when you are ready to
go to sleep. This medicine works very quickly to put you to sleep.
Do not take this medicine when your schedule does not
permit you to get a full night's sleep (7 to 8 hours). If you
must wake up before this, you may continue to feel drowsy and may
experience memory problems, because the effects of the medicine
have not had time to wear off.
Zolpidem may be taken with or without food or on a full or
empty stomach. It may work faster if you take it on an empty
stomach. However, if your doctor tells you to take the medicine a
certain way, take it exactly as directed.
Dosing—
The dose of zolpidem will be different for different patients. Follow
your doctor's orders or the directions on the label. The
following information includes only the average doses of zolpidem.
If your dose is different, do not change it unless your
doctor tells you to do so.
The number of tablets that you take depends on the strength of
the medicine.
| For oral dosage form (tablets):
| For the treatment of insomnia (trouble in sleeping):
| Adults—10 milligrams (mg) at bedtime.
| Older adults—5 mg at bedtime.
| Children up to 18 years of age—Use and dose must
be determined by the doctor. |
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Missed dose—
If you miss a dose of this medicine, skip the missed dose and
go back to your regular dosing schedule. Do not double doses.
Storage—
To store this medicine:
| Keep out of the reach of children.
| Store away from heat and direct light.
| Do not store in the bathroom, near the kitchen sink, or in
other damp places. Heat or moisture may cause the medicine to
break down.
| Do not keep outdated medicine or medicine no longer needed.
Be sure that any discarded medicine is out of the reach of
children. |
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Precautions While Using This Medicine
If you think you need to take zolpidem for more than 7 to 10
days, be sure to discuss it with your doctor. Insomnia that lasts
longer than this may be a sign of another medical problem.
This medicine will add to the effects of alcohol and other CNS
depressants (medicines that slow down the nervous system, possibly
causing drowsiness). Some examples of CNS depressants are
antihistamines or medicine for hay fever, other allergies, or
colds; sedatives, tranquilizers, or sleeping medicine;
prescription pain medicine or narcotics; barbiturates; medicine
for seizures; muscle relaxants; or anesthetics, including some
dental anesthetics. Check with your doctor before taking any
of the above while you are using this medicine.
This medicine may cause some people, especially older persons,
to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less
alert than they are normally. Even though zolpidem is taken at
bedtime, it may cause some people to feel drowsy or less alert on
arising. Also, this medicine may cause double vision or other
vision problems. Make sure you know how you react to zolpidem
before you drive, use machines, or do anything else that could be
dangerous if you are dizzy, or are not alert or able to see well.
If you develop any unusual and strange thoughts or behavior
while you are taking zolpidem, be sure to discuss it with your
doctor. Some changes that have occurred in people taking this
medicine are like those seen in people who drink alcohol and then
act in a manner that is not normal. Other changes may be more
unusual and extreme, such as confusion, worsening of depression
hallucinations (seeing, hearing, or feeling things that are not
there), suicidal thoughts, and unusual excitement, nervousness, or
irritability.
If you will be taking zolpidem for a long time, do not stop
taking it without first checking with your doctor. Your doctor may
want you to reduce gradually the amount you are taking before
stopping completely. Stopping this medicine suddenly may cause
withdrawal side effects.
After taking zolpidem for insomnia, you may have difficulty
sleeping (rebound insomnia) for the first few nights after you
stop taking it.
If you think you or someone else may have taken an overdose
of this medicine, get emergency help at once. Taking an
overdose of zolpidem or taking alcohol or other CNS depressants
with zolpidem may lead to breathing problems and unconsciousness.
Some signs of an overdose are severe drowsiness, severe nausea or
vomiting, staggering, and troubled breathing.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some
unwanted effects. Although not all of these side effects may
occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the
following side effects occur:
| Less common
| Clumsiness or unsteadiness; confusion—more
common in older adults; mental depression |
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| Rare
| Dizziness, lightheadedness, or fainting;
falling—more common in older adults; fast
heartbeat ; hallucinations (seeing, hearing, or
feeling things that are not there); skin rash;
swelling of face; trouble in sleeping; unusual
excitement, nervousness, or irritability; wheezing
or difficulty in breathing |
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| Symptoms of overdose
| Clumsiness or unsteadiness (severe); dizziness
(severe); double vision or other vision problems;
drowsiness (severe); nausea (severe); troubled
breathing; slow heartbeat; vomiting (severe) |
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Other side effects may occur that usually do not need medical
attention. These side effects may go away during treatment as your
body adjusts to the medicine. However, check with your doctor if
any of the following side effects continue or are bothersome:
| Less common
| Abdominal or stomach pain; daytime drowsiness ;
diarrhea; double vision or other vision problems;
drugged feelings; dryness of mouth; general
feeling of discomfort or illness; headache;
memory problems; nausea; nightmares or unusual
dreams; vomiting |
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After you stop using this medicine, your body may need time to
adjust. The length of time this takes depends on the amount of
medicine you were using and how long you used it. During this time
check with your doctor if you notice any of the following side
effects:
| Abdominal or stomach cramps or discomfort; agitation,
nervousness, or feelings of panic; convulsions
(seizures); flushing; lightheadedness ;
muscle cramps; nausea ; sweating; tremors;
uncontrolled crying; unusual tiredness or weakness;
vomiting; worsening of mental or emotional problems |
Other side effects not listed above may also occur in some
patients. If you notice any other effects, check with your doctor.
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