Special Precautions Taking Zolpidem

Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep.

Before taking zolpidem,

• tell your doctor and pharmacist if you are allergic to zolpidem, any other medications, or any of the ingredients in the zolpidem product you are using. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants (‘mood elevators’) including imipramine (Tofranil) and sertraline (Zoloft); chlorpromazine; itraconazole (Onmel, Sporanox); ketoconazole (Nizoral); medications for anxiety, colds or allergies, mental illness, pain, or seizures; rifampin (Rifadin, Rimactane, in Rifamate, in Rifater) sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• you should not take more than one sleeping pill on the same night. If you have taken a zolpidem product or a different type of sleeping pill at bedtime and you wake up in the middle of the night, you should not take a zolpidem sublingual tablet (Intermezzo) or any other sleeping pill.
• tell your doctor what herbal products you are taking, especially St. John’s wort.
• tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications. Also tell your doctor if you have or have ever had depression; mental illness; thoughts of harming or killing yourself or trying to do so; a problem with heavy snoring; sleep apnea (condition in which breathing briefly stops many times during the night); other breathing problems such as asthma, bronchitis, and emphysema; myasthenia gravis (condition that causes weakness of certain muscles); or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking zolpidem, call your doctor.
• talk to your doctor about the risks and benefits of taking zolpidem if you are 65 years of age or older. Older adults should not usually take zolpidem because it is not as safe or effective as other medications that can be used to treat the same condition.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking zolpidem.
• you should know that zolpidem may cause drowsiness, decreased mental alertness, prolonged reaction time, and problems with coordination the day after you take it. Your ability to drive or operate machinery the day after you take zolpidem may be impaired even if you feel fully awake. Do not drive a car or operate machinery the day after you take an extended-release zolpidem product. If you are taking the sublingual tablets (Intermezzo), do not drive unless you feel fully awake and at least 4 hours have passed since you took the medication. Talk to your doctor about the risks of driving or operating machinery the day after you take any other zolpidem products.
• do not drink alcohol during your treatment with zolpidem. Alcohol can make the side effects of zolpidem worse.
• you should know that some people who took zolpidem got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, were sleep-walking, or were involved in other activities while not fully awake. After they woke up, these people were usually unable to remember what they had done. Call your doctor right away if you find out that you have been driving or doing anything else unusual while you were sleeping.
• you should know that your behavior and mental health may change in unexpected ways while you are taking this medication. It is hard to tell if these changes are caused by zolpidem or if they are caused by physical or mental illnesses that you may already have or suddenly develop. Tell your doctor right away if you experience any of the following symptoms: aggressiveness, strange or unusually outgoing behavior, hallucinations (seeing things or hearing voices that do not exist), feeling as if you are outside of your body, memory problems, difficulty concentrating, anxiety, becoming easily agitated, slowed speech or movements, new or worsening depression, thinking about killing yourself or trying to do so, confusion, and any other changes in your usual thoughts, mood, or behavior. Be sure that your family knows which symptoms may be serious so that they can call the doctor if you are unable to seek treatment on your own.