Ambien (Zolpidem): Insomnia Treatment Option, Side Effects, and Dosage

A Hypnotic Medication, Ambien Can Help to Initiate and Maintain Sleep

Ambien (zolpidem) is a prescription medication used for insomnia treatment that has important side effects and safety precautions
Ambien (zolpidem) is a prescription medication used for insomnia treatment that has important side effects and safety precautions. Getty Images

The pharmaceutical drug zolpidem - sold under the brand names of Ambien, Ambien CR, and Intermezzo - is a commonly prescribed hypnotic medication used to initiate sleep and to treat insomnia. What are the common side effects and dosage of Ambien? Learn about this medicine and important safety precautions and whether it is right for you to relieve difficulty sleeping.

Uses of Ambien to Treat Insomnia

Ambien is a hypnotic drug that has direct effects on the central nervous system, specifically the brain.

It causes drowsiness and is safe and effective for initiating and maintaining sleep. It is used to treat insomnia or acute insomnia.

You may be prescribed a standard or controlled-release (CR) formulation of the drug. There is also a fast-acting form that is taken under the tongue (sublingually). These vary slightly in how long it takes the body to metabolize them, but their effects are the same.

What Are the Available Dosages of Ambien?

Depending on the formulation used, there are different dosages of Ambien. Women in particular are advised by the U.S. Food and Drug Administration (FDA) to use lower doses due to the potential risks of morning hangover effects that may impact safe driving. 

The doses of the various formulations of zolpidem include the following:

  • Ambien: 5 mg or 10 mg
  • Ambien CR: 6.25 mg or 12.5 mg
  • Intermezzo (sublingual): 1.75 mg or 3.5 mg

Any decision regarding the proper dose should be discussed with your prescribing physician and consideration of your entire list of medications should occur.

How Does Ambien Work?

Ambien promotes the activity of GABA receptors, a special type of neurotransmitter. Neurotransmitters are chemicals that serve as messengers between nerve cells (neurons). The additional activity of the GABA receptors inhibits neuron activity that contributes to insomnia.

Who Should Not Use Ambien?

Fortunately, the risk of tolerance or dependence with extended use of Ambien is less than with other benzodiazepines.

The medication should not be taken with alcohol or with other drugs that suppress the central nervous system or respiratory system, as it may slow or stop your breathing.

It may not be the best drug to use if you have a history of alcohol abuse, drug abuse, depression, psychiatric disorders, lung, or liver problems. It should be used with caution in the elderly or debilitated.

What Are Common Side Effects of Ambien?

There are many potential side effects of any drug. At high doses, Ambien may cause amnesia (memory loss), suppression of REM sleep, or breathing difficulties. Abrupt cessation of the medication at higher doses may also cause rebound insomnia. Although an individual likely won't experience most side effects associated with the drug - and may indeed not have any of them - some that commonly occur include:

  • Headache
  • Drowsiness, lethargy, or a "drugged" feeling
  • Dizziness, lightheadedness
  • Constipation or diarrhea
  • Back pain
  • Allergic reactions
  • Sinusitis (sinus infection)
  • Pharyngitis (sore throat)
  • Dry mouth
  • Flu-like symptoms
  • Palpitations (irregular heartbeat)
  • Depression
  • Rash

What Are Potential Serious Reactions of Ambien?

With the use of any drug, there are also risks of serious side effects. These occur more rarely, but include:

  • Worsening depression
  • Suicidal thoughts
  • Aggressive behavior
  • Complex sleep-related behaviors (such as doing activities while asleep)
  • Hallucinations
  • Amnesia (memory loss)
  • Anaphylaxis (allergic reaction such as throat swelling and difficulties breathing)
  • Withdrawal after stopping the drug abruptly

What Safety Precautions Need to Be Taken With Ambien?

Ambien should be avoided in pregnancy and with breastfeeding. Certain individuals, as mentioned above, should use the medication with caution or not at all. There is no monitoring necessary with Ambien's use.

If you experience any difficulties with the use of Ambien, you should be in close contact with your primary health provider.


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Cooper, D.H. et al. The Washington Manual of Medical Therapeutics. 32nd edition, 2007. 14. Lippencott, Williams & Wilkins. New York.

Katzung, B.G. Basic & Clinical Pharmacology. 9th edition, 2004. 134-140. The McGraw-Hill Companies, Inc. New York.

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