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Your guide to medication Zolpidem

Zolpidem is a medication that can be used to treat insomnia and sleep problems.

Medication name: Zolpidem ("ZOL-pi-dem")
Brand name: Stilnoct¬ģ ("STIL-nokt")
Medication type: Non-benzodiazepine hypnotic medicine (also sometimes called a ‚ÄėZ drug‚Äô)
Ways to take it: Tablets (5mg and 10mg strengths are available)

What can it be used for?
If you are 18 or over, the doctor can prescribe zolpidem for you as a licensed medicine if you have sleep problems.

There is less research about its use and effectiveness in young people under 18. Even so, specialists might prescribe it ‚Äėoff-label‚Äô if they believe it is the best medicine for you.

Read our guide to sleep problems

About zolpidem

How zolpidem works

Zolpidem boosts the effectiveness of a chemical in the brain called gamma-aminobutyric acid (GABA) by attaching to the receptor sites in the brain where GABA normally works.

GABA is a chemical that calms nerve excitability in the brain. If the action of GABA in the brain is boosted, then sleep is improved.

Sleep problems and mental health

Zolpidem and everyday life

Frequently asked questions

Zolpidem starts to work very quickly in your body. You should start to feel sleepy soon after taking it.

There is no information to suggest that zolpidem affects weight.

You may want to let your family and friends know you are taking zolpidem so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Some people have reported doing things like walking, preparing food, making phone calls, having sex and even driving while they were not fully awake. They do not remember doing these things after they wake.

If you take zolpidem with alcohol, or with other medicines for mental health conditions like antidepressants, this is more likely to happen.

If this happens to you, go back to your doctor to try another medicine.

Zolpidem can affect your recent memory, especially if you do not go to bed just after taking it, or if your sleep gets interrupted.

Make sure that you can get seven to eight hours of uninterrupted sleep if you are going to take zolpidem.

Alcohol

Do not drink alcohol while taking zolpidem, because having the two together might make you go into a deep sleep where you find it difficult to wake up.

If you need to drive a car or ride a bike, or use machines at work, taking alcohol and zolpidem together could be dangerous to yourself and other people.

Street drugs

It is very easy, and serious, to overdose with any combination of zolpidem and street drugs.

Using cannabis with zolpidem will make its sedative effect worse. You could go into a very deep sleep where you may have difficulty waking up.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.

Using heroin or methadone with zolpidem may increase their combined sedative effects. You may have difficulty waking up.

Using cocaine or other stimulants (like ecstasy, amfetamines, MDA, or 6-APB) with zolpidem is dangerous - it might lead to less of a high but can cause hallucinations.

Zolpidem does not mix well with some other medicines. Tell your doctor or pharmacist if you are taking any other medicines

Do not drink caffeine drinks while you are taking zolpidem.

Caffeine has the opposite effect of zolpidem in your body, and stops it working.

Caffeine can also cause anxiety and sleep loss - stopping these drinks might help to improve your symptoms.

The tablets may not be suitable for you if you have problems eating some sugars or dairy (milk-based) foods, as they contain lactose.

Let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

Taking zolpidem may make you feel tired, dizzy or confused, and may give you double-vision during the day when you start taking it.

These effects are made much worse if you take zolpidem with alcohol.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you.

Do not worry - most people drive as normal while taking zolpidem.

Pregnancy

Women who are pregnant should not take zolpidem without first discussing it with the doctor.

Small studies suggest no higher risk of malformations or miscarriage when usual doses have been taken.

If you are taking zolpidem during the last three months of pregnancy, you should tell your midwife and doctor so that they can look out for withdrawal symptoms.

Post-natal

Similar type drugs to zolpidem have been reported to cause muscle weakness, breathing difficulties and low blood sugars in newborn babies. Zolpidem itself does not appear to cause any of these problems but only further studies will confirm this.

Your baby may have breathing or feeding difficulties for a while.

They may also have low body temperature and their muscles may be floppy.

Breastfeeding

Zolpidem is passed to the baby through breast milk, but only in very small amounts.

If you must take zolpidem, talk to your doctor or midwife about your feeding options.

Sex

Zolpidem can have side effects that might impact your sex life. These include:

  • not feeling like you want to have sex

These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

If it works for you, zolpidem may have a positive effect on your sex life as your symptoms settle, and you can concentrate on your relationships.

Fertility

There is no evidence to suggest that zolpidem affects fertility.

If you want to get pregnant, however, you should discuss taking zolpidem with your doctor. Promethazine is usually the first choice. (Please see more information below).

Zolpidem is not a banned substance in sport.

Zolpidem has side effects, however, that might make you less able to take part in sports that need a lot of focus.

These side effects include feeling sleepy, dizzy, confused and having double vision.

Do not worry - many people play sport while taking zolpidem, and the good effects of zolpidem may have a positive impact on your sporting performance as you sleep better.

Try not to start or stop zolpidem just before your exams.

Zolpidem can make you feel tired or confused, and may give you double vision when you start taking it.

Stopping zolpidem can give you rebound symptoms of sleeplessness.

You should talk to your doctor about any future exams if you are starting or stopping zolpidem. You might decide together to delay starting or stopping it until you have done them.

If they are more than a few days away, however, you might find that it is better to start zolpidem to improve your sleep and your motivation to study.

Do not worry - most people take exams as normal while taking zolpidem.

Your doctor should know

  • You need to talk to your doctor or¬†pharmacist¬†before starting treatment with zolpidem if any of the following apply to you:

    • you have myasthenia gravis (a problem that causes severe muscle weakness)
    • your lungs do not work properly (respiratory disease)
    • you have sleep apnoea (a problem where you stop breathing for short periods at night)
    • you have serious liver problems

    You also need to talk to your doctor or pharmacist if any of the following apply to you:

    • you have any liver problems
    • you have ever been dependent on alcohol or drugs
    • you have ever experienced¬†psychosis, or have had other mental health problems like¬†depression
    • you have recently taken zolpidem or other similar medicines for more than four weeks

Uses, warnings, safety and side effects

Taking zolpidem

How long will I need to take zolpidem for?

You should not take zolpidem for more than four weeks at a time.

You and your doctor should talk about how long you need to take zolpidem before you start treatment with the medication.

People can become dependent on the effects of zolpidem if they take it for more than a month, and then when they stop, they are more likely to get withdrawal symptoms.

Some people take zolpidem for a very short time (two to five days).

You may take zolpidem for two to four weeks, to get you into a new sleep routine, and then stop it so that you do not get hooked on it.

You should only take zolpidem as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

Zolpidem should be taken at the lowest dose possible for the shortest possible time.

Your doctor might suggest ways to improve sleep naturally by changing some habits such as:

  • stopping daytime naps
  • reducing the intake of caffeine and alcohol
  • having a regular sleep-wake routine
  • making sure your sleeping area is as comfortable and quiet as possible

This is called the 'sleep hygiene approach' and you can talk about it with your doctor.

You should take zolpidem just before you go to bed.

If you can make sure that you get seven to eight hours of uninterrupted sleep, you will get fewer side effects like drowsiness the next day.

You can take it before or after food.

What if I miss a dose?

If you forget to take it by bedtime, just start again on the next night.

Do not take a forgotten dose during the day.

Do not take a double dose.

What will happen if I forget to take my zolpidem?

You could get your old symptoms back and have difficulty getting to sleep. You could also get withdrawal symptoms.

Stopping the use of zolpidem

Zolpidem may give you withdrawal symptoms if you stop taking it all at once.

You might get any of the following symptoms:

  • rebound sleeplessness
  • muscle pain or aches or cramps
  • feeling anxious, restless, irritable or confused
  • fast or uneven heartbeat
  • feeling strange or having nightmares or hallucinations (sensing things that are not there)
  • uncomfortable feelings in your stomach and gut
  • feeling unreal in yourself, like a puppet
  • feeling apart from reality
  • numbness and tingling in hands and feet
  • being more sensitive to light, noise and physical contact than normal
  • having seizures (fits)

Your doctor will help you to reduce zolpidem slowly over a few days at the end of your treatment.

If you suffer from any of these symptoms, go back to your doctor for advice.

Warnings and safety

Safety headlines

If you have taken more zolpidem than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately ‚Ästeven if you do not feel any different.

Zolpidem can cause serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital with your medicine if you get any of these symptoms.

Stopping zolpidem suddenly can cause withdrawal symptoms. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or confused in the first few days after taking zolpidem. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking zolpidem. If you take zolpidem while you are pregnant, it may affect the developing baby. Recent studies suggest it is unlikely to cause withdrawal symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more zolpidem than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately ‚Ästeven if you do not feel any different. Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You could get any of the following symptoms:

  • feeling drowsy
  • sleeping deeply
  • falling into a coma

If you have taken zolpidem with other drugs, including alcohol, you could get more serious side effects. You must get help quickly. Tell the doctors everything you have taken, so they can help you.

Go to a doctor or hospital straight away if you get any of the following symptoms:

  • a rash
  • swallowing or breathing problems
  • swelling of your lips, face, throat or tongue

When to see your doctor

Tell your doctor as soon as possible if you get any of the following side effects:

  • amnesia (memory loss)
  • unusual behaviour for you, like sleepwalking
  • delusions or hallucinations (believing, seeing or hearing things that are not real)
  • your sleeping problems get worse

Side effects

Side effects

Common side effects of taking zolpidem (affecting up to one in ten people) include:  

  • diarrhoea (loose poo)
  • nausea (feeling sick) or vomiting (being sick)
  • pain in your abdomen (gut)
  • headache
  • feeling tired, drowsy or sleepy in the day
  • feeling agitated
  • having nightmares
  • poor memory and slowed thinking
  • feeling dizzy
  • having back pain

A study done with children and young people aged six to 17 years showed that the following side effects were most common in this age group:

  • dizziness
  • headache
  • delusions or hallucinations (believing, seeing or hearing things that are not real)

There are other side effects that you can get when taking this medicine - we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

Taking zolpidem

How long will I need to take zolpidem for?

You should not take zolpidem for more than four weeks at a time.

You and your doctor should talk about how long you need to take zolpidem before you start treatment with the medication.

People can become dependent on the effects of zolpidem if they take it for more than a month, and then when they stop, they are more likely to get withdrawal symptoms.

Some people take zolpidem for a very short time (two to five days).

You may take zolpidem for two to four weeks, to get you into a new sleep routine, and then stop it so that you do not get hooked on it.

You should only take zolpidem as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

Zolpidem should be taken at the lowest dose possible for the shortest possible time.

Your doctor might suggest ways to improve sleep naturally by changing some habits such as:

  • stopping daytime naps
  • reducing the intake of caffeine and alcohol
  • having a regular sleep-wake routine
  • making sure your sleeping area is as comfortable and quiet as possible

This is called the 'sleep hygiene approach' and you can talk about it with your doctor.

You should take zolpidem just before you go to bed.

If you can make sure that you get seven to eight hours of uninterrupted sleep, you will get fewer side effects like drowsiness the next day.

You can take it before or after food.

What if I miss a dose?

If you forget to take it by bedtime, just start again on the next night.

Do not take a forgotten dose during the day.

Do not take a double dose.

What will happen if I forget to take my zolpidem?

You could get your old symptoms back and have difficulty getting to sleep. You could also get withdrawal symptoms.

Stopping the use of zolpidem

Zolpidem may give you withdrawal symptoms if you stop taking it all at once.

You might get any of the following symptoms:

  • rebound sleeplessness
  • muscle pain or aches or cramps
  • feeling anxious, restless, irritable or confused
  • fast or uneven heartbeat
  • feeling strange or having nightmares or hallucinations (sensing things that are not there)
  • uncomfortable feelings in your stomach and gut
  • feeling unreal in yourself, like a puppet
  • feeling apart from reality
  • numbness and tingling in hands and feet
  • being more sensitive to light, noise and physical contact than normal
  • having seizures (fits)

Your doctor will help you to reduce zolpidem slowly over a few days at the end of your treatment.

If you suffer from any of these symptoms, go back to your doctor for advice.

Warnings and safety

Safety headlines

If you have taken more zolpidem than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately ‚Ästeven if you do not feel any different.

Zolpidem can cause serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital with your medicine if you get any of these symptoms.

Stopping zolpidem suddenly can cause withdrawal symptoms. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or confused in the first few days after taking zolpidem. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking zolpidem. If you take zolpidem while you are pregnant, it may affect the developing baby. Recent studies suggest it is unlikely to cause withdrawal symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more zolpidem than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately ‚Ästeven if you do not feel any different. Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You could get any of the following symptoms:

  • feeling drowsy
  • sleeping deeply
  • falling into a coma

If you have taken zolpidem with other drugs, including alcohol, you could get more serious side effects. You must get help quickly. Tell the doctors everything you have taken, so they can help you.

Go to a doctor or hospital straight away if you get any of the following symptoms:

  • a rash
  • swallowing or breathing problems
  • swelling of your lips, face, throat or tongue

When to see your doctor

Tell your doctor as soon as possible if you get any of the following side effects:

  • amnesia (memory loss)
  • unusual behaviour for you, like sleepwalking
  • delusions or hallucinations (believing, seeing or hearing things that are not real)
  • your sleeping problems get worse

Side effects

Side effects

Common side effects of taking zolpidem (affecting up to one in ten people) include:  

  • diarrhoea (loose poo)
  • nausea (feeling sick) or vomiting (being sick)
  • pain in your abdomen (gut)
  • headache
  • feeling tired, drowsy or sleepy in the day
  • feeling agitated
  • having nightmares
  • poor memory and slowed thinking
  • feeling dizzy
  • having back pain

A study done with children and young people aged six to 17 years showed that the following side effects were most common in this age group:

  • dizziness
  • headache
  • delusions or hallucinations (believing, seeing or hearing things that are not real)

There are other side effects that you can get when taking this medicine - we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

About this information

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

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