Zolpidem is known as an improved drug from the category of antidepressants and sleep regulators, which is used alone or in combination with other drugs to treat sleep disorders. By affecting the central nervous system, this drug has the ability to improve the quality and duration of sleep. In addition, zolpidem is an effective drug in reducing anxiety and relieving psychological concerns related to sleep problems. In this article, we will review the pharmaceutical forms, uses, mechanism of action, amount and time of use, precautions and contraindications of Zaleplon.
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Pharmaceutical forms of zolpidem
Zolpidem drug is available in 5 mg and 10 mg capsule forms in the Iranian market. Drugs of the same group include meprobamate, zalplon, hydroxyzine, buspirone, chloral hydrate, dexmedetomidine, droperidol, s zopiclone, ramelton, etc.
Zolpidem uses
This drug is used for a short period of time to treat people who have trouble sleeping. If you have other sleep problems, such as not being able to sleep through the night, this medicine may not be right for you. Zaleplon is known as a sleep aid. This drug works on specific centers in the brain to calm you down and help you fall asleep faster. If you notice that you have done any of these activities after taking this medicine (i.e., you forgot but remembered after a while), tell your doctor right away. If you have this reaction to the drug, you should not use this drug or similar drugs (such as eszopiclone).
Pharmacological effects and mechanism of action of zolpidem drug
Mechanism of action of zolpidem pyrazolopyrimidine; The agonist of the GABA-BZD receptor complex. These receptors are widely scattered in the brain, and by connecting to the GABA receptor site, it increases the nerve transmission effects of this chemical mediator. This connection causes the opening of the chloride channel on the receptor, which increases the polarization of the neuron. 70% of this drug is eliminated through urine and 17% through feces.
Dosage of zolpidem
Take this medicine orally as directed by your doctor. Zaleplon works very quickly, so it is important to take it just before or when you go to bed. If you use this medicine, note that you must have enough time for proper sleep (about 8 to 9 hours). Taking this medicine has caused memory loss or complete consciousness in some patients, so it is suggested to avoid doing things that require consciousness (such as driving).
Time to take zolpidem capsules
Dosage is based on medical condition, age and response to treatment. Because this medicine is usually prescribed for a short time, your doctor will tell you when to stop taking it or when to reduce it. After stopping zolpidem, some patients experience side effects such as anxiety or difficulty falling asleep (relapsed insomnia). If you suddenly stop taking this medicine, you may experience withdrawal symptoms (such as unusual moods, depression, anxiety, stomach or muscle cramps, vomiting, sweating, tremors, or seizures).
Notes regarding the use of Zolpidem
- This drug is prescribed by a doctor for short-term treatment of insomnia. The recommended dose is 10 mg initially, which is 5 mg for people with low weight. A dose of 20 mg may also be required for patients who do not benefit from a lower dose.
- Indications for use and recommended dosage in children are not stated by the manufacturer.
- This drug is recommended for the short-term treatment of insomnia in the elderly. The recommended dose is 5 mg per day, the total amount of which should not exceed 10 mg.
- After taking zolpidem medicine, some patients have woken up and started doing different things like (driving, eating, etc.), but after waking up, they don’t remember anything (short-term forgetfulness). This medicine has caused short-term amnesia in some patients, so avoid taking it without a doctor’s prescription.
Precautions
Before taking zolpidem, if you are allergic to it or other ingredients in the drug, do not use it. This medicine may contain inactive ingredients that can cause allergic reactions or sensitivities. If you have medical records such as liver problems, very high or low blood pressure, breathing problems (such as asthma), depression, personal or family history of substance use disorder (such as overuse or addiction to drugs or alcohol) and… with a doctor in Consult regarding the risks of use. Also, alcohol or marijuana (cannabis) can make you dizzy or drowsy.
- Use caution in mild to moderate hepatic impairment. The use of this drug is not recommended with severe liver failure. Also, short-term amnesia has occurred in some patients after consumption.
- Use caution in patients with respiratory disease or in patients experiencing clinical depression (conditions may worsen).
- Treatment can cause drowsiness and decrease the level of consciousness. Patients, especially the elderly, are more at risk of falling.
- Worsening of depression, including suicidal thoughts and actions (including complete suicide), has been reported in predominantly depressed patients treated with sedatives or hypnotics.
- Post-marketing reports have indicated that complex sleep behaviors may occur with the drug alone at recommended doses with or without concomitant use of alcohol or other central nervous system (CNS) depressants.
- Dose adjustment of the drug and other concomitant CNS depressants may be necessary when administering the drug with such agents due to potential additive effects.
- It is not recommended to use with other hypnotic or addictive drugs before bedtime or at midnight.
- The risk of psychomotor impairment the next day, including impaired driving, increases if the medication is taken with less than a full night’s sleep (7 to 8 hours). If taking the drug in these conditions, prohibit patients from driving and other activities that require full mental alertness.
- Signs and symptoms associated with withdrawal of other CNS depressants have been reported following rapid dose reduction or abrupt discontinuation of sedatives or hypnotics.
- Complex sleep behaviors including sleep walking, sleep driving, and engaging in other activities while not fully awake occur in some patients. Some of these events may result in serious injury, including death. If the patient experiences complex sleep behavior, discontinue treatment immediately.
Zolpidem contraindications
- Hypersensitivity
- Pregnant women (with prescription)
- Patients who have experienced complex sleep behaviors after taking Zalplon.
Zolpidem side effects
Short-term memory loss or lack of coordination, especially in the first 2 hours after taking zaleplon, has been reported in some patients. Taking the medicine correctly just before going to sleep reduces the risk of these side effects. If any of these effects persist or worsen, tell your doctor or pharmacist right away. In case of serious side effects such as mental or behavioral changes (such as restlessness, confusion, seeing or hearing things that are not there, rare thoughts of suicide), unusual behavior, etc., stop taking the medicine and see a doctor.
- Headache
- dizziness
- nausea
- stomach ache
- weakness
- dysmenorrhea
- eye’s pain
- forgetfulness
- paresthesia
- shaking
Zolpidem drug interactions
- Class X interactions (avoid): azelastine (nasal), bromperidol, orphenadrine, oxomazine, paraldehyde, rifampin, sodium oxybate, tea herb, thalidomide
- Reduction of zolpidem effects by drugs: deferasirox, enzalutamide, erdafitinib, evocidinib, mitotane, rifampin, sarilumab, ciltuximab, tea grass, tocilizumab, carbamazepine, moderate and strong inducers of CYP3A4, dabrafenib
- Increasing the effects of drugs by zolpidem: azelastine (nasal), blonanserin, buprenorphine, carbamazepine, flunitrazepam, methotrexate, metyrosine, orphenadrine, oxycodone, paraldehyde, piribdil, pramipexole, ropinirole, rotigotine, sodium oxybate, suvarexant, thalidomide.
- Increasing the effects of zolpidem by drugs: ketoconazole (systemic), lemborexant, lisuride, lofexidine, magnesium sulfate, melatonin, methotrexate, metoclopramide, minocycline (systemic), nabilone, oxomazine, prampanel, ritonavir, rufinamide, tetrahydrocannabinol, tetrahydrocannabinol and cannabidiol, alizapride, brimonidine ( topical), bromopride, bromperidol, cannabidiol, marijuana (cannabis), chlormethiazole, chlorphenesin carbamate, ciprofloxacin (systemic), CNS depressants, strong CYP3A4 inhibitors, dimetinden (topical), dronabinol, droperidol, fluvoxamine, itraconazole
- Interactions with food: This drug should not be used with or after food, because the maximum plasma concentration and bioavailability decrease and the time to reach the peak plasma concentration increases.
Taking zolpidem during pregnancy and breastfeeding
This drug is in group C in terms of the risks of use during pregnancy. It means that it can be used in special conditions and under the special supervision of a doctor. Animal studies in the field of Zolpidem have not shown any risk and no specific human studies are available.
Zolpidem storage conditions
Zolpidem (zaleplon) should be stored at room temperature and away from light and moisture. All chemical and herbal medicines should be kept out of the reach of children and animals. Dispose of this medicine according to health principles and avoid pouring it into the streets, sewers, etc.
The last word about Zolpidem
In the conclusion of this article from the positive green online pharmacy magazine, we can point out the popularity and widespread use of zolpidem in the management and treatment of sleep disorders. Sleep disorders are common problems that have adverse effects on people’s quality of life and general health. Zolpidem is known as an effective and proven drug in helping to improve sleep problems and relieve mental anxieties related to it. However, taking sleeping pills or similar drugs can cause addiction or dangerous side effects such as psychological or behavioral changes (such as restlessness, confusion, seeing or hearing things that are not there, rare suicidal thoughts), abnormal behavior, etc.
Site source: Medscape