zolpidem tartrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
zolpidem tartrate: clinical details
Prescribing considerations
- Identify and address underlying causes of insomnia.
- Agree a stopping strategy and explain dependence, withdrawal and rebound insomnia.
- Assess psychiatric history, suicidality, substance or alcohol misuse, respiratory and hepatic function, falls risk and concurrent medicines.
- Counsel about next-day impairment, alcohol avoidance, amnesia and complex sleep behaviours.
Contraindications and cautions
- Hypersensitivity to zolpidem or a formulation excipient
- Obstructive sleep apnoea
- Myasthenia gravis
- Severe hepatic insufficiency
- Acute or severe respiratory depression
- Children and adolescents under 18 years, and patients with psychotic illness
Monitoring
- Clinical response and continuing need
- Daytime sedation, cognition, falls and driving risk
- Tolerance, misuse, dependence and withdrawal
- Depression, suicidality, paradoxical reactions or complex sleep behaviours
- Sedation and respiratory depression with other CNS depressants
Clinical pharmacology
An imidazopyridine hypnotic that preferentially modulates alpha-1-containing GABA-A receptors. Hepatic metabolism principally involves CYP3A4, with CYP1A2 contribution. Exposure is increased in older adults and hepatic impairment.
Formulation and product differences
- The selected Zentiva product is a film-coated oral tablet containing lactose and is essentially sodium-free.
- Zalzo is an orodispersible tablet that disperses on the tongue and may be swallowed with or without water.
- Zalzo contains lactose and aspartame, a source of phenylalanine.
zolpidem tartrate preparations and strengths
Dispersible tablet
Route: Oral
Strengths: 5 mg, 10 mg
Tablet
Route: Oral
Strengths: 5 mg, 10 mg
zolpidem tartrate interactions
Check prescribed, non-prescribed and herbal products with a pharmacist or prescriber.
Alcohol
Increases sedation, impaired coordination, next-day driving impairment and the risk of complex sleep behaviours; avoid combining them.
Opioids
Additive central nervous system depression can cause profound sedation, respiratory depression, coma or death.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.