Zolpidem is a type of sleeping pill that treats bad bouts of insomnia.
You can only get zolpidem on prescription. It comes as tablets, including ones that dissolve under your tongue.
It's also known as:
- Nytamel
- Stilnoct
- Zolnod
- Edluar
Uses of zolpidem
Zolpidem helps you fall asleep more quickly and also helps to stop you waking up during the night.
You'll usually take it for a short period because your body gets used to it quickly. After a few weeks, it's unlikely to have the same effect. Your body can also become dependent on it.
Check if you can take zolpidem
You can take zolpidem if you're 18 or over. But it is not suitable for some people.
Non-urgent advice: Check with your GP or pharmacist if you:
- have had an allergic reaction to any medicines in the past
- have liver or kidney problems
- have had heart problems or a condition called long-QT-syndrome
- have myasthenia gravis, an illness that causes muscle weakness
- have breathing problems or sleep apnoea
- have ever had mental health problems
- have ever had issues with alcohol or drugs
- are pregnant, trying to get pregnant, or breastfeeding
See the patient information leaflet that comes with your medicine for a full list of conditions to check with your GP.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Non-urgent advice: Talk to your GP if you're:
- trying to get pregnant
- pregnant
- breastfeeding
Contraception and fertility
Zolpidem does not affect how contraception. This includes the combined pill and the morning-after pill.
There is no evidence that zolpidem reduces fertility in either men or women.
Talk to your GP or pharmacist if you're trying for a baby. Your GP may review your treatment.
Pregnancy and zolpidem
Zolpidem is not recommended in pregnancy. This is because we do not know its effect on the baby.
Talk to your GP if you become pregnant while taking zolpidem. They will help you decide what to do. They may prescribe a different medicine.
Zolpidem may cause drowsiness or withdrawal symptoms in newborn babies.
Taking zolpidem at the end of pregnancy increases the chances of your baby having these problems. Your baby may need to stay in hospital for extra monitoring for a few days after they're born.
Breastfeeding and zolpidem
Do not breastfeed if you are taking zolpidem.
Zolpidem passes into breast milk in very small amounts.
Talk to your public health nurse or GP if you are taking zolpidem.
When you start taking zolpidem
Always take zolpidem exactly as your GP has told you. Do not take more than your prescribed dose.
You can take zolpidem with or without food. Swallow the tablet whole with a drink of water. Do not crush or chew it.
Zolpidem takes around 30 minutes to work, so take it just before you go to bed.
Avoid alcohol
Do not drink alcohol while you are taking zolpidem.
Alcohol and zolpidem together can make you sleep very deeply. You might not breathe properly and can have difficulty waking up.
Avoid caffeine
Do not have drinks with caffeine while you're on zolpidem. These include coffee, tea and cola. Caffeine has the opposite effect of zolpidem on your body. It can stops the medicine from working.
Zolpidem will make you sleepy (drowsy). It affects people in different ways and some people may feel sleepier than others. This includes feeling sleepier during the daytime.
Vehicles, machinery and zolpidem
Do not drive a car, ride a bike, or use tools or machines until you see how zolpidem affects you.
The day after you take zolpidem you may:
- feel drowsy, sleepy, dizzy or confused
- take longer to make decisions
- have blurred or double vision
- be less alert
Wait at least 8 hours before driving, using machinery or working at heights after you take zolpidem.
Talk to your GP or pharmacist if you are unsure if it is safe for you to drive while taking zolpidem.
See your patient information leaflet for more information about possible side effects which could affect your driving.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Dosage
Usually you will take one 10mg tablet every night.
You might start on a lower dose of 5mg if you:
- are age over 65
- have kidney or liver problems
Your GP might tell you to take a tablet just 2 or 3 nights a week, instead of every night.
How long you will take zolpidem
You will usually take zolpidem for between 2 days and 4 weeks.
Your body gets used to this medicine quickly. This means it will not work as well the longer you take it.
Talk to your GP if you feel you need to take it for longer than 4 weeks. They will be able to discuss your sleep problems and recommend other things that may help.
Stopping zolpidem
Do not stop taking this medicine suddenly. You may get withdrawal symptoms. Tell your GP if you want to stop taking zolpidem.
Withdrawal symptoms include:
- your insomnia returns more intensely than before
- you feel anxious, restless, have mood changes
- you become very sensitive to light, noise, and touch
Urgent advice: Contact your GP straight away if you:
- feel anxious, restless, irritable or confused
- have a headache
- get palpitations
- have nightmares or hallucinations
- are more sensitive to light, noise and touch than normal
- lose touch with reality
- feel distant from your body
- feel numbness and tingling in your hands and feet
- have aching muscles
- get stomach problems
- have problems sleeping
- have fits (seizures)
Your GP might recommend reducing your dose of zolpidem slowly over a few days or weeks.
Addiction and zolpidem
You are unlikely to become addicted to zolpidem if you just take it for a few weeks. But your body can become dependent on zolpidem.
Talk to your GP or pharmacist especially if you have been taking zolpidem for a long time.
If you take too much
Emergency action required: Call 112 or 999 or go to your nearest emergency department (ED) if you:
- take more than your prescribed dose of zolpidem
Do not drive yourself to the ED. Get someone else to drive or call 999 or 112 for an ambulance.
Bring the zolpidem packet or leaflet and any remaining medicine.
If you forget to take it
If you forget to take your tablet at bedtime, do not take it at any other time. Skip the missed dose and take your next dose as normal, before bedtime the next night.
Never take 2 doses at the same time.
Never take an extra dose to make up for a forgotten one.
Side effects
Zolpidem can cause side effects, but not everyone gets them.
There are things you can do to help cope with common side effects:
A bad taste in your mouth or dry mouth
Using a mouthwash before bedtime may help. Ask a pharmacist to recommend one that's good for a dry mouth, as some can make a dry mouth worse. You can also try taking sips of water and keep some water by your bed at night.
Feeling sleepy or tired the next day
Do not drive, cycle or use tools or machinery if you're feeling this way. Do not drink any alcohol as it will make you feel more tired.
Headaches
Make sure you rest and drink plenty of fluids. Do not drink alcohol. Ask your pharmacist to recommend a painkiller.
Talk to your GP if headaches last longer than a week or are severe.
Feeling dizzy
Stop what you're doing and sit or lie down until you feel better. Drink plenty of fluids, especially water. Do not drink alcohol. Avoid coffee, cigarettes and drugs. Do not drive, cycle or use tools or machinery until you feel better.
Feeling sick or getting sick
Stick to simple meals and do not eat rich or spicy food if you feeling sick (nausea) or getting sick (vomiting).
Get plenty of fresh air and take regular sips of a cold drink such as water. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.
Do not take any medicines to treat vomiting without speaking to a pharmacist or doctor.
If you take contraceptive pills and you're getting sick your contraception may not protect you from pregnancy. Check the pill packet for advice.
Diarrhoea
Drink lots of fluids, such as water, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.
Do not take any medicines to treat diarrhoea without speaking to a pharmacist or GP.
If you take the combined pill or the progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Back pain
Try to stay active and continue with your daily activities. Do not stay in bed for long periods of time. Try doing some exercises and stretches for back pain. Ask your pharmacist to recommend a painkiller.
Talk to your GP if the back pain is:
- severe
- stopping you from doing your day-to-day activities
- not getting better after a few weeks
- getting worse over time
Zolpidem can also cause stomach pain. Contact a GP or pharmacist if the advice on how to cope does not help and a side effect is still bothering you.
Serious side effects
Urgent advice: Stop taking zolpidem and call your GP straight away if you:
- develop memory loss (amnesia)
- see or hear things that are not real (hallucinations)
- fall over - particularly if you are over the age of 65
- have delusions - are imagining things that are not true
- feel low or sad - this could be a sign of depression
- have sleep problems that get worse after taking zolidem
- feel drowsy or very sleepy
- feel dizzy
- get blurred vision, see double or have other sight problems
- have a loss of appetite
- start sleep walking or other unusual behaviour
- feel intense elation or euphoria
- have problems with your liver, which will show up on blood tests
- feel dependent on zolpidem to feel normal
- have breathing problems
Serious allergic reactions
A serious allergic reaction (anaphylaxis) to zolpidem is rare.
Emergency action required: Call 112 or 999 or go to an emergency department (ED) if you:
- get a rash that is itchy, red, swollen, blistered or peeling
- are wheezing
- get tightness in your chest or throat
- have trouble breathing or talking
- have swelling in your mouth, face, lips, tongue or throat
Read the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Sleepwalking and zolpidem
Sometimes people sleepwalk or do another activity in their sleep after taking zolpidem.
This is more likely to happen if you take zolpidem with alcohol or other medicines that make you drowsy. These can include medicines for mental health problems like depression or anxiety.
If this happens to you, ask your GP for advice.
Zolpidem and other medicines
Tell your GP or pharmacist if you are taking any other medicines. This includes herbal remedies, vitamins or supplements.
Some medicines and zolpidem can affect each other. This can increase your chance of side effects.
Some medicines can make you more drowsy if you are taking zolpidem.
Talk to your GP or a pharmacist before taking zolpidem if you take medicines for:
- hay fever, rashes or other allergies that can make you sleepy. For example, chlorpheniramine or other drowsy antihistamines)
- schizophrenia or bipolar disorder
- depression
- epilepsy
- surgery or dental treatment
- anxiety
- sleep problems
- fungal infections, such as ketoconazole and itraconazole
- HIV infections
- pain, such as codeine, methadone, morphine, oxycodone, pethidine or tramadol
Also tell your GP or pharmacist if you take clarithromycin, erythromycin, rifampicin or St John's wort.
Herbal medicines and zolpidem
Do not take any herbal remedies that make you feel sleepy while taking zolpidem. These can increase the drowsy effects of your medicine.
Do not take St John's wort, the herbal remedy for depression.
Recreational drugs and zolpidem
You could go into a very deep sleep and have difficulty waking up if you take zolpidem while using:
- cannabis
- heroin
- methadone
Talk to a GP if you think you might use recreational drugs while you're taking zolpidem.
Fact check
This content was fact checked by a pharmacist, a GP, and the National Medication Safety Programme (Safermeds).
