Zolpidem

What zolpidem tartrate is and how it works

Zolpidem is a prescription-only sedative-hypnotic ('sleeping pill') used for the short-term treatment of insomnia, particularly trouble falling asleep. It carries a serious boxed warning about complex sleep behaviors -- see above. (1) (2) (4)

Take zolpidem exactly as your prescriber directs, only when you can devote a full night (at least 7-8 hours) to sleep, and only for the short period recommended. Never combine it with alcohol. If you have been taking it regularly, never stop it abruptly on your own -- ask your prescriber how to reduce the dose safely. The one exception is if you experience a complex sleep behavior (see boxed warning): contact your prescriber immediately and avoid taking any further doses in that specific situation.

Mechanism of action: how zolpidem tartrate works

Zolpidem is an imidazopyridine that acts as a positive allosteric modulator at the GABA-A receptor, selective for the omega-1 (alpha-1-containing) receptor subtype, increasing chloride channel opening and neuronal inhibition to promote sleep onset, with less effect on sleep architecture than older benzodiazepines at recommended doses. (1) (2)

What zolpidem tartrate is used for

Before taking zolpidem tartrate

Do not take / not appropriate for

• Do not take zolpidem if you have previously experienced a complex sleep behavior (such as sleep-walking or sleep-driving) after taking it. (United States, Canada, Australia) (1) (4) (5)
• Do not take zolpidem if you have myasthenia gravis, severe liver problems, obstructive sleep apnoea, or severe/acute breathing problems. (United Kingdom, Canada) (2) (4)
• Do not drink alcohol while taking zolpidem. (all countries) (2) (5)
• Do not take zolpidem if you are allergic to it or any of its ingredients. (all countries) (1)

Tell your clinician about

• Any personal or family history of sleepwalking, or any previous complex sleep behaviour on a sedative-hypnotic medicine.
• Any history of depression, mental illness, or suicidal thoughts.
• Any history of alcohol or drug misuse or dependence.
• Liver or breathing problems, including sleep apnoea.
• All other medicines you take, especially anything else that makes you sleepy (opioids, other sedatives, some antidepressants).
• If you are pregnant, planning pregnancy, or breastfeeding.
• Your sex -- your prescriber will use this, along with other factors, when deciding your starting dose in some countries (see How to take).

How to take zolpidem tartrate

• Take zolpidem exactly as prescribed, as a single dose immediately before bedtime -- do not take a second dose during the same night.
• Only take it when you can devote a full night (at least 7-8 hours) to sleep before you need to be fully alert again, such as for driving.
• Do not take it with or right after a meal -- this can slow how quickly it works.
• Use it for the shortest time your prescriber recommends -- typically no more than a few weeks, and often just a matter of days.
• If you have been taking zolpidem regularly and need to stop, do not stop abruptly on your own -- your prescriber will taper the dose down gradually to reduce withdrawal risk.
• Exception: if you experience a complex sleep behavior (see boxed warning above), contact your prescriber immediately and do not take zolpidem again until you have spoken with them -- do not wait.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (7)

Missed dose

Zolpidem is taken only when you are about to go to sleep with a full night available, not on a fixed daily schedule -- if you did not take it at bedtime and it is now close to morning or you no longer have at least 7-8 hours before you need to be alert, skip that dose rather than taking it late. Contact your prescriber if you are unsure.

Overdose

Seek emergency medical attention if you or someone else may have taken too much zolpidem, especially if combined with alcohol or other sedating medicines. Signs can include extreme drowsiness, slowed or difficult breathing, or loss of consciousness. (1) (2)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Alcohol: significantly increases sedation and impairment risk -- avoid entirely while taking zolpidem. (2) (5)
• Opioid pain medicines: combined use can cause profound sedation, breathing difficulty, coma, or death -- only combine if your prescriber decides there is no alternative, at the lowest doses and shortest duration needed, with monitoring. (2) (4)
• Other sedating medicines (other sleep aids, some antidepressants, anti-anxiety medicines): additive drowsiness and CNS depression. (1) (2)
• Certain antifungal medicines (e.g. ketoconazole) and other strong CYP3A4 inhibitors can raise zolpidem levels in the body, increasing side-effect risk -- a dose adjustment may be needed. (1) (2)
• Rifampin and St John's wort can make zolpidem less effective. (1) (2)
• Sertraline and some other antidepressants can raise zolpidem blood levels. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Screen for a personal/family history of sleepwalking or prior complex sleep behaviour on a sedative-hypnotic
• Screen for sleep apnoea, significant breathing problems, myasthenia gravis, and severe liver disease
• Review other sedating medicines and alcohol use
• Assess for depression or suicide risk

During treatment

• Re-evaluate if insomnia has not improved after the expected short course (often within about 1-2 weeks) -- this may signal an underlying condition needing separate treatment.
• Watch for any new complex sleep behaviour, worsening mood, or signs of dependence.
• Periodic review to confirm continued need, since long-term use is generally not recommended.

Storage

Store at room temperature, around 20-25°C (68-77°F). Keep in a secure place out of reach of others, given the risk of misuse, dependence, and diversion.

Frequently asked questions

References

1. AMBIEN (zolpidem tartrate) tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, initial US approval 1992 · United States · accessed 2026-07-29 · source 1
2. Zolpidem Tartrate 10mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Zentiva Pharma UK Limited · United Kingdom · accessed 2026-07-29 · source 2
3. List of nationally authorised medicinal products -- Active substance: zolpidem, Procedure No. PSUSA-00003151-202308European Medicines Agency (EMA), Human Medicines Division · European Union · accessed 2026-07-29 · source 3
4. SUBLINOX (zolpidem tartrate sublingual orally disintegrating tablets, 5 mg and 10 mg) -- Product Monograph including Patient Medication InformationHealth Canada product monograph, Bausch Health, Canada Inc. · Canada · accessed 2026-07-29 · source 4
5. STILNOX (zolpidem tartrate) Tablets -- Australian Product InformationTherapeutic Goods Administration (TGA) / sponsor (Sanofi-Aventis Australia Pty Ltd) -- Australian Product Information · Australia · accessed 2026-07-29 · source 5
6. Search for a current Medsafe data sheet or Pharmac listing for zolpidem/Stilnox, and NZ controlled-drug scheduling statusMedsafe data sheet index search, Pharmac Schedule search, and NZ Misuse of Drugs scheduling documentation · New Zealand · accessed 2026-07-29 · source 6
7. Questions and Answers: Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidemU.S. Food and Drug Administration -- Drug Safety and Availability communication · United States · accessed 2026-07-29 · source 7

Brand names by country

Single-ingredient zolpidem tartrate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries