Warnings

Ambien

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 13, 2022

Warnings

What are the risks of taking Ambien (zolpidem tartrate)?

Ambien can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or about other treatment options.
Complex sleep behavior:

Complex sleep behaviors may occur following the first or any subsequent use of Ambien. Symptoms of complex sleep behavior include sleep-walking, sleep-driving, and engaging in other activities while not fully awake. Severe, even fatal injuries may result because of this. Other complex sleep behavior, including preparing and eating food, making phone calls, and having sex, have also been reported. People usually do not remember these events. Ambien should be discontinued immediately if complex sleep behaviors occur.

Central nervous system effects:

Risk factor: Co-administration with other CNS drugs such as benzodiazepines, opioids, tricyclic antidepressants, alcohol.
Like other sedative-hypnotics, Ambien has a CNS-depressant (central nervous system depressant) effect, which worsens if Ambien is being used with other CNS-depressant drugs. The CNSdepressant effect may cause severe daytime drowsiness and psychomotor impairment, including slowed speech, decreased movement, and impaired cognitive symptoms. Do not drink alcohol with Ambien. If you take other CNS-depressant medications, dosage adjustment of Ambien and other CNS depressants may be necessary.

Next-day impairment:

Risk factor: Taking Ambien with less than a full night of sleep (7 to 8 hours); if a higher than the recommended dose is taken; if coadministered with other CNS depressants or alcohol; or if coadministered with other drugs that increase the blood levels of Ambien.
If Ambien is taken with less than a full night of sleep (7 to 8 hours), next-day impairment is likely to occur. Examples of next-day impairment include drowsiness, sleepiness, reduced alertness, blurred/double vision, impaired driving the morning after zolpidem treatment. You should refrain from driving or performing any activities requiring complete mental attention.

Severe allergic reaction:

You can experience a severe allergic reaction after taking the first or subsequent doses of Ambien. Symptoms of an anaphylactic allergic reaction include swelling of the tongue, throat, and face. You should seek emergency medical help if you experience any of these symptoms. If you have ever had an allergic reaction to Ambien in the past, you should never try to retake Ambien.

Abnormal thinking and behavioral changes:

Abnormal thinking and behavioral changes have been reported in patients treated with sedative-hypnotics, including Ambien. Some of the changes include aggressiveness, agitation, and bizarre behavior. Hallucinations have also been reported in patients taking zolpidem; you may hear or see things that do not exist.

Worsening depression:

Risk factor: History of depression
If you have a history of depression, Ambien may worsen your depression. Increased suicidal thoughts, ideations, and actions have been reported. Intentional overdosage is also more common if someone already has depression. You should call your doctor and get emergency medical care if you have thoughts of harming yourself while taking zolpidem.

Respiratory depression:

Risk factors: sleep apnea; pre-existing respiratory impairment
Clinical trials have shown that taking zolpidem at the dose of 10 mg has caused respiratory depression leading to decreased oxygen saturation in patients with sleep apnea. Respiratory depression has also been reported in patients with other pre-existing respiratory impairments. If you have a history of lung disease or any breathing problems, taking Ambien at high doses may not be safe for you. You should discuss with your healthcare professionals about the risks and benefits of taking Ambien.

Exacerbation of liver disease:

Risk factor: History of liver disease
If you have liver disease, your liver may not clear Ambien as rapidly as people with normal liver function; taking Ambien may worsen your liver disease. You should talk to your doctor about other safer alternatives to help you fall asleep.

Withdrawal effects:

You should talk to your doctor if you want to discontinue Ambien. You should not stop Ambien abruptly, especially at high doses; abrupt discontinuation can cause severe withdrawal effects. Your healthcare professionals will give you instructions on how to reduce the dose of Ambien gradually.

What should I tell my doctor before starting Ambien (zolpidem tartrate)?

To make sure that Ambien is safe for you, tell your doctor if you have ever had:
- Depression, mental illness, suicidal thoughts and ideations
- Sleep apnea and other breathing problems
- Drug or alcohol addiction
- Kidney or liver disease
- Lung disease
Tell your doctor or pharmacist if you are allergic to zolpidem (Ambien) or any of the ingredients of zolpidem products. You can ask your pharmacist for a list of the ingredients.
Suppose you are taking any of the following: antidepressants, cold and allergy medications, sleep medicine, sedatives, anti-anxiety pills, and any medications for pain, mental illness, and seizures. Tell your doctor what other prescription and non-prescription medications you are taking, including over-the-counter products, vitamins, herbal supplements. Dosage adjustment may be necessary to reduce the risk of side effects.
Tell your doctor all prescription and non-prescription medications you are taking, including over-the-counter products, vitamins, herbal supplements; especially if you are taking any of the following: antidepressants, cold and allergy medications, sleep medicine, sedatives, anti-anxiety pills, and any medications for pain, mental illness, and seizures. Dosage adjustment may be necessary to reduce the risk of side effects.

What proper medical care should I take while on Ambien (zolpidem tartrate)?

Follow instructions on the prescription label or any instructions provided by your doctor.
Keep all of the lab and doctor appointments.
Be vigilant with any changes in your body, as Ambien can cause a life-threatening allergic reaction that requires emergency medical care.
Do not share Ambien with anyone, even if they have the same symptoms as you. Ambien is a controlled substance; selling or giving Ambien away is against the law.

What drugs can interact with Ambien (zolpidem tartrate)?

Many drugs can interact with Ambien, leading to decreased effectiveness or increased adverse effects. Taking Ambien with other medications that make you drowsy can worsen this effect. Examples of these medications are opioid pain relievers, sleep medicines, muscle relaxers, medicines for seizures and anxiety.

Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with zolpidem (Ambien). Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

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