How zolpidem works
Zolpidem is an active ingredient from the group of so-called “Z-drugs” (see initial letter). Drugs from this group have a sleep-promoting and calming (sedative) effect.
The nerve cells are in contact with each other via certain interfaces, the synapses. Here they communicate with each other via activating or inhibiting messenger substances: If a nerve cell releases such a messenger substance, it can be perceived by the neighboring nerve cell at certain docking sites.
Zolpidem interferes with this nerve cell communication by making the docking sites more sensitive to the inhibitory neurotransmitters. As a result, even a low concentration of inhibitory neurotransmitters can have a calming or sleep-promoting effect.
Absorption, breakdown and excretion
The sleeping pill is taken as a tablet and around 70 to 80 percent of it is quickly absorbed by the body. It quickly reaches the brain, where it unfolds its effect.
Zolpidem is mainly broken down by the liver into ineffective metabolic products. About half of these are excreted in the stool and half in the urine.
In total, it takes about two to four hours for half of the absorbed active substance to be excreted. The likelihood of feeling tired the next day (the so-called “hangover effect”) is therefore very low.
Zolpidem is used for the short-term treatment of sleep disorders in adults if they are of a certain severity. Long-term use can lead to a habituation effect.
Short-term in this context means a few days to a maximum of two weeks.
How zolpidem is used
The sleeping pill is currently only available in the form of tablets and sublingual tablets, which dissolve in the mouth after a few seconds. The latter are particularly suitable for patients who have problems swallowing or are tube-fed.
The tablet is taken in the evening before going to bed. Healthy adults take a single dose of ten milligrams of zolpidem, older patients or patients with liver damage take five milligrams.
The duration of use should be a few days to a maximum of two weeks. To stop taking the drug, the dose of zolpidem should be gradually reduced (“tapering”). The total duration of use (treatment and tapering) should not exceed four weeks.
What side effects does Zolpidem have?
Occasionally, i.e. in every hundredth to thousandth patient, symptoms such as confusion, irritability and double vision also occur.
When zolpidem is discontinued, so-called rebound insomnia can occur, which manifests itself in a renewed increase in insomnia. Therefore, the active ingredient should not be discontinued abruptly but by slowly reducing the dose.
What should be considered when taking zolpidem?
Contraindications
Zolpidem must not be taken if:
- severe liver dysfunction
- sleep apnea syndrome
- severe respiratory dysfunction
- myasthenia gravis (pathological muscle weakness)
Interactions
During treatment with zolpidem, other drugs that depress the nervous system and alcohol should be avoided. Otherwise the depressant effect may be excessively increased. This also drastically increases the risk of falls, especially in older patients.
Zolpidem is broken down in the liver. If active substances that influence the drug-degrading enzymes are taken at the same time, the effect of the sleeping pill may be weakened or intensified.
The active ingredient is also broken down slowly in patients with liver dysfunction, making it more effective. A reduced dosage is therefore usually sufficient for a sufficient effect.
Age restriction
Zolpidem is not approved for children and adolescents under the age of 18, as there is insufficient data in this age group.
Pregnancy and breastfeeding
Only limited data are available on the use of zolpidem during pregnancy. No increased risk of malformation is known from animal studies and exposed pregnancies.
Its use as an occasional and temporary sleep aid is acceptable during pregnancy. If sleep medication is required for a longer period of time, better researched alternatives should be used.
Zolpidem passes into breast milk in small quantities. Due to insufficient studies, it is recommended to avoid treatment with zolpidem during breastfeeding.
How to obtain medication with zolpidem
Zolpidem is available on prescription in Germany, Austria and Switzerland and can be obtained from pharmacies on presentation of a valid prescription.
How long has Zolpidem been known?
Due to its rapid breakdown in the body, the active ingredient zolpidem has been developed as a safe and effective sleeping pill.