Zolpidem is a non-benzodiazepine which acts as a sedative and hypnotic. It acts on your brain to produce soothing and calming effects. It is sold under some trendy brand names like Ambien and Belbien with the dosage of 10mg most commonly used. This drug was sent to the European Commission which accepted it, and thus its use is now adopted throughout Europe. Zolpidem used for? This class of drugs in used to treat insomnia which is a condition related to difculty sleeping as a short term treatment. This helps a person fall asleep easily and makes one less likely wake up during night intervals. Therefore, it is used for improving sleep onset and sleep onset latency. This is used only for adults’ ages 18 years and older. It is used as the drug of choice when hypnotic indicated in the elderly. How does it work? Zolpidem is a GABA receptor agonist. It works by balancing certain chemicals level in the brain, which is the reason for insomnia. GABA (gammaaminobutyric acid) blocks those neurotransmitters that make one’s brain active and not allow them to sleep. It binds to alpha one subunit of some ion channels and shows its hypnotic properties with some anxiolytic and anticonvulsant properties. Thus, being an agonist Zolpidem boosts GABA effect and provides a calming effect on the brain. Belbien has two variations one is immediaterelease form, and other is extended-release form. The extended form has two layers, rst layers dissolves and make you fall asleep, and then 2nd or inner layers dissolve slowly and help you stay asleep without waking up at night.
Major Brand Names Zolpidem is sold under several brand names, but of those, the most popular ones are these two which are available in tablet forms: ●Ambien 10mg ●Belbien10mg Routes of Administration You can take these tablets like other medications, my mouth with a simple water glass about 7 to 8 hours before sleep once a day. However, different routes of administration include sublingually, oromucosal spray and also rectally. Pharmacokinetics It is metabolized through the liver and excreted through kidneys and faeces. The onset of action is around 30 minutes, and the duration of action is 3 hours. Elimination half-life is 2.5 to 3 hours. How to use and Dosage It is usually taken on an empty stomach once at night in the form of a tablet. Don’t crush or chew it. After taking this drug, you must have a sleep of around 7 to 8 hours. Suppose you don’t sleep for this period or wake up early. In that case, you can experience a memory loss—irritability and trouble in doing other activities like driving and handling any machinery at work. Therefore, make sure to have proper sleep hours if you are taking this medicine. Dosage is based on medical conditions you have, your age, sex, current medications and response to this drug if you are taking this before. The drug is removed slowly in women than men; thus, a small dose is usually recommended in females. Older adults also have a high risk of adverse side effects due to comorbid conditions, so they are also prescribed low doses. Generally, a dose of more than 10 milligrams is not recommended. It is used for short term use as a few weeks.
Mostly it is prescribed for 2 or 3 nights of the week instead of every night to avoid addiction and dependency. Withdrawal of drug The dose is usually tapered off, and your doctor may lower your dose slowly to prevent you from severe withdrawal symptoms. The most common symptoms encountered when you suddenly stop using this drug include nausea, vomiting, abdominal cramps anxiety and ushing. If you have been using Zolpidem for an extended period and wants to stop using it, it’s mandatory to tell your pharmacist or a doctor, who will adjust your dose. Rebound insomnia When you stop taking medication, you may experience difculty sleeping for a period of 1 to 2 days, after which it will go away. This is called rebound insomnia. Suppose it persists after two days then its important t contacts your doctor. Complex sleep behaviours including sleep-driving, sleepwalking and doing other chores. So, the events may lead to severe consequences. It would help if you warned vehicle drivers and machine operators prehard. Common side effects The most common side effects related to Zolpidem includes Confusion Constipation Diarrhoea Dizziness Dry mouth Headache Lethargy Loss of coordination Nausea Sore throat Stomach upset Stuffy nose Visual problems Serious side effects It would be best if you always discussed some of the severe conditions related to the use of zolpidem with your doctor, and these are as follows: Aggressiveness Agitation Angioedema Depression Hallucinations Loss of memory Mood changes Severe allergic reactions Suicidal thoughts Effects on organs Eyes: It results in blurred vision, diplopia, redness of eyes and abnormal vision Genitourinary: In females, issues related to menstruation and vulvovaginal itching and redness are very common. Moreover, urinary tract infections are common in both males and females. Heart: It results in High blood pressure and increased heart rate Immunological: Its results in recurrent symptoms of cold and also infections at different sites of the body. Metabolism: It may result in loss and increase of appetite Musculoskeletal: Commonly results in neck pain, backache and muscle cramps.
Skin: rash and wrinkling of skin are common. It also results in urticarial. Interactions with other drugs Zolpidem has a wide range of reactions with other medications. Therefore, it’s essential to provide your doctor with a good history of illness and medication use. Most commonly, it interacts with these chemicals and drugs: Alcohol Anti seizures Antidepressants Benzodiazepines Chlorpromazine Itraconazole Muscle relaxants Opioids Pain medications Rifampin Tricyclic antidepressants Pregnancy and its use About 95% of women experiences problems related to sleep in their pregnancy, for which they try to have medications. As these medicines have some excellent effects regarding ease of sleep, they have some of the harmful effects on the health of mother and child. Its use has not been assigned to a pregnancy category by the FDA. There are no controlled data in human studies; however, animal studies have revealed incomplete ossications and fetal growth problems. Use of this drug in pregnancy, especially in last trimester has effects on the newborn. Limpness, difculty breathing and sleepiness are seen in babies born to mothers who use Zolpidem.
Additionally, other researches shave shown the increased risk of preterm delivery, low birth weights and respiratory issues in babies. Also, these drugs affect the release of oxytocin and vasopressin in mother, which results in vasoconstriction of the uterus, which impacts the central ventilator drive of baby and results in respiratory depression. Due to vasoconstriction blood ow to uterus decreased and also inuenced fetal growth. Breastfeeding Zolpidem can pass breast milk and effects baby, which shows withdrawal symptoms like muscle cramps, shaking, sweat and seizures. Therefore, it is important to consult a doctor before using such medications to avoid such effects. Legality and usage in the European world Starting in 1988 Zolpidem was used in the European market under the trade name of Synthelabo. After that in 1992, it was approved throughout the world under the brand name of Ambien. It was 2007 when this drug become available as a generic medication. Europe’s Coordination Group for Mutual Recognition and Decentralization has set recommendations for Zolpidem use by agreeing on its benets and risks balance. Commission later approved this and now its use throughout Europe. However, prescriptions for this drug have declined worldwide because of medication misuse risks and its wide range of side effects. European Sleep Research Society has recommended it as a secondline therapy which is being used after non-pharmacological options, including Cognitive therapies. Recreational use It is used medically at moderate doses, but when its doses are used at a high level, it affects drug dependency. The risk of dependency is much higher if you are addicted to alcohol or other drugs. Chronic users of these drugs at high doses develop physical dependence and have severe withdrawal symptoms, including abrupt seizures. Therefore, its use is highly regulated because if its recreational use and dependence. It is also very important to take the exact amount of dose prescribed by a doctor or pharmacist. Contraindications Use of Zolpidem is contraindicated in those patients having any of these given conditions. Children Delirium Hypersensitivity to Zolpidem Liver disorders Myasthenia gravis Neurocognitive disorders Obstructive sleep apnea Old age Psychotic illness Respiratory illness Its use is contraindicated with Calcium/magnesium/potassium/sodium oxidates to an adverse reaction. Warnings and precautions Because of the broad risks of health problems, it is essential to share proper information with your doctor about your health conditions. Therefore, you can avoid complications. Complex sleep behaviours like sleepwalking, sleepdriving, and engaging in other activities of which person is not fully awake may occur. Some of these events could be the cause of severe results, including death. Therapy should be discontinued yours Doctor’s consultation if a person experiences any these behaviours.