Zolpidem Tartrate interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of zolpidem. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving zolpidem should be advised to avoid the consumption of alcohol. For faster sleep onset, zolpidem should not be administered with or immediately after a meal.

  2 sources

  1. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  2. Yamreudeewong W, Henann NE, Fazio A, Lower DL, Cassidy TG "Drug-food interactions in clinical practice." J Fam Pract 40 (1995): 376-84

Conditions

Conditions in which Zolpidem Tartrate needs care, as documented in this source.

• Alcoholic Intoxication

  Major

  Anxiolytic, sedative, and hypnotic agents should generally not be given to patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of these agents may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with such agents should be administered cautiously in patients who might be prone to acute alcohol intake.

  8 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  3. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  5. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  6. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  7. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  8. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):

• Depressive Disorder

  Major

  A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

  14 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  4. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  5. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  6. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  8. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):

  Show all 14 sourcesShow fewer sources

  9. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):
  10. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  11. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  12. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):
  13. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  14. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Liver Diseases

  Major

  Zolpidem is primarily metabolized by the liver. The plasma concentrations and half-life of zolpidem have been shown to increase substantially in the presence of chronic hepatic insufficiency. Therapy with zolpidem should be administered cautiously in patients with impaired hepatic function. Since many of the drug's adverse effects may be dose-related, especially those involving the central nervous system or gastrointestinal tract, an initial dosage of 5 mg is recommended for these patients.

  2 sources

  1. Langtry HD, Benfield P "Zolpidem. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential." Drugs 40 (1990): 291-313
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):

• Substance-Related Disorders

  Major

  Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

  7 sources

  1. Cavallaro R, Regazzetti MG, Covelli G, Smeraldi E "Tolerance and withdrawal with zolpidem." Lancet 342 (1993): 374-5
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. Gericke CA, Ludolph AC "Chronic abuse of zolpidem." JAMA 272 (1994): 1721-2
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  5. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  6. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  7. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):

• Glaucoma

  Moderate

  Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

  2 sources

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  2. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):

• Kidney Diseases

  Moderate

  Zolpidem is extensively metabolized by the liver and subsequently excreted in the urine, primarily as metabolites. Limited data suggest that the pharmacokinetic disposition of zolpidem is not altered in the presence of renal insufficiency or even end-stage renal disease, and that there is no accumulation of unchanged drug after repeated dosing. However, the effects of possible metabolite accumulation have not been studied. While dosage adjustments are generally not required, close monitoring is recommended in patients with impaired renal function treated with zolpidem.

  2 sources

  1. Langtry HD, Benfield P "Zolpidem. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential." Drugs 40 (1990): 291-313
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):

• Respiratory Insufficiency

  Moderate

  Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

  11 sources

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  2. Lheureux P, Debailleul G, De Witte O, Askenasi R "Zolpidem intoxication mimicking narcotic overdose: response to flumazenil." Hum Exp Toxicol 9 (1990): 105-7
  3. Murciano D, Aubier M, Palacios S, Parients R "Comparison of zolpidem (Z), triazolam (T), and flunitrazepam (F) effects on arterial blood gases and control of breathing in patients with severe chronic obstructive pulmonary disease (COPD)." Chest 97 Suppl (1990): s51-2
  4. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  5. Biban P, Baraldi E, Pettennazzo A, Filippone M, Zacchello F "Adverse effect of chloral hydrate in two young children with obstructive sleep apnea." Pediatrics 92 (1993): 461-3
  6. Greenberg SB, Faerber EN "Respiratory insufficiency following chloral hydrate sedation in two children with Leigh disease (subacute necrotizing encephalomyelopathy)." Pediatr Radiol 20 (1990): 287-8
  7. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  8. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):

  Show all 11 sourcesShow fewer sources

  9. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  10. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  11. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):

Therapeutic duplication

Drug classes that overlap with Zolpidem Tartrate, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• hypnotics

  The recommended maximum number of medicines in the 'hypnotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'hypnotics' category.

  Example product in the source data (US market): Xywav