STOP TAKING ZOLPIDEM
ZOLPIDEM AT-HOME WITHDRAWAL AND TAPERING PROGRAM

ZOLPIDEM SIDE EFFECTS MAY INCLUDE: 

Allergy, daytime drowsiness, dizziness, drugged feeling, headache, indigestion, nausea, difficulty with coordination, memory loss, tolerance, dependency, changes in behavior and thinking, more outgoing, strange behavior, agitation, worsening of depression, suicidal thoughts, abdominal pain, abnormal dreams, abnormal vision, amnesia, anxiety, arthritis, back pain, bronchitis, burning sensation, chest pain, confusion, constipation, coughing, daytime sleeping, decreased mental alertness, depression, diarrhea, difficulty breathing, difficulty concentrating, difficulty swallowing, diminished sensitivity to touch, dizziness on standing, double vision, dry mouth, emotional instability, exaggerated feeling of well-being, eye irritation, falling, fatigue, fever, flu-like symptoms, gas, general discomfort, hallucination, hiccup, high blood pressure, high blood sugar, increased sweating, infection, insomnia, itching, joint pain, lack of bladder control, lack of coordination, lethargy, light-headedness, loss of appetite, menstrual disorder, migraine, muscle pain, nasal inflammation, nervousness, numbness, paleness, prickling or tingling sensation, rapid heartbeat, rash, ringing in the ears, sinus inflammation, sleep disorder, speech difficulties, swelling due to fluid retention, taste abnormalities, throat inflammation, throbbing heartbeat, tremor, unconsciousness, upper 

ZOLPIDEM ADVERSE REACTIONS MAY INCLUDE: per PDR 

Severe: visual impairment, pulmonary embolism, ventricular tachycardia, pulmonary edema, myocardial infarction, arrhythmia exacerbation, anaphylactic shock, angioedema, GI obstruction, bronchospasm, renal failure, azotemia, thrombosis, bone fractures, intracranial bleeding, suicidal ideation, laryngeal edema, anaphylactoid reactions, hepatic encephalopathy

Moderate: hallucinations, amnesia, memory impairment, depression, palpitations, constipation, blurred vision, conjunctival hyperemia, impaired cognition, hypertension, chest pain, orthostatic hypotension, sinus tachycardia, edema, dysphagia, dyspenea, vainitis, dysuria, cystitis, urinary incontinence, hyperglycemia, elevated hepatic enzymes, dysarthria, migraine, hypotension, angina, phlebitis, furunculosis, bullous rash, gastritis, hemorrhoids, myashtenia, conjunctivitis, photopsia, hypoxia, urinary retention, impotence, gout, hyperlipidemia, hypercholesterolemia, hyperbilirubinemia, anemia, lymphadenopathy, leukopenia, hot flashes, tetany, tolerance, confusion, euphoria, ataxia, complex sleep-related behaviors, respiratory depression, erythema, oral ulceration, jaundice, withdrawal, psychological dependence, physiological dependence 

Mild: dizziness, headache, drowsiness, nausea, malaise, back pain, myalgia, sinusitis, fatigue, lethargy, anxiety, xerostomia, diarrhea, influenza, psychomotor impairment, rash, arthralgia, muscle cramps, abnormal dreams, nightmares, agitation, syncope, pallor, hyperhidrosis, pruritus, urticaria, anorexia, vomiting, dysgeusia, gastroesophageal reflux, flatulence, infection, fever, pharyngitis, tinnitus, occular irritation, occular pain, rhinitis, cough, menorrhagia, vaginal irritation, hypoesthesia, parethesias, emotional lability, tremor, flushing, photosensitivity, acne vulgaris, hypersalivation, eructation, dental caries, tenesmus, weight loss, restless legs syndrome, chills, lacrimation, epistaxis, laryngitis, mastalgia, nocturia, increased urinary frequency, polyuria, purpura, libido decrease, yawning, appetite stimulation, hiccups, dyspepsia, asthenia, diplopia, vertigo, insomnia, somnambulism, abdominal pain 

ZOLPIDEM  BOXED WARNINGS: per PDR:

Coadministration with other CNS depressants, complex sleep-related behaviors, driving or operating machinery, drug-induced complex sleep-related behaviors, ethanol ingestion.      

Sedative-hypnotics can cause complex sleep-related behaviors such as phone calls, sexual activity, preparing and eating food, or sleep driving while not fully awake and in some cases having no memory of the event. These behaviors appear to be more frequent with nonbenzodiazepine benzodiazepine-receptor agonists (NBRAs), such as zolpidem, than other sedative-hypnotics. Although rare, serious injuries or death have occurred; therefore, zolpidem and other NBRAs are contraindicated in patients with a history of drug-induced complex sleep-related behaviors. Patients should be informed of the risks before receiving any medication from this class, including instructions to discontinue the medication if they experience a sleep-related episode and to contact their healthcare provider immediately. Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of NBRAs to the FDA MedWatch Safety Information and Adverse Event Reporting Program.[64083] Because zolpidem has a rapid onset of action and causes CNS depressant activity, zolpidem products indicated for insomnia due to difficulty with sleep initiation should only be administered immediately before retiring and with at least 7 to 8 hours remaining before the planned time of waking. Zolpidem products indicated for difficulty returning to sleep after middle-of-the-night awakenings should only be taken while the patient is in bed and has at least 4 hours of bedtime remaining before the planned time of waking. Vehicle drivers and machine operators should be warned that hypnotics, such as zolpidem, have a possible risk of adverse reactions including drowsiness, prolonged reaction time, dizziness, sleepiness, blurred/double vision, reduced alertness and impaired driving, even the day after use. Patients should be instructed to avoid driving or operating machinery or performing other tasks requiring mental alertness for at least 8 hours after taking immediate-release formulations, and patients receiving the extended-release formulation should be alerted about the potential impact on such activities the full day after use. Patients receiving zolpidem for middle-of-the-night awakenings should wait for at least 4 hours after dosing and until they feel fully awake before driving or engaging in other activities requiring full mental alertness. Because zolpidem can cause drowsiness and a decreased level of consciousness, there is a higher risk of falls, particularly in the elderly, with the potential for subsequent severe injuries. Zolpidem use has been associated with severe injuries such as hip fractures and intracranial hemorrhage. Due to gender differences in the elimination of zolpidem, a lower initial dose is recommended in adult females (women). Plasma levels of zolpidem in some patients, particularly women, may be high enough the morning after use to impair activities requiring mental alertness, such as driving. The risk for next-morning impairment is higher if zolpidem products are taken without adherence to the proper hours for sleep recommended following use or if a higher than the recommended dose is taken. Risks for impairment are also increased during coadministration with other CNS depressants with zolpidem or with use of drugs that increase the blood levels of zolpidem. Concurrent alcohol or CNS depressant use increases the risk for CNS depression, impairment, complex sleep-related behaviors, and other additive effects. Patients taking zolpidem should avoid ethanol ingestion. Lower initial dosages of zolpidem should be considered in patients taking other CNS-depressant therapies. Anterograde amnesia may be particularly evident at zolpidem doses above 10 mg/day.

top of page