The Ambien (Zolpidem) Hangover, You Have Been Officially Warned

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Impaired alertness the morning after Ambien (zolpidem) use has prompted the FDA to issue a warning. The FDA now recommends that the bedtime dose be lowered because new data show that blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving. As you know zolpidem is marketed in generic form and under the brand names Ambien, Ambien CR, EdluarZolpimist, and Intermezzo.

The impaired mental alertness and impaired driving, for example, is highest for patients taking the extended-release forms of these drugs (Ambien CR and generic zolpidem er). Women appear to be more susceptible to this risk because they eliminate zolpidem from their bodies more slowly than men.

What this means for you is that the manufacturers of Ambien, Ambien CR, Edluar, and Zolpimist are expected to lower the recommended dose. The recommended dose of zolpidem for women should be lowered from 10 mg to 5 mg for immediate-release products (Ambien, Edluar, and Zolpimist) and from 12.5 mg to 6.25 mg for extended-release products (Ambien CR). For men, the FDA is requiring that labeling recommends that health care providers prescribe the lower doses of zolpidem (5 mg for immediate-release and 6.25 mg for extended-release).

What has your experience been? Do you think you were impaired the morning after the use of zolpidem?

Dr O.

The full FDA safety announcement and dosing recommendations can be found here: http://www.fda.gov/Drugs/DrugSafety/ucm334033.htm

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