Quviviq vs. Ambien for Insomnia: 5 Differences Between These Sleeping Pills

If you’re finding it difficult to get a good night’s sleep, you may have considered giving a medication like Ambien (zolpidem) a try. Ambien has been around for over 30 years, and it’s currently one of the recommended treatment options for adults with insomnia. 

But, within the last 10 years, a new medication class called orexin receptor antagonists hit the market, offering a new approach to insomnia treatment. Quviviq (daridorexant), approved in 2022, is the most recent addition to the class.

Quviviq works differently than Ambien. And they also have some different side effects and risks. We cover five of the key differences between Quviviq and Ambien, below.

1. Quviviq and Ambien work differently to help you sleep

Ambien is a type of sedative-hypnotic medication that’s sometimes called a “Z-drug.” Ambien works on proteins in the brain called gamma-aminobutyric acid (GABA) A receptors. This causes your brain to slow down, which helps you fall asleep faster. 

Immediate-release (IR) forms of Ambien are approved to help you fall asleep. The extended-release (ER) version lasts longer, helping you fall asleep and stay asleep.

Quviviq also affects brain chemicals, but in a different way. It blocks a chemical called orexin that’s involved in keeping you awake. That’s why it’s considered an orexin antagonist. By blocking orexin, Quviviq can help you fall asleep and stay asleep.

2. Quviviq and Ambien have several common side effects and some that are different

During clinical studies, not all people taking Quviviq or Ambien reported side effects. For those who did, common side effects that the medications shared included headaches and dizziness.

Drowsiness, which can carry over into the next day, is also possible with Quviviq and Ambien. Next-day drowsiness may be more likely if you take your dose and aren’t able to get 7 to 8 hours of sleep. This drowsiness can affect your alertness and impair your ability to do certain activities like driving.

Both Quviviq and Ambien have also been linked to what’s known as complex sleep behaviors. Complex sleep behaviors are activities that you do when you’re not fully awake, and you usually don’t remember doing them. Examples include sleepwalking, sleep driving, and cooking or eating food while asleep.

But, in general, more side effects have been reported with Ambien than Quviviq. In addition to headaches, drowsiness, and dizziness, people taking Ambien report dry mouth, back pain, and diarrhea. Sinus inflammation, sore throat, and lack of energy are also possible.

Good to know: For both medications, many side effects appear to be linked to higher dosages. So, if you’re experiencing side effects with a higher dosage, your symptoms might get better or go away with a lower dosage.

3. Quviviq may be less likely than Ambien to cause withdrawal symptoms

Quviviq and Ambien are both considered controlled substances. Controlled substances have the potential for misuse, as well as physical and mental dependence. Both medications are in the same controlled substance category (Schedule IV), but their potential risks may be different.

Ambien has been shown to cause dependence in some people, resulting in withdrawal symptoms if stopped too quickly. Higher dosages and nightly use may increase this risk. Withdrawal symptoms can include trouble sleeping, nausea, and nervousness. Sweating, shaking (tremors), and sudden confusion have also been reported.

Due to its risk for dependence, it’s generally recommended to only take Ambien for a short period of time. And to avoid withdrawal symptoms, you should talk to your healthcare provider about lowering your dosage safely before stopping treatment with Ambien.

Quviviq, on the other hand, wasn’t shown to cause dependence or withdrawal symptoms during clinical trials. More research is needed to confirm these findings. It’s also OK to take Quviviq for a longer period of time.

4. Quviviq is meant to be taken every night, while Ambien can be taken as needed

Another difference between Quviviq and Ambien is how often you take them — meaning, every night versus as needed. Quviviq is meant to be taken every night. In studies, it has been shown to be safe and effective when taken this way for up to 12 months.

Ambien, on the other hand, can be taken as needed (up to once per night). This includes the sublingual (under the tongue) tablets, which can be taken if you wake up during the night and can’t fall back asleep. As mentioned above, it’s generally recommended to take Ambien for the shortest amount of time possible.

5. Ambien is available in more dosage forms than Quviviq

Currently, Quviviq is only available as oral tablets that come in two doses: 25 mg and 50 mg. Ambien is available in multiple dosage forms, including IR tablets and capsules, ER tablets, and sublingual tablets (Edluar and generic forms of Intermezzo).

The capsule form of Ambien is only approved for adults younger than 65 years old. This is because it’s only available in one dose (7.5 mg), which isn’t appropriate for this age group. If you're age 65 or older, you may be more sensitive to Ambien’s side effects. For this reason, lower Ambien doses are recommended.

Good to know: The different forms of Ambien are approved for specific problems associated with insomnia. These include issues with falling asleep, staying asleep, or waking up in the middle of the night. So you might not be able to swap one form for another. Talk to your healthcare provider to learn more.

How to save on Quviviq and Ambien

There are ways to save on Quviviq and Ambien. GoodRx can help you navigate between GoodRx coupons and copay savings cards to save money on your prescription.

• Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of Quviviq at an exclusive cash price of $135. You may also be able to pay as little as $9.97 for generic Ambien.

• Save with a copay savings card: If you have commercial insurance, you may be eligible to pay as little as $0 for Quviviq using a savings card from the manufacturer. Refills may cost as little as $25.

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Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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