Zolpidem (Generic Ambien) Side Effects, Dosage, Precautions, and More

Zolpidem is the generic version of the sleep medication Ambien, which is also available in a longer-acting form known as Ambien CR. This sleep medication — along with zaleplon (Sonata) and eszopiclone (Lunesta) — is widely prescribed and known for its lack of a “hangover” effect. 

These atypical benzodiazepines are different from typical benzodiazepines, such as lorazepam (Ativan), alprazolam (Xanax), or diazepam (Valium), in that they are used to treat insomnia but not anxiety.

Zolpidem can cause many concerning side effects, such as changes in behavior, abnormal thinking, sedation, and even driving while asleep. This medication also causes a higher risk of falls and fractures in people who are 65 years of age and older. 

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Because of these risks, you should always talk with your healthcare provider before taking zolpidem. This article will explain what you need to know about zolpidem and what to expect when taking it. 

What is zolpidem (generic Ambien)?

Zolpidem is a medication that’s often prescribed to help with insomnia, or trouble sleeping. It works by affecting the gamma-aminobutyric acid (GABA) receptor in the brain, causing you to feel sleepy. 

It’s best to only take zolpidem for short periods of time, to lower the risk of becoming dependent on the medication.

Generic zolpidem vs. Ambien

Zolpidem or zolpidem tartrate is the generic name of Ambien. If your healthcare provider prescribes either zolpidem or Ambien, your prescription bottle will usually say zolpidem tartrate because the pharmacy provided the generic version of the medication. 

Like all generics, zolpidem has been confirmed to be equivalent to Ambien through testing. Therefore, there isn’t any reason to be concerned about taking the generic version.

Zolpidem dosage

Zolpidem comes in 5 mg and 10 mg tablets. The usual dosage of zolpidem is 10 mg once daily. But sometimes your healthcare provider may prescribe a lower dosage, such as 5 mg once daily — especially if you are age 65 or older, female, at risk for falls, or have liver problems.

Similarly, the extended-release (ER) version of zolpidem comes in 6.25 mg and 12.5 mg tablets. The lower dose is recommended for the same groups of people as mentioned above.

Zolpidem side effects

Side effects from zolpidem are common and often concerning, including:

• Drowsiness and daytime drowsiness

• Dizziness

• Diarrhea

• Drugged feeling (more common with regular, long-term use)

Zolpidem risks 

Although very rare, there are a few serious side effects that can occur. These include:

• Hallucinations

• Bizarre behavior

• Sleepwalking

Zolpidem drug interactions

Zolpidem can interact with other medications and substances that cause drowsiness. These interactions carry a higher risk of a serious reaction, such as altered thinking, behavior problems, and too much sedation. 

Many people who experience severe health problems from zolpidem are combining it with other medications. Mixing zolpidem with opioid pain relievers, anti-anxiety medications, muscle relaxers, or alcohol can be dangerous.

Always talk to your healthcare provider and pharmacist about other medications you are taking if you are prescribed zolpidem.

Zolpidem precautions

If you are prescribed zolpidem, there are a few precautions to be aware of:

• You should avoid driving or operating machinery after zolpidem, until it begins to wear off. This is generally about 8 hours after you’ve taken a tablet.

• If you are 65 or older, you should also use extra care when walking around the house after taking zolpidem, because of the risk of falling. It’s best to take a tablet right before you plan to get in bed.

• If you stop taking zolpidem abruptly, after taking it daily for longer periods of time, you can experience withdrawal effects, such as insomnia or vomiting. Always talk to a healthcare provider if you plan to stop taking zolpidem.

What to avoid when taking zolpidem

Since zolpidem causes sleepiness and sedation, you should avoid taking it with over-the-counter (OTC) sleep aids. Combining them could cause dangerous levels of drowsiness. You should also avoid using recreational drugs when taking zolpidem due to the risk of serious side effects. 

Zolpidem should only be taken if you have at least 7 to 8 hours to devote to sleep. Avoid trying to wake up before that amount of time has elapsed. Doing so could raise your risk of accidental injuries.

How long does it take for zolpidem to work?

The peak effect of zolpidem usually happens about 90 minutes after taking it, but you may start to notice its effects in as soon as 15 to 30 minutes. If you take zolpidem with food, the effects tend to happen more slowly.

Why is zolpidem a controlled substance?

Zolpidem is a controlled substance because there is a risk of your body becoming dependent on the medication for its effects. Zolpidem is a Schedule IV medication, which means that it carries less risk of dependency than Schedule I, II, and III medications but more risk than Schedule V medications.

Zolpidem and emergency department visits

In 2010, there were a total of 42,274 zolpidem-related emergency department visits, most of which involved women. 

Women are more susceptible to the risks that might cause an emergency department visit due to differences in how their bodies break down the medication. Thus, the FDA recommends women stick to the lower doses of zolpidem and zolpidem ER. 

Alternatives to taking zolpidem

Think of zolpidem as a short-term solution to insomnia: Don’t take it with alcohol or other medications, and think about taking the lowest doses possible. 

You can also try alternative strategies for treating insomnia, such as:

• Avoiding caffeine

• Exercising regularly

• Sleeping in quiet, darkened surroundings

• Limiting nighttime use of TV and computers, which are stimulating

Why trust our experts?

Written 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.

Edited by:

Samvida Patel, MNSP, INHC

Samvida Patel, MNSP, INHC, is a health editor at GoodRx. She is a nutritionist and integrative nutrition health coach with over 8 years of experience in health communications.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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