User:Mr. Ibrahem/Zolpidem

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Mr. Ibrahem/Zolpidem
Clinical data
Trade namesAmbien, others[1]
Other namesZolpidem tartrate
AHFS/Drugs.comMonograph
MedlinePlusa693025
Pregnancy
category
  • AU: B3
Dependence
liability		Low to moderate[2]
Routes of
administration		By mouth (tablet), sublingual, oromucosal (spray), rectal
Drug classImidazopyridine (Z-drug), nonbenzodiazepine, hypnotic
Physiological data
ReceptorsGABAA receptor agonist
AgonistsGABA
MetabolismLiver through CYP3A4 and CYP1A2
Legal status
Legal status
Pharmacokinetic data
Bioavailability70% (by mouth)
Protein binding92%
MetabolismLiver through CYP3A4 and CYP1A2
Metabolites(ZCA) zolpidem 6-carboxylic acid; (ZPCA) zolpidem phenyl-4-carboxylic acid
Onset of action1–2 hours
Elimination half-life2.5–3 hours[4]
Duration of action3 hours
ExcretionKidney (56%)
fecal (34%)
Identifiers
  • N,N-Dimethyl-2-[6-methyl-2-(4-methylphenyl)imidazo[1,2-a]pyridin-3-yl]acetamide hemitartrate
Chemical and physical data
FormulaC19H21N3O
Molar mass307.397 g·mol−1
3D model (JSmol)
  • CN(C)C(=O)Cc1c(nc2ccc(C)cn12)c3ccc(C)cc3
  • InChI=1S/C19H21N3O/c1-13-5-8-15(9-6-13)19-16(11-18(23)21(3)4)22-12-14(2)7-10-17(22)20-19/h5-10,12H,11H2,1-4H3 checkY
  • Key:ZAFYATHCZYHLPB-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Zolpidem, sold under the brand name Ambien, among others, is a medication primarily used for the short-term treatment of sleeping problems.[4][7] Guidelines recommend that it be used only after counselling and behavioral changes, such as sleep hygiene, have been tried.[8][9][10] It decreases the time to sleep onset by about 15 minutes and at larger doses helps people stay asleep longer.[3] It is taken by mouth and is available in conventional tablets, sublingual tablets, or oral spray.[4]

Common side effects include daytime sleepiness, headache, nausea, and diarrhea.[4] Other side effects include memory problems, hallucinations, and abuse.[3] The recommended dose was decreased in 2013 due to next-morning impairment.[11] Additionally, driving the next morning is not recommended with either higher doses or the long-acting formulation.[11] While flumazenil can reverse zolpidem's effects, usually supportive care is all that is recommended in overdose.[12]

Zolpidem is a nonbenzodiazepine Z drug which acts as a sedative and hypnotic.[4][13] Zolpidem is a GABAA receptor agonist of the imidazopyridine class.[4] It works by increasing GABA effects in the central nervous system by binding to GABAA receptors at the same location as benzodiazepines.[4] It generally has a half-life of two to three hours.[4] This, however, is increased in those with liver problems.[4]

Zolpidem was approved for medical use in the United States in 1992.[4] It became available as a generic medication in 2007.[14] In the United States, it has a monthly cost of about US$8 for immediate release and US$66 for controlled release medication, as of 2017.[3] Zolpidem is a Schedule IV controlled substance under the Controlled Substances Act of 1970 (CSA).[3] More than ten million prescriptions are filled a year in the United States, making it one of the most commonly used treatments for sleeping problems.[15][16] In 2017, it was the 50th most commonly prescribed medication in the United States, with more than 15 million prescriptions.[17][18]

References[edit]

  1. ^ "International brands for zolpidem". Drugs.com. Archived from the original on 12 June 2018. Retrieved 15 March 2018.
  2. ^ Attarian, Hrayr P. (2016). Clinical Handbook of Insomnia. Springer. p. 109. ISBN 9783319414003. Archived from the original on 2021-08-27. Retrieved 2019-07-03.
  3. ^ a b c d e Matheson E, Hainer BL (July 2017). "Insomnia: Pharmacologic Therapy". American Family Physician. 96 (1): 29–35. PMID 28671376. Archived from the original on 2018-08-19. Retrieved 2018-08-18.
  4. ^ a b c d e f g h i j "Zolpidem Tartrate". The American Society of Health-System Pharmacists. Archived from the original on 16 March 2018. Retrieved 15 March 2018.
  5. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 9 August 2020. Retrieved 9 September 2020.
  6. ^ "Interpreting Urine Drug Tests (UDT)". Archived from the original on 25 October 2023. Retrieved 24 October 2023.
  7. ^ "Stilnoct 10mg Film-Coated Tablets - Summary of Product Characteristics (SmPC)". UK Electronic Medicines Compendium. 21 May 2018. Archived from the original on 20 August 2018. Retrieved 19 August 2018.
  8. ^ "Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia". NICE. 28 April 2004. Archived from the original on 20 August 2018. Retrieved 19 August 2018.
  9. ^ Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. (December 2017). "European guideline for the diagnosis and treatment of insomnia". Journal of Sleep Research. 26 (6): 675–700. doi:10.1111/jsr.12594. PMID 28875581. Open access icon
  10. ^ Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD (July 2016). "Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians". Annals of Internal Medicine. 165 (2): 125–33. doi:10.7326/M15-2175. PMID 27136449. Open access icon
  11. ^ a b "Drug Safety and Availability - FDA Drug Safety Communication: FDA approves new label changes and dosing for zolpidem products and a recommendation to avoid driving the day after using Ambien CR". www.fda.gov. Archived from the original on 2018-04-06. Retrieved 2018-03-15.
  12. ^ Gunja N (June 2013). "The clinical and forensic toxicology of Z-drugs". Journal of Medical Toxicology. 9 (2): 155–62. doi:10.1007/s13181-013-0292-0. PMC 3657020. PMID 23404347.
  13. ^ Gunja, N (June 2013). "The clinical and forensic toxicology of Z-drugs". Journal of Medical Toxicology. 9 (2): 155–62. doi:10.1007/s13181-013-0292-0. PMC 3657020. PMID 23404347.
  14. ^ "FDA Approves First Generic Versions of Ambien (Zolpidem Tartrate) for the Treatment of Insomnia" (Press release). Archived from the original on 2010-03-06. Retrieved 2010-01-24.
  15. ^ "Zolpidem". LiverTox. Archived from the original on 16 March 2018. Retrieved 15 March 2018.
  16. ^ "Some Sleep Drugs Can Impair Driving". U.S. Food and Drug Administration (FDA). 13 June 2013. Archived from the original on 27 July 2019. Retrieved 15 March 2018.
  17. ^ "The Top 300 of 2020". ClinCalc—. Archived from the original on 18 March 2020. Retrieved 11 April 2020.
  18. ^ "Zolpidem Tartrate - Drug Usage Statistics". ClinCalc. 23 December 2019. Archived from the original on 12 April 2020. Retrieved 11 April 2020.
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