1. About zolpidem
Zolpidem is a sleeping pill.
It's used to treat insomnia (when you might have trouble getting to sleep and staying asleep). It helps you fall asleep more quickly and makes you less likely to wake up during the night.
Zolpidem comes as tablets. It's only available on prescription.
2. Key facts
- Zolpidem takes around 1 hour to work.
- You'll usually take it for just a few weeks (up to 4 weeks).
- Common side effects are a metallic taste in your mouth or a dry mouth, and feeling sleepy in the daytime.
- Do not drink alcohol or caffeine while you're on zolpidem.
- Zolpidem is also called by the brand name Stilnoct.
3. Who can and can't take zolpidem
Zolpidem can be taken by most adults aged 18 and over.
It's not suitable for some people. To make sure zolpidem is safe for you, tell a doctor if you:
- have had an allergic reaction to zolpidem or any other medicines in the past
- have liver or kidney problems
- have myasthenia gravis, an illness that causes muscle weakness
- have breathing problems or sleep apnoea (where you stop breathing for short periods while sleeping)
- have ever had mental health problems
- have ever had issues with alcohol or drugs
- are trying to get pregnant, already pregnant, or breastfeeding
4. How and when to take it
Zolpidem tablets come in 2 different strengths – 5mg and 10mg.
The usual dose is one 10mg tablet, taken 1 hour before you go to bed. If you're over 65 years old, or if you have kidney or liver problems, the doctor may start you on a lower dose of 5mg.
Swallow the tablet whole with a drink of water. Do not crush or chew it. You can take zolpidem with or without food.
It's important to follow the doctor’s advice when taking this medicine. They may ask you to take a tablet just 2 or 3 nights a week, instead of every night.
Do not take more than your prescribed dose.
What if I forget to take it?
If you forget to take your zolpidem, leave out the missed dose. Start again the next night and take your zolpidem at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
What if I take too much?
Urgent advice: Contact 111 for advice now if:
- you take more than your prescribed dose of zolpidem
Ask 111 for advice, even if you do not feel any different.
Go to 111.nhs.uk or call 111.
If you need to go to hospital, take the zolpidem packet or leaflet inside it, plus any remaining medicine, with you.
It's a good idea to get a friend or family member to go with you to hospital, in case you become sleepy on the way. Do not drive yourself.
5. Side effects
Like all medicines, zolpidem can cause side effects in some people, although not everyone gets them.
Common side effects
A common side effect is a bitter or metallic taste in your mouth or a dry mouth. Talk to a doctor or pharmacist if these side effects bother you or do not go away.
Using a mouthwash before bedtime may help. Choose one that's good for a dry mouth, as some can make a dry mouth worse. You can also try taking sips of water and keep some water by your bed at night.
Serious side effects
Some people can get serious side effects with zolpidem. Stop taking zolpidem and call a doctor as soon as possible if you:
- develop memory loss (amnesia)
- see or hear things that are not real (hallucinations)
- fall over – particularly if you are over the age of 65
- think things that are not true – these are called delusions
- feel low or sad – this could be a sign of depression
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to zolpidem.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue, or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of zolpidem. For a full list, see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
6. Pregnancy and breastfeeding
Do not take zolpidem if you're pregnant, as it may harm your baby. There's some evidence that taking zolpidem can increase the risk of your baby coming early (before 37 weeks) and having a lower birthweight.
Taking zolpidem right up until you go into labour may increase your baby's chances of having withdrawal symptoms as soon as they're born.
For more information about how zolpidem can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.
Zolpidem and breastfeeding
If a doctor or health visitor says that your baby is healthy, it's OK to take zolpidem while breastfeeding. Zolpidem passes into breast milk in very small amounts.
However, it's best to try some practical steps to help you sleep first. The side effects of taking zolpidem could make you feel too tired to breastfeed and look after your baby.
Do not share a bed with your baby if you're taking zolpidem.
If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to a health visitor or doctor as soon as possible.
Non-urgent advice: Tell a doctor or a pharmacist if you're:
- trying to get pregnant
7. Cautions with other medicines
Some medicines and zolpidem can interfere with each other and increase your chance of having side effects. Certain medicines may increase the drowsy (sedating) effects of zolpidem.
Speak to a doctor or a pharmacist before starting on zolpidem if you take any of the following:
- drowsy antihistamines such as chlorphenamine or promethazine
- medicines to treat schizophrenia and bipolar disorder
- medicines to treat depression
- medicines for epilepsy
- medicines to calm or reduce anxiety
- medicines for sleep problems
- medicines used to treat fungal infections (such as ketoconazole and itraconazole)
- ritonavir (a medicine used to treat HIV infections)
- strong painkillers (such as codeine, methadone, morphine, oxycodone, pethidine or tramadol)
Mixing zolpidem with herbal remedies and supplements
Do not take any herbal remedies that make you feel sleepy while taking zolpidem.
These can increaase the drowsy (sedating) effects of your medicine.
For safety, tell a doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
8. Common questions
How does zolpidem work?
Zolpidem helps improve your sleep by boosting a chemical in your brain called gamma-aminobutyric acid (GABA).
GABA blocks some of the neurotransmitters that send messages in the brain. This has a calming effect on the brain, which helps you get to sleep.
How long will it take to work?
Zolpidem should work within 1 hour of taking it.
How will zolpidem make me feel?
Zolpidem will make you feel sleepy (drowsy). It affects people in different ways and some people may feel sleepier than others.
When you first start taking this medicine, you may feel sleepy during the daytime for the first few days. Be aware that this can affect you being able to carry out everyday tasks.
Will I sleepwalk with zolpidem?
Some people have reported doing things like sleepwalking, making food and making phone calls while they're asleep after taking zolpidem. They do not remember when they wake up.
If this happens to you, stop taking zolpidem and go back to the doctor for advice.
How long will I take it for?
You'll usually be prescribed zolpidem for just 2 to 4 weeks.
This is because your body gets used to this medicine quickly. After taking it for a few weeks, it's unlikely to have the same effect. Your body can also become dependent on it.
If you still have problems sleeping after you finish your course of zolpidem, try the lifestyle changes recommended below.
See the doctor again if these changes do not help.
Can I get addicted to zolpidem?
If you just take it for a few weeks, you're unlikely to become addicted to zolpidem.
However, you may become dependent on this medicine if you take it for longer than 4 weeks.
Ask a doctor or pharmacist for advice about stopping zolpidem.
They can help you come off your medicine gradually if you have been taking it for a long time, or if you're worried about becoming dependent on it.
Is it safe to take for a long time?
Zolpidem should only be used short term (usually up to 4 weeks) for sleep problems. This is because your body can become dependent on it.
See a doctor if you feel you need to take it for longer than 4 weeks. They will be able to discuss your sleep problems and recommend other things that may help.
What will happen when I stop taking it?
If you have been taking zolpidem for less than 4 weeks, you're unlikely to have any problems.
If you have been taking zolpidem for longer than 4 weeks, do not stop taking this medicine suddenly. You may get withdrawal symptoms.
Your insomnia can come back and it may be worse than before. You may also feel anxious, restless and have mood changes. You may become very sensitive to light, noise and being touched.
Speak to the doctor first about coming off zolpidem. They may recommend reducing your dose of zolpidem slowly, over a few days or weeks. This will help prevent withdrawal symptoms if you've been taking it for more than 4 weeks.
Can I drive or ride a bike?
If zolpidem makes you sleepy, dizzy or clumsy, gives you blurred vision or you cannot concentrate or make decisions, do not drive a car, ride a bike or operate machinery.
This may be more likely when you first start taking zolpidem, but could happen at any time – for example, when starting another medicine.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to a doctor or pharmacist if you're unsure whether it's safe for you to drive while taking zolpidem.
Will it affect my fertility?
There's no firm evidence to suggest that taking zolpidem will reduce fertility in either men or women.
But speak to a pharmacist or doctor if you and your partner are trying for a baby. Your doctor may review your treatment.
Is there any food or drink I need to avoid?
Do not have drinks that contain caffeine while you're on zolpidem. These include coffee, tea, cola and energy drinks and hot chocolate.
Caffeine has the opposite effect of zolpidem on your body and stops it working.
Can I drink alcohol with it?
No. Do not drink alcohol while you're on zolpidem.
Alcohol and zolpidem together can make you sleep very deeply, so you do not breathe properly and can have difficulty waking up.
How long will it stay in my system?
Zolpidem does not stay in your system for more than about 12 hours.
But some people feel sleepy the next morning when they wake up.
If this happens to you, do not do any activities that require you to be fully alert, such as driving, cycling, or using tools or machinery.
Will recreational drugs affect it?
Using cannabis with zolpidem will make its sleep-inducing (sedative) effects worse. You could go into a very deep sleep, where you have difficulty waking up.
Using heroin or methadone with zolpidem may also increase the sedative effects of both drugs. Again, you could go into a very deep sleep and have difficulty waking up.
Talk to a doctor if you think you might use recreational drugs while you're taking zolpidem.
Can lifestyle changes help with insomnia?
There are a number of things you can do to help yourself beat insomnia:
- set regular times for going to bed and waking up
- relax before bedtime – try taking a warm bath or listening to calming music
- use thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise
- avoid caffeine, cigarettes (or e-cigarettes), alcohol, heavy meals and exercise for a few hours before going to bed
- do not watch TV or use phones, tablets or computers just before going to bed
- do not nap during the day
- write a list of your worries, and any ideas about how to solve them, before you go to bed to help you forget about them until the morning