Ambien is a drug belonging to the group of hypnotics. The active ingredient of the drug is zolpidem tartrate. Each tablet contains 10 mg of active substance and auxiliary components.
Pharmacological properties of Ambien
According to the mechanism of therapeutic action, Ambien belongs to the category of hypnotics. According to its chemical structure, it belongs to the group of imidazopyridines. These substances act as selective agonists of omega 1 – benzodiazepine receptors. The main pharmacological action is hypnotic and sedative. Taking it in therapeutic dosages does not result in muscle relaxant, anticonvulsant, or anxiolytic effects. Ambien has a stimulating effect on omega-benzodiazepine receptors of certain brain structures. This, in turn, helps open neural channels for chloride ions. The drug significantly speeds up the process of falling asleep and reduces the number of awakenings at night.
In general, under the influence of the drug, the quality of sleep improves, and its overall duration increases. Moreover, while taking the drug, daytime drowsiness and lethargy are not observed. The drug substance is very quickly absorbed in the intestine. The maximum concentration in the blood is achieved after a short time – from half an hour to 3 hours. The concentration of the active substance in the blood plasma directly depends on the dosage taken.
Metabolism occurs in the liver with the formation of several inactive products. Most of it is excreted through the kidneys, about a third through the intestines. Zolpidem tartrate does not have an inducing effect on liver microsomal enzymes. A small amount of the active substance may pass into breast milk in nursing women.
Indications for use
According to the instructions for use, the main indications for taking the drug are sleep disorders of various origins. These include difficulty falling asleep, waking up at night, and waking up early.
Directions for use and dosage
The medication must be taken orally immediately before going to bed. A single dosage is 10 mg of the active substance. If the patient is weakened or has liver dysfunction, a single dosage is 5 mg. If the clinical effect of taking 5 mg is insufficient and the patient tolerates the drug well, the dosage can be increased to 10 mg.
The duration of the therapeutic course should not exceed 4 weeks. If insomnia is transient, it is recommended to take the drug for 3–5 days. For situationally caused insomnia, the course is from 2 to 3 weeks. If the course of treatment takes several days, there is no need to gradually withdraw the drug. If the course of treatment lasted several weeks, cancellation may cause the development of so-called rebound insomnia. To avoid this, it is necessary to discontinue Ambien gradually – the dosage is initially gradually reduced until complete withdrawal.
Ambien is usually very well tolerated. However, side effects may develop.
- From the mental sphere, the following phenomena may develop: headache, drowsiness, sensations similar to intoxication. Insomnia and anterograde amnesia may increase. The clinical severity of anterograde amnesia is directly proportional to the dosage of the drug. Hallucinations, confusion, nightmares, psychomotor agitation, and aggression occur. Sometimes somnambulism and drug dependence develop.
- Neurological disorders can be expressed by ataxia, disturbances in gait, balance, and coordination of movements. Elderly patients may fall frequently.
- From the neuroendocrine system, a decrease in libido may be observed. Digestive disorders are expressed by nausea, vomiting, diarrhea, abdominal pain, and increased activity of liver enzymes.
- The musculoskeletal system may respond by developing muscle weakness.
- On the skin, allergic reactions, rashes, itching, and hyperhidrosis may develop.
- Other reactions observed include the development of angioedema, diplopia, and increased fatigue.
Contraindications to the use of the drug Ambien may be as follows:
- Acute or chronic severe respiratory failure, sleep apnea.
- Acute or chronic severe liver failure.
- Since the drug contains lactose, Ambien is contraindicated in cases of lactose intolerance, lactase deficiency or galactose-glucose malabsorption syndrome.
- Pregnancy and breastfeeding period.
- Hypersensitivity or individual intolerance to any of the ingredients or the drug as a whole.
The drug should be used with caution in patients with severe myasthenia gravis, depression, alcohol and drug addiction.
Special instructions for use
If insomnia persists for more than 7 days during treatment, this may indicate that the patient has severe mental disorders or damage to the central nervous system. Therefore, it is always necessary to carefully monitor the patient’s health status and promptly identify existing disorders. To avoid complications such as anterograde amnesia, the patient must be given the opportunity to sleep at least 7 hours a day.
The risk of developing paradoxical reactions is usually higher in elderly and elderly patients. If signs of such reactions appear, you must immediately stop taking the drug. A decrease in the sedative and hypnotic effect is possible in the case of a course of treatment for 2–3 weeks.