This article describes possible interactions with zolpidem oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Zolpidem comes as tablets and capsules that you’ll swallow, including an extended-release (ER)* tablet and one that dissolves in your mouth.
* “Extended-release” means the drug is slowly released into your body over a period of time after you take it.
Boxed warning: Risk of unusual sleep behaviors
Zolpidem has a boxed warning for the risk of unusual sleep behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). See the end of this article for more information about this warning.
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Other drugs and zolpidem
The drugs in the list below may interact with zolpidem oral tablet. This article doesn’t include all drugs that may interact with zolpidem.
Drug classes or drugs that may interact with zolpidem oral tablet include:
- benzodiazepines:
- drug examples: alprazolam (Xanax), clonazepam (Klonopin)
- what might happen: can increase the risk of side effects of zolpidem and the benzodiazepine
- certain antibiotics:
- certain antidepressants:
- certain seizure drugs:
- drug examples: carbamazepine (Tegretol, others), phenytoin (Dilantin)
- what might happen: can make zolpidem less effective
- certain antifungals:
- drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
- what might happen: can increase the risk of severe side effects of zolpidem
- opioids:
- drug examples: fentanyl (Fentora, others), morphine (MS Contin, others)
- what might happen: can increase the risk of side effects of zolpidem and the opioid
- sedative/hypnotic drugs, other than zolpidem, and other drugs used to aid sleep:
- drug examples: eszopiclone (Lunesta), melatonin
- what might happen: can increase the risk of side effects of zolpidem and the other sleep drug
- protease inhibitors:
- drug examples: atazanavir (Reyataz), darunavir (Prezista)
- what might happen: can increase the risk of side effects of zolpidem
- gabapentin (Neurontin, others):
- what might happen: can increase the risk of side effects of zolpidem and gabapentin
- rifampin (Rimactane):
- what might happen: can make zolpidem less effective
- chlorpromazine:
- what might happen: can increase the risk of side effects of zolpidem
- trazodone:
- what might happen: can increase the risk of side effects of zolpidem and trazodone
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When to avoid zolpidem
Certain health conditions or other factors could increase some risks with zolpidem oral tablet. Because of this, doctors may not prescribe zolpidem in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for zolpidem oral tablet:
- Unusual sleep behaviors after taking zolpidem: In rare cases, zolpidem can cause atypical sleep behaviors, such as driving while asleep. Doctors won’t prescribe zolpidem again if you’ve had this side effect from taking the drug in the past. In fact, Zolpidem has a boxed warning about this effect. See the “Boxed warning” section at the end of this article to learn more.
- Past allergic reaction to zolpidem: If you’ve ever had an allergic reaction to zolpidem oral tablet, taking it again may cause another allergic reaction.
Before you start taking zolpidem, tell your doctor if anything listed above relates to you. They can recommend whether you should take zolpidem. They can also tell you what not to take with zolpidem.
Questions about zolpidem and interactions
Here you’ll find answers to some common questions about zolpidem and possible interactions.
Does zolpidem interact with blood pressure medications?
Yes, sometimes. Zolpidem is known to interact with a specific group of blood pressure medications called calcium channel blockers (CCBs). Examples include verapamil (Verelan) and diltiazem (Tiazac).
Taking zolpidem and a CCB together increases the risk of severe side effects of zolpidem. These can include dizziness, sedation, and trouble breathing.
Talk with your doctor or pharmacist to learn more about whether medications you take interact with zolpidem.
Are there antidepressants that are safe to take with zolpidem?
Yes, there are. But some antidepressants are safer to take with zolpidem than others.
Zolpidem is known to interact with a group of drugs called tricyclic antidepressants (TCAs). Examples include amitriptyline and imipramine. Taking zolpidem and a TCA together raises your risk of side effects, including decreased alertness.
Zolpidem can also interact with sertraline and fluoxetine, which belong to a group of drugs called selective serotonin reuptake inhibitors. Zolpidem may also interact with mirtazapine and trazodone, which are atypical antidepressants.
It’s important to note that you may still be able to take zolpidem with an antidepressant, even if there’s an interaction. It depends on your specific health factors and treatment plan. You, your doctor, and your pharmacist can determine the risks and benefits if zolpidem interacts with a medication you take.
That said, there are certain antidepressants that aren’t known to interact with zolpidem. Duloxetine (Cymbalta) is an example.
If you take an antidepressant, talk with your doctor or pharmacist before taking zolpidem. They can determine if there is an interaction, and whether this combination is safe for you.
Alcohol and zolpidem
Zolpidem oral tablet is known to interact with alcohol. Taking zolpidem oral tablet and drinking alcohol can increase the risk of certain side effects, including:
- unusual sleep behaviors*
- problems with decision-making and coordination
- next-day “hangover” effects after taking zolpidem
If you drink alcohol and have concerns about avoiding it while taking zolpidem oral tablet, talk with your doctor.
* Zolpidem has a boxed warning about this effect. See the “Boxed warning” section at the end of this article to learn more.
Other interactions and zolpidem
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether zolpidem oral tablet has these interactions.
The information below doesn’t include all other possible interactions with zolpidem.
Zolpidem and supplements
Before taking zolpidem oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Zolpidem interactions with herbs
Zolpidem oral tablet may interact with St. John’s wort. This herb is often used to ease symptoms of depression. Taking zolpidem and St. John’s wort can make zolpidem less effective.
Zolpidem can also interact with valerian, which is an herb that’s used for aiding sleep. But taking zolpidem and valerian increases the risk of side effects from either.
Because of this, ask your doctor or pharmacist before taking any of these products while taking zolpidem oral tablet.
Zolpidem interactions with vitamins
Zolpidem oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any of these products while taking zolpidem oral tablet.
Zolpidem and food
Zolpidem oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking zolpidem oral tablet.
Zolpidem and vaccines
Zolpidem oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while using zolpidem oral tablet.
Zolpidem and lab tests
Zolpidem oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any tests while taking zolpidem oral tablet.
Zolpidem and cannabis or CBD
Studies of cannabis (commonly called marijuana) and cannabis products have shown that these substances interact with zolpidem. Taking zolpidem and using cannabis increases the risk of side effects either substance may cause, particularly problems with balance, coordination, and thinking.
Before you take zolpidem, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and zolpidem
Certain medical conditions or other health factors may increase the risk of interactions with zolpidem oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking Zolpidem, tell your doctor about your health history. They’ll determine whether zolpidem is right for you.
These health conditions or other factors might interact with zolpidem oral tablet:
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Preventing zolpidem interactions
You may be able to help avoid certain interactions with zolpidem oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking zolpidem oral tablet.
Taking zolpidem exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about zolpidem and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does zolpidem have the same interactions as similar medications, such as eszopiclone?
- How do side effects of zolpidem compare with those of daridorexant (Quviviq)?
- Does my risk of interactions depend on my dosage of zolpidem?
- Could I still take zolpidem even if it interacts with a health condition I have or another medication I take?
Boxed warning for zolpidem
Zolpidem oral tablet has a boxed warning for the risk of unusual sleep behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Treatment with zolpidem can cause unusual sleep behaviors in rare cases. Examples include making phone calls, driving, and having sex while asleep. People typically don’t remember these events when they happen. These behaviors may lead to injury or even be life threatening in extreme cases.
The risk of unusual sleep behaviors with zolpidem is increased if you consume alcohol while taking the drug.
You should immediately stop taking zolpidem and contact your doctor if you have unusual sleep behaviors during treatment. If you’ve had this side effect of zolpidem in the past, your doctor likely won’t prescribe the drug again. They can recommend other treatments that may be safer for you instead.
To learn more, talk with your doctor.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
