Zolpidem ER, Zolpidem

Medically reviewed by Victor Nguyen, PharmD, MBA on May 30, 2023
Written by Patricia Weiser, PharmD

Specifically, the Food and Drug Administration (FDA) has approved zolpidem to treat:

• sleep onset insomnia (trouble falling asleep)
• sleep maintenance insomnia (trouble staying asleep)
• mid-sleep insomnia, also called middle insomnia (trouble falling back to sleep after waking up in the middle of the night)

These approved uses differ based on the form of zolpidem your doctor prescribes.

This article describes zolpidem’s uses, side effects, and more. Below you’ll also find some coupon options to help save on the cost of zolpidem.

This article doesn’t provide coupons for all forms of zolpidem. To find coupons for zolpidem extended-release oral tablet, see this article.

Boxed warning: Risk of unusual sleep behaviors

Zolpidem has a boxed warning about the risk of unusual sleep behaviors. Boxed warnings are the most serious warnings from the FDA.

For details, see the “Interactions and warnings for zolpidem” section below.

Zolpidem may cause mild or serious side effects (also known as adverse effects). More common mild side effects of zolpidem and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about zolpidem’s side effects, ask your doctor or pharmacist. You can also read the prescribing information* for zolpidem.

* To view zolpidem’s prescribing information, see the “Article resources” section below.

Mild side effects

More common mild side effects reported with some forms of zolpidem are listed below. These side effects may differ based on the form of zolpidem you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about zolpidem’s side effects based on the form, see the prescribing information* for zolpidem.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Zolpidem oral tablet’s mild side effects include:

• drowsiness
• dizziness
• diarrhea
• headache
• mild allergic reaction†

Zolpidem extended-release oral tablet’s mild side effects include:

• headache
• next-day sleepiness
• dizziness
• nausea
• mild allergic reaction†

* To view zolpidem’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for zolpidem” section below.

Serious side effects

Serious side effects of zolpidem are listed below. These side effects may differ based on the form of zolpidem you take.

This article doesn’t include all possible serious side effects of the drug. To learn more about zolpidem’s side effects based on the form, see the prescribing information* for zolpidem.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, zolpidem’s serious side effects include:

• impaired cognitive and motor skills (slowed ability to think, pay attention, move, and react), which may continue into the next morning or day after taking zolpidem
• slowed breathing
• hallucinations (seeing or hearing things that aren’t really there)
• unusual thinking or changes in behavior, such as aggressive behavior
• suicidal thoughts or behaviors
• boxed warning: risk of unusual sleep behaviors†
• severe allergic reaction†

* To view zolpidem’s prescribing information, see the “Article resources” section below.
† For details about this side effect, see the “Interactions and warnings for zolpidem” section below.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Below you’ll find answers to a few commonly asked questions about zolpidem. 

How does zolpidem compare with Quviviq, zopiclone, alprazolam, or clonazepam?

Zolpidem, daridorexant (Quviviq), and zopiclone (Lunesta) are similar drugs. They are all approved by the Food and Drug Administration (FDA) to treat insomnia (trouble sleeping).

Alprazolam and clonazepam aren’t FDA-approved to treat insomnia. Instead, clonazepam is approved to treat seizures or panic disorder. And alprazolam is prescribed to treat anxiety or panic disorder. 

Zolpidem, zopiclone, alprazolam, and clonazepam are available as generic drugs. Quviviq is only available as a brand-name drug. Generic drugs are usually less costly than brand-name drugs.

Talk with your doctor or pharmacist to learn more about how zolpidem compares with other drugs.

Are brand names available for zolpidem?

Yes, Zolpidem is available in the following brand-name prescription drugs:

• Ambien oral tablet
• Ambien CR extended-release oral tablet
• Edluar sublingual tablet

Extended-release medications release the drug into your body over a period of time. A sublingual tablet is placed under your tongue to dissolve.

Talk with your doctor or pharmacist if you have questions about zolpidem or similar brand-name drugs.

Is zolpidem a controlled substance? Can it cause addiction or withdrawal?

Yes, zolpidem is a controlled substance. The government regulates controlled substances due to their risks of misuse, dependence, or addiction.

With misuse, a drug is used in a different way or for a different purpose than your doctor prescribed it for. With dependence, your body needs the drug to function as usual. And with addiction, you are unable to stop using the drug, even if it may cause harm.

If you take zolpidem every night, especially long term, your body can become used to having it. Then, if you suddenly stop taking it, you may develop withdrawal symptoms. These are uncomfortable side effects that can occur when you stop taking a drug that your body has become dependent on.

Because of these risks, your doctor will likely prescribe zolpidem as a short-term treatment for insomnia (trouble sleeping). Or they may recommend only taking it as needed (occasionally) instead of every night.

If you have questions about controlled substances and zolpidem, talk with your doctor or pharmacist.

Will zolpidem 10 milligrams (mg) cause more side effects than the drug’s other strengths?

Possibly. The risk or severity of a drug’s side effects generally increases with taking higher strengths of the drug. Zolpidem comes in several strengths ranging from 1.75–12.5 mg. The available strengths vary with the form your doctor prescribes.

It’s important to take zolpidem exactly as your doctor prescribes. This will help lessen the risk of side effects from the drug. For example, your doctor will likely recommend taking zolpidem oral tablet right before you go to bed. They’ll also recommend taking it only if you have at least 7–8 hours to sleep before you have to wake up.  

Doctors usually prescribe the lowest strength of zolpidem that’s effective for treating insomnia (trouble sleeping). Talk with your doctor or pharmacist if you have questions about zolpidem’s possible side effects.

What is zolpidem’s half-life? How does zolpidem work?

Zolpidem’s half-life is 2.5–3 hours. A drug’s half-life is the length of time it takes for your body to clear half of a dose. Zolpidem usually starts working within 30 minutes to an hour.

The drug stays in your system for up to 23 hours. However, several factors can shorten or lengthen this timeline, such as:

• the form of zolpidem your doctor prescribes
• other health conditions you have
• other medications you take
• whether you take your dose without food*
• your sex at birth†

Zolpidem treats insomnia (trouble sleeping) by helping you fall asleep, stay asleep, or both. It works by boosting the activity of a brain chemical called gamma-aminobutyric acid (GABA). GABA is thought to have calming effects and can make you feel sleepy.

Talk with your doctor or pharmacist if you have questions about what to expect with zolpidem treatment and how long it takes to start working.

* Food delays zolpidem’s effects, so it may take longer to start working if you take it with food or just after eating. It’s important to note that Zolpidem should be taken without food. For more information, see the “Dosage of zolpidem” section below.
† On average, females take longer to clear zolpidem from their bodies than males. Sex and gender exist on spectrums. In this article, we use the terms “female” and “male” to refer to a person’s sex assigned at birth.

Can zolpidem be prescribed for anxiety?

It’s not likely. Zolpidem isn’t approved by the Food and Drug Administration (FDA) for treating anxiety. Instead, it’s approved for treating insomnia (trouble sleeping).

In fact, anxiety has been reported as a side effect of zolpidem. This side effect wasn’t common in the drug’s studies.*

Some people may have insomnia as a symptom of a mental health condition, such as depression or an anxiety disorder. Before prescribing zolpidem, your doctor will help identify possible causes and recommend ways to manage them.

* For details about zolpidem’s studies, see its prescribing information in the “Article resources” section below.

The Food and Drug Administration (FDA) approves prescription drugs such as zolpidem for certain conditions. Approved uses for zolpidem are described below.

Use for insomnia

Doctors may prescribe zolpidem oral tablet, extended-release oral tablet, and sublingual tablet for treating insomnia (trouble sleeping). It’s used for this purpose in adults. It’s usually prescribed as a short-term treatment.

The specific uses of zolpidem differ based on the form of the drug:

• Zolpidem oral tablet is approved to treat sleep onset insomnia (trouble falling asleep when you first try to go to sleep).
• Zolpidem extended-release oral tablet is approved to treat sleep onset insomnia, sleep maintenance insomnia (trouble staying asleep), or both. (Extended-release medications release the drug into your body over a period of time.)
• Zolpidem sublingual tablet is approved to treat mid-sleep insomnia, also called middle insomnia. You place a sublingual tablet under your tongue to dissolve. With middle insomnia, you have trouble falling back to sleep after waking up in the middle of the night.  

Zolpidem sublingual tablet is not recommended for mid-sleep insomnia in people who wake up within 4 hours of actual wake-up time.

The dosage of zolpidem your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking zolpidem

Zolpidem oral tablet is swallowed without food.

Zolpidem extended-release oral tablet is swallowed without food. Extended-release medications release the drug into your body over a period of time. You should not chew, crush, or split zolpidem extended-release oral tablet.

Zolpidem sublingual tablet is taken without food. You place a sublingual tablet under your tongue to dissolve.

Your doctor will talk with you about how to take zolpidem. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Overdose of zolpidem

You should not take more zolpidem than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much zolpidem, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Below, you’ll find information about zolpidem’s possible interactions and warnings.

Interactions of zolpidem

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take zolpidem, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription drugs
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for zolpidem” section below.

Warnings for zolpidem

Some people should not take zolpidem, and others should take it cautiously.

Boxed warning: Risk of unusual sleep behaviors

Zolpidem has a boxed warning about the risk of unusual sleep behaviors. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

With unusual sleep behaviors, people perform activities without being fully awake. They usually don’t remember doing them. Examples include:

• sleepwalking
• preparing and eating meals
• making phone calls or texting
• having sex
• driving

Unusual sleep behaviors were not reported in studies* of zolpidem. But these behaviors have been reported since the drug became available for use.

These behaviors can lead to serious injury or even death. So it’s important for you and others in your home to monitor for any unusual sleep behaviors. If you experience any of the above behaviors, tell your doctor. They’ll likely have you stop taking zolpidem. They may recommend other ways to manage your condition.

To learn more, talk with your doctor or pharmacist.

* For details about zolpidem’s studies, see its prescribing information in the “Article resources” section below.

Other warnings

Zolpidem could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether zolpidem is a safe option for you. These warnings may differ based on the form of zolpidem you take.

Ask your doctor about specific warnings for zolpidem, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Zolpidem can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to zolpidem or any of its ingredients, your doctor will likely not prescribe zolpidem. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to zolpidem, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and zolpidem

Information about zolpidem and pregnancy and breastfeeding is described below.

Zolpidem and pregnancy

It may not be safe to take zolpidem while breastfeeding. It’s possible that newborns who were exposed to the drug during the third trimester could develop side effects, such as excessive drowsiness or slowed breathing.

If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. They may suggest birth control options to use during treatment with zolpidem.

Zolpidem and breastfeeding

It may not be safe to take zolpidem while breastfeeding. It’s possible that children exposed to the drug through breast milk could develop side effects. These include excessive drowsiness or slowed breathing.

If you’re currently breastfeeding and need to take zolpidem, the drugmaker suggests pumping and discarding breast milk during treatment. And they suggest doing this for 23 hours after your previous dose of treatment.

If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication.

You may be able to save money on your prescription for zolpidem by using our Perks discount coupons. They can be found at the end of this article.

If you have questions about how to pay for zolpidem, talk with your doctor or pharmacist.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes zolpidem’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about zolpidem or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Can zolpidem cause weight gain?
• Is it safe to take zolpidem with gabapentin?
• What should I do if zolpidem is not working?
• Is it safe to take zolpidem every night?

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Zolpidem tartrate extended-release tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/625fad5b-8817-4773-a2fc-20b662140e6e/spl-doc
• Zolpidem tartrate sublingual tablets, for oral use. (2020). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/6db679f6-b1f8-4fbf-9e87-9cef4650c45a/spl-doc
• Zolpidem tartrate tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/61c3d6c7-0d9c-4e46-b091-88d84893e14a/spl-doc

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.