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Zolpidem

This is how zolpidem works

The nerve cells are in contact with one another via certain interfaces, the synapses. Here they communicate with each other via activating or inhibiting messenger substances: If a nerve cell releases such a messenger substance, it can be perceived by the neighboring nerve cell at certain docking points.

The active ingredient zolpidem intervenes in this nerve cell communication by making the docking points more sensitive to the inhibiting messenger substances. As a result, even a low concentration of inhibiting messenger substances can have a calming or soporific effect.

Uptake, breakdown and excretion of zolpidem

The sleeping pill is taken as a tablet and quickly absorbed into the body. It quickly reaches the brain, where it works.

The active ingredient is mainly broken down by the liver into ineffective metabolic products. About half of these are excreted in the stool and half in the urine. In total, it takes about two to four hours for half of the absorbed active substance to be excreted.

When is zolpidem used?

Zolpidem is used for the short-term treatment of sleep disorders when they are of a certain severity. A habituation effect can occur with long-term use.

This is how zolpidem is used

Currently, the sleeping pill is only available in the form of tablets and sublingual tablets, which dissolve in the oral cavity after seconds. The latter are particularly suitable for patients who have problems swallowing or are fed through a tube.

The tablet is taken in the evening before going to bed. Healthy adults take a single dose of ten milligrams of zolpidem, elderly patients or those with liver damage take five milligrams.

The duration of the application should be a few days to a maximum of two weeks. To stop taking the dose, the zolpidem dosage should be gradually reduced (“tapering off”). Overall, the duration of use (treatment and tapering) should not exceed four weeks.

What are the side effects of zolpidem?

Side effects of zolpidem in every tenth to hundredth person treated are infections of the respiratory tract, hallucinations, nightmares, drowsiness, exhaustion, dizziness, headache, insomnia, nausea, vomiting, diarrhea, abdominal pain and memory lapses with regard to the time after ingestion.

Occasionally, i.e. in every hundredth to one thousandth patient, symptoms such as confusion, irritability and double vision also occur.

When stopping zolpidem, so-called rebound insomnia can occur, which manifests itself as a renewed increase in insomnia. Therefore, the active ingredient should not be stopped suddenly, but rather by slowly reducing the dose.

What should be considered when taking zolpidem?

Other drugs that depress the nervous system and alcohol should be avoided during treatment with zolpidem. Otherwise the dampening effect may be excessively increased. It also dramatically increases the risk of falling, especially for older patients.

Zolpidem is broken down in the liver. If you take active ingredients that affect the drug-degrading enzymes at the same time, the effect of the sleeping pill can be weakened or increased. A weakened effect results, for example, with simultaneous administration of the antibiotic rifampicin or the epilepsy drugs carbamazepine and phenytoin. On the other hand, antifungal agents, some antibiotics and grapefruit juice can increase the effect of sleeping pills.

Even in patients with liver dysfunction, the active ingredient is only broken down slowly, which makes it more effective. In this case, a reduced zolpidem dosage is usually sufficient for a sufficient effect.

Since only limited data are available on the use of zolpidem during pregnancy and breastfeeding, sleeping pills should be avoided during this time. It can also cross the placenta and pass into breast milk, which can lead to high levels of the active substance in the child's body.

How to get medication with zolpidem

Because zolpidem should only be used for a short time, the sleeping pill is subject to prescription in every dose. With a doctor's prescription you can get zolpidem in the pharmacy. In higher dosages, which are not therapeutically useful, zolpidem is a marketable and prescription narcotic drug in Germany.

How long has zolpidem been known?

The original patent for zolpidem was held by the pharmaceutical company Sanofi-Aventis until 2007. Since then, preparations with this active ingredient have been marketed by many generic manufacturers. Like zopiclone and zaleplon, zolpidem belongs to the so-called "Z generation". This mainly induces sleep, but hardly has an anxiolytic or relaxing effect, as older sleeping pills from the benzodiazepine group (such as diazepam) do. Due to the rapid breakdown in the body, the Active ingredient zolpidem developed a safe and highly effective sleep aid.

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