Indications for EDLUAR:
Short-term treatment of insomnia.
Use lowest effective dose. Place 1 tab under tongue and allow to dissolve; do not take with food, water, or alcohol. Initially 5mg (in women), and 5mg or 10mg (in men) at bedtime (take only if able to get 7–8hrs of sleep before becoming active again). Both: if 5mg dose ineffective, may increase to max 10mg. Elderly, debilitated, or hepatic impairment: 5mg once daily at bedtime. Effect delayed if taken with a meal.
<18yrs: not recommended.
Risk of CNS depressant effects and next-day impairment. Evaluate for co-morbid diagnoses before initiation. Reevaluate if insomnia fails to remit after 7–10 days of use. Depression. Suicidal tendencies. Abnormal thinking and behavioral changes. Compromised respiratory function. Sleep apnea. Myasthenia gravis. Hepatic impairment. Drug or alcohol abuse. Write ℞ for smallest practical amount. Withdraw gradually. Elderly (higher risk of falls). Debilitated. Labor & delivery. Neonates. Pregnancy. Nursing mothers: monitor infants; may consider pumping/discarding breast milk during and for 23hrs after administration.
Concomitant other sedative-hypnotics including other zolpidem products: not recommended. Increased risk of CNS depression, drowsiness, psychomotor impairment with alcohol, other CNS depressants (eg, benzodiazepines, opioids, tricyclics). May be potentiated by CYP3A4 inhibitors (eg, ketoconazole), sertraline; use lower zolpidem dose. Decreased alertness with imipramine, chlorpromazine. May be antagonized by CYP3A4 inducers (eg, rifampin).
Drowsiness, dizziness, diarrhea, drugged feelings (long-term); CNS effects, complex behaviors (eg, sleep-driving), anaphylaxis, angioedema.