About Ambien
Ambien belongs to a new class of sleep medication prescribed for
insomnia, frequent awakening,
or an inability to sleep long enough. You should only take Ambien
when you have time for 6-8 hours of sleep. This drug is usually
prescribed for no more than a week or two, though if used infrequently
and at lower doses, it may be used to correct sleep disturbances
that do not respond to a short period of treatment. Ambien is metabolized
much more quickly than other common sleep medications, so is far
less likely to leave you feeling sleepy in the morning.
While Ambien works effectively to decrease the amount of time it
takes to get to sleep, it's best to combine it with a 'sleep
hygiene' regimen. Maintaining a regular bedtime, avoiding
caffeine and heavy foods in the evening, and giving yourself
time to relax before going to bed, are all ways to make your
treatment as successful as possible.
This medication should only be taken before 6-8 hours of
uninterrupted rest, and should not be used during air travel.
Cases of temporary amnesia (forgetting what you were doing
for the 6-8 hours of Ambien's normal effectiveness) have been
reported under these circumstances. Do not combine Ambien
with alcohol, or any other prescription drug that causes drowsiness,
as overdose may result.
Ambien is only available by prescription.
Ambien Side Effects
Ambien may interfere with some laboratory tests, consult your doctor
or the test lab in advance for instructions. Notify your doctor
if you experience any side effects at all on waking the next morning
if you have had a full night's rest.
Normal Side Effects: Drowsiness. Take Ambien only on going
to bed, not more than 5-15 minutes before actually lying down.
Consult your doctor about the best way to discontinue Ambien, as
you will likely have difficulty sleeping for a night or two after
you stop taking it. This is normal, but the effect can be minimized
by slowly stepping off your treatment. If you continue to maintain
a regular bedtime schedule, this will also help to minimize rebound
sleeplessness.
Less Common Side Effects: amnesia (if taken on a plane),
decreased appetite, drowsiness (daytime), dizziness, diarrhea, high
blood sugar, migraine, nausea, water retention.
Rare Side Effects - Consult your doctor immediately if any
of the following occur: agitation, blurred vision, confusion, glaucoma,
hallucination, heart problems, high blood pressure, irritability,
muscle spasm, muscle tremor, nightmares, rash, sleep walking, suicidal
or abnormal thoughts.
Cautions: There are few cautions for Ambien use, and fewer
absolute contraindications for this treatment. While the possibility
exists that allergic reaction could occur, or that you may experience
unpleasant side effects, this sleep medication is considered to
be very safe.
Please inform your physician of any of the following circumstances, drug allergies, or medications you may be taking now. Be sure that your doctor clearly explains how to use this medication, and any special precautions you may need to take.
- Allergy: An allergic reaction to this drug in the past,
or during treatment, is a contraindication for continued use.
This is very rare.
- Depression or mental illness: Your doctor might consider
another treatment, as Ambien may not be suitable in combination
with all other medications for these conditions. The risk of unusual
mental side effects may be increased, report any changes in thinking
or behavior to your doctor.
- Diabetes: Ambien may occasionally cause high blood sugar.
- Glaucoma: In rare cases Ambien may cause this condition.
- Heart problems: In rare cases Ambien may cause or worsen
these conditions.
- History of alcoholism or drug abuse: May increase your
risk of dependence or of dangerous drug interactions, may be more
likely to have some liver impairment.
- Kidney or liver impairment: Your doctor may decrease
your dose of Ambien, especially in cases of liver problems, by
50%.
- Lung condition (serious): In rare cases Ambien has exacerbated
respiratory problems.
- Pregnancy or intention to become pregnant: Ambien is
not considered safe for pregnant or nursing women.
- Sleep Apnea (temporary suspension of breathing during
sleep) - Ambien may worsen this condition. Individuals with sleep
apnea should not generally use sedatives as sleep aids.
Ambien Interactions
Ambien is a central nervous system depressant, and may react strongly
with other medication that has a similar effect. Be cautious about
taking Ambien with any medication that warns it 'may cause drowsiness'
or cautions you against driving or operating heavy machinery. Check
the labels on over the counter medication, as these will not all
mix safely with your treatment.
- Alcohol - Ambien and alcohol can accelerate central nervous
system depression. Avoid mixing the two, as this could increase
side effects and possibly be dangerous. Drinking alcohol may also
contribute to insomnia, decreasing the effectiveness of your treatment,
even if you do not directly mix them. Ambien users are generally
advised to avoid alcohol use.
- Azole antifungals - Drugs like Diflucan
(fluconazole), Nizoral
(ketoconazole), and Sporanox
(itraconazole), may lead to a toxic buildup of Ambien.
- Benzodiazepines (a class of antidepressants, anti-panic agents,
sleep medications, and muscle relaxants) such as Ativan
(lorazepam), Valium (diazepam),
Halcion (triazolam), Restoril (temazepam), Librium (chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam),
and others, may increase the risk of side effects. The sleep medications
of this class, Halcion and ProSom, should never be used at the
same time as Ambien. Do not take multiple sleep medications together.
- Caffeine - This stimulant may decrease the effectiveness of
Ambien treatment, do not take it in the afternoon or evening while
taking Ambien. Caffeine may be found in soda, coffee, tea (except
herbal teas), some herbal diet formulas, and chocolate.
- Desyrel (trazodone) - Risk of additive
CNS depression.
- Effexor (venlafaxine)
may increase the risk of hallucinations when taken with Ambien,
do not combine these treatments.
- Ephedra - This herb may act as a stimulant, decreasing the effects
of the medication.
- Ginseng - This herb may act as a stimulant, decreasing the effects
of the medication.
- Kava kava - Do not take this herb while using Ambien, oversedation
may result.
- Kola nut - This herb may act as a stimulant, decreasing the
effects of the medication.
- Ma Huang - This herb may act as a stimulant, decreasing the
effects of the medication.
- Narcotic pain medication, like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone,
acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine),
Vicodin (hydrocodone, acetaminophen),
or Vicoprofen (hydrocodone, ibuprofen)
should not be mixed with Ambien, except under the direction of
your physician. If your doctor gives you instructions concerning
how long to wait between taking these medications, follow them
exactly.
- Norflex (orphenadrine)
- Risk of oversedation.
- Norvir (ritonavir) may lead to a toxic buildup of Ambien.
- Nicotine - This stimulant may decrease the effectiveness of
Ambien treatment.
- Rifater (rifampin) may decrease the benefits of Ambien.
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal
(butalbital, aspirin, and caffeine), Phenobarbitol, Seconal, or
other barbiturates.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil (paroxetine),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline)
may increase the risk of side effects from Ambien.
- Skeletal muscle relaxants such as Flexeril
(cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol),
or Robaxin (methocarbamol)
may cause oversedation in combination with Ambien.
- Sleep medication like Sonata
(zaleplon) or over the counter sleeping pills should not be
used with Ambien.
- St. John's Wort - Do not take this herb while using Ambien.
- Tranquilizers like Haldol (haloperidol), Mellaril (thioridazine),
or Thorazine (chlorpromazine) may cause oversedation in combination
with Ambien.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may increase
the risk of side effects from Ambien.
- Valerian - Do not take this herb while using Ambien.
- Wellbutrin or Zyban (bupropion)
- May increase risk of side effects.
If you are unsure about the safety of combining any medication
with Ambien, consult your doctor or pharmacist.
Ambien Directions
Ambien is available in 5 mg and 10 mg doses. A 10 mg dose is the
most common, individuals are not advised to take more than 10 mg
per day.
If you are being treated for a long term sleep disorder that responds
slowly to treatment, your doctor may advise you to lower your Ambien
dosage to 5 mg and take it only 2-4 times per week, or on nights
when you can't sleep. Lower, less frequent doses of Ambien will
decrease chances of tolerance, which would render treatment ineffective.
Take Ambien on an empty stomach right as you are going to bed.
Food will slow absorption of this medication and delay sleep onset.
The tablets may be broken or crushed. Do not take double doses;
take only as much and only as often as your doctor suggests.
Ambien may make you sleepy very suddenly within 10-20 minutes
of taking it, particularly when you first begin to use it;
if you are not lying down, you may experience a decrease of
coordination or find that it is difficult to think clearly.
Ambien should be taken only at bedtime, and you should not
attempt to drive or operate machinery for at least six hours
after use. Take this medication only when you will have time
for a full night's sleep, at least 6-8 hours for most people.
If you have less time to sleep, it is much more likely that
you will still feel sedated or lethargic when you get up.
Be cautious if you plan to drive or perform dangerous tasks
the next morning, avoid these activities if you find yourself
feeling tired or experience slowed reactions.
Ambien may cause rebound sleeplessness if you stop taking it abruptly.
Your doctor may advise you to cut your dose to 5 mg before stopping
Ambien treatment to minimize this.
Store Ambien away from direct light and heat. Store in a dry location;
avoid storing it in the bathroom, near sinks, or other areas where
it may become damp. Do not use after the expiration date.
Keep Ambien away from children; both when storing it, and when
discarding any unused medication.
Ambien is a trademark of Sanofi-Synthelabo, Inc.
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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