HOW should this medicine be used?
Zolpidem comes as a tablet (Ambien) and an extended-release (long-acting) tablet (Ambien CR) to take by mouth. Zolpidem also comes as a sublingual tablet (Edluar, Intermezzo) to place under the tongue and an oral spray (Zolpimist) which is sprayed into the mouth over the tongue. If you are taking the tablets, extended-release tablets, sublingual tablets (Edluar), or oral spray, you will take the medication as needed, not more than one time a day, immediately before bedtime. If you are taking the sublingual tablets (Intermezzo), you will take the medication as needed, not more than one time during the night if you wake up and have difficulty returning to sleep. Zolpidem will work faster if it is not taken with a meal or immediately after a meal. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use zolpidem exactly as directed.
You will probably become very sleepy soon after you take zolpidem and will remain sleepy for some time after you take the medication. Plan to go to bed right after you take zolpidem tablets, extended-release tablets, sublingual tablets (Edluar), and oral spray and to stay in bed for 7 to 8 hours. Take zolpidem sublingual tablets (Intermezzo) only when you are already in bed and can remain in bed for at least 4 more hours. Do not take zolpidem if you will be unable to remain asleep for the required number of hours after taking the medication. If you get up too soon after taking zolpidem, you may experience memory problems.
Swallow the extended release tablets whole; do not split, chew, or crush them. Tell your doctor or pharmacist if you cannot swallow tablets.
Do not open the pouch that contains the sublingual tablet (Intermezzo) until you are ready to take the tablet. To remove the sublingual tablet (Edluar) from the blister pack, peel off the top layer of paper and push the tablet through the foil. To take either brand of sublingual tablet, place the tablet under your tongue, and wait for it to dissolve. Do not swallow the tablet whole or take the tablet with water.
To use the oral spray, follow these directions and those that appear in the package label:
- Before using zolpidem spray for the first time, or if you have not used the spray bottle for 14 days, you must prime the pump.
- Line up the arrows on the cap and the base of the container. Squeeze the cap at the arrows and pull the cap and base apart to separate. Remove the clear protective cap from the pump.
- To prime the pump, hold the container upright. Point the black spray opening away from your face and other people. Press down on the pump with your forefinger, release and let it return to the starting position and repeat 4 more times. You should see a fine spray come out of the container.
- To use zolpidem spray, hold the container upright with the black spray opening pointed directly into your mouth, over the top of your tongue. Press down fully on the pump to make sure that a full dose of zolpidem is sprayed.
- Let the pump return to the starting position. If your doctor prescribed only one spray of zolpidem, put the clear protective cap back over the pump at the top of the base after each use. If your doctor has prescribed two sprays of zolpidem for your dose, a second spray should be used.
- Snap the child-resistant cap back onto the base and rotate the cap and base so that the arrows are not lined up. This is to help prevent a child from using the spray mist bottle.
Your sleep problems should improve within 7 to 10 days after you start taking zolpidem. Call your doctor if your sleep problems do not improve during this time or if they get worse at any time during your treatment.
Zolpidem should normally be taken for short periods of time. If you take zolpidem for 2 weeks or longer, zolpidem may not help you sleep as well as it did when you first began to take the medication. Talk to your doctor about the risks of taking zolpidem for 2 weeks or longer.
Zolpidem may be habit forming. Do not take a larger dose of zolpidem, take it more often, or take it for a longer time than prescribed by your doctor.
Do not stop taking zolpidem without talking to your doctor, especially if you have taken it for longer than 2 weeks. If you suddenly stop taking zolpidem, you may develop unpleasant feelings or mood changes or you may experience other withdrawal symptoms such as shakiness, lightheadedness, stomach and muscle cramps, nausea, vomiting, sweating, flushing, tiredness, uncontrollable crying, nervousness, panic attack, difficulty falling asleep or staying asleep, uncontrollable shaking of a part of your body, and rarely, seizures.
You may have more difficulty falling asleep or staying asleep on the first night after you stop taking zolpidem than you did before you started taking the medication. This is normal and usually gets better without treatment after one or two nights.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with zolpidem and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( Web Site) or the manufacturer's website to obtain the Medication Guide.
What OTHER INFORMATION should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Zolpidem is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.