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INTERACTIONS Alcohol enhances the sedative effect of zolpidem, joint use is not recommended. Drugs that act depressingly on the central nervous system (neuroleptics, barbiturates, other sleeping pills, anxiolytics / sedatives, antidepressants with sedative action, narcotic analgesics, antitussive central action), antiepileptic drugs, general anesthetics, antihistamines with sedative effect, antihypertensive central action; baclofen; thalidomide; pizotifen - when combined, there is an intensification of the oppressive effect on the central nervous system and the risk of respiratory depression increases; buprenorphine - risk of respiratory depression; ketoconazole (a powerful inhibitor of CYP3A4) reduces the clearance of zolpidem, in connection with which it is possible to increase its sedative effect; itraconazole (inhibitor CYP3A4) - a slight, clinically insignificant change in the pharmacokinetics and pharmacodynamics of zolpidem. Rifampicin (inducer CYP3A4) accelerates metabolism, reduces the concentration and effectiveness of zolpidem.
Overdose Overdose Symptoms: European post-marketing reports on zolpidem overdose report a violation of consciousness (from drowsiness to mild coma). Fixed one case of cardiovascular and respiratory disorders. There was a complete recovery after taking doses of zolpidem tartrate to 400 mg (40 times greater than MPDH).Cases of overdose caused by the simultaneous administration of many drugs, depressing the central nervous system, including zolpidem, led to more severe consequences, up to lethal outcomes.Treatment: induction of vomiting or immediate gastric lavage (depending on the condition), the purpose of activated charcoal. The monitoring of vital functions (breathing, pulse, blood pressure, etc.) is shown, if necessary, symptomatic and supportive therapy. It should be abandoned the use of any sedatives (even with pronounced stimulation).
METHOD OF APPLICATION AND DOSAGE Inside (immediately before bed) in a single dose of 10 mg. In elderly or debilitated patients, if liver function is impaired, treatment is started with a dose of 5 mg. If necessary (insufficient clinical effect) and good tolerability of the drug, the dose may be increased to 10 mg. The maximum daily dose is 10 mg. The course of treatment should not exceed 4 weeks. With transient insomnia, the recommended course of treatment is 2-5 days, in case of a situational one - 2-3 weeks. Very short periods of treatment do not require the gradual withdrawal of the drug. In the case of long-term use of the drug to reduce the possibility of development of ricochet insomnia, the abolition of zolpidem should be carried out gradually (first a decrease in the daily dose and then the withdrawal of the drug).
SIDE EFFECTS From the nervous system: often - drowsiness, a feeling of intoxication, headache, dizziness, increased insomnia, anterograde amnesia (the effects of amnesia can be associated with behavioral reactions), the risk of developing which increases in proportion to the dose, hallucinations, agitation, nightmares; infrequently - confusion, irritability; frequency is unknown - impairment of consciousness, dysphoria, aggressiveness, visual and auditory hallucinations, increased excitability, behavioral reactions, somnambulism, drug dependence (can develop even when therapeutic doses are used), withdrawal of drug - withdrawal syndrome or ricochet insomnia, decreased libido, gait disturbance , ataxia, falls (mainly in elderly patients), drug addiction (reduction of sedative and hypnotic effects when applied for several weeks). Most side effects from the psyche are paradoxical reactions. From the digestive system: often - diarrhea, nausea, vomiting, abdominal pain; frequency unknown - increased activity of hepatic enzymes. From the musculoskeletal system: the frequency is unknown - muscle weakness. On the part of the skin: the frequency is unknown - rash, itching, urticaria, increased sweating. Allergic reactions: the frequency is unknown - angioedema.
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