Short-term treatment of insomnia characterized by difficulties with sleep initiation.
Individualize. Give once daily immediately before bedtime. 10mg (two actuations). Max 10mg/day. Elderly, debilitated, or hepatic impaired: 5mg (one actuation); monitor closely. Concomitant CNS depressants: use downward dose adjustments. Effects delayed if used with or immediately after a meal.
Evaluate for co-morbid diagnoses (eg, physical and/or psychiatric disorders) prior to treatment. Reevaluate if insomnia persists after 7–10 days of use. Monitor for new onset behavioral changes, worsening of depression, or suicidal thinking. Hepatic impairment. Conditions that affect metabolism or hemodynamic response. Compromised respiratory function. Sleep apnea. Myasthenia gravis. Drug abusers. Write ℞ for smallest practical amount. Withdraw gradually. Debilitated. Elderly. Pregnancy (Cat.C). Nursing mothers.
Additive effects with concomitant other CNS depressants (eg, imipramine, chlorpromazine), or alcohol (avoid); reduce dose. Potentiated by potent CYP3A4 inhibitors (eg, ketoconazole); reduce zolpidem dose. Antagonized by CYP3A4 inducers (eg, rifampin).
Drowsiness, dizziness, diarrhea, drugged feeling, headache; abnormal thinking, behavioral changes, complex behaviors (eg, sleep-driving), hallucinations, amnesia, anxiety, other neuropsychiatric symptoms; anaphylaxis, angioedema.
Pump (60 metered actuations)—1