Zolpidem: short-term insomnia treatment explained

The NHS says zolpidem is for short-term management of severe insomnia. It boosts a calming chemical in the brain called GABA, which helps you fall asleep and cuts down on waking in the night.

It comes only as tablets.

Take it just before you go to bed, swallowing the tablet whole with water; do not crush or chew it. It takes about 30 minutes to work, and it can be taken with or without food.

The NHS gives a standard dose of one 10 mg tablet at bedtime, with a lower 5 mg starting dose for people aged 65 or over or with kidney or liver problems. A doctor may prescribe it for only two or three nights a week, not every night.

If you miss a dose, skip it and take the next dose the following night. Never double up.

Overdose signs include severe drowsiness, confusion, coma, dizziness, fainting, low blood pressure, muscle weakness and shallow breathing. Call NHS 111, or 999 if someone cannot be woken or is struggling to breathe.

Zolpidem is prescribed for between 2 days and 4 weeks. The body develops tolerance quickly after several weeks, and dependency may develop beyond that. If sleep problems continue, speak to your doctor instead of continuing the tablets, and consider changes such as a regular sleep schedule, a warm bath and a screen-free wind-down.

Most common effects are mild, and the NHS gives each some practical advice.

• Bitter or metallic taste or dry mouth.

• Next-day drowsiness: avoid driving, cycling, machinery and alcohol.

• Headaches, dizziness, nausea or vomiting, diarrhoea and back pain.

• Call NHS 111 or speak to a doctor for memory loss, hallucinations, delusions, depression or falls, particularly in people over 65. Anaphylaxis needs 999.

Some people have done things such as sleepwalking, eating or making phone calls while not fully awake. The NHS says the risk increases with alcohol or with mental health medicines. If it happens, stop taking zolpidem and contact your doctor.

Raise liver or kidney problems, myasthenia gravis, breathing problems or sleep apnoea, mental health history, past alcohol or drug problems, and any plan to become pregnant.

Drowsy antihistamines such as chlorphenamine and promethazine, antipsychotics, antidepressants, epilepsy medicines, anxiety medicines, other sedatives, ciprofloxacin, ketoconazole, itraconazole, ritonavir and opioids all interact. Alcohol is strictly to be avoided; it can lead to dangerously deep sleep and breathing problems. Avoid herbal remedies that make you sleepy, and note that caffeine can counteract it.

It is not usually recommended in pregnancy because data are insufficient, and newborns can be drowsy or show withdrawal. Breastfeeding is permissible if the baby is healthy, with occasional short use only, and without co-sleeping.

After short use, stopping causes minimal problems. After longer use, a gradual reduction is recommended. Report suspected side effects to the MHRA Yellow Card scheme.