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Zolpidem is a medication used to help with sleep problems, but it comes with specific risks and important precautions. People taking zolpidem should be aware that it can cause significant drowsiness, dizziness, and even slow or shallow breathing, especially if combined with other substances that affect the central nervous system. This includes medicines for pain (like opioids), anxiety, other sleep aids, alcohol, muscle relaxants, or certain antihistamines found in allergy or cold products. Combining zolpidem with these products can increase the chance of serious side effects, so it is essential to inform your healthcare provider of all medications, supplements, vitamins, and herbal products you are taking.

Certain medications, such as sodium oxybate and similar compounds, are not recommended to be used with zolpidem. Other drugs, including some antifungals like ketoconazole, antibiotics like rifampin, and herbal supplements such as St. John's Wort, may also alter how zolpidem is removed from the body, affecting its effectiveness and safety. Your doctor may need to adjust your dose or monitor you more closely if these or similar medications are necessary.

Special caution is required for pregnant individuals and people with pre-existing conditions such as breathing problems, liver disease, or a history of substance misuse, as they may face greater risks from zolpidem. It is important to discuss your full medical history with your healthcare provider prior to starting this medication.

If you accidentally take more zolpidem than prescribed, or if someone else, especially a child, takes it, seek emergency medical help right away. Signs of overdose include trouble breathing, severe drowsiness, inability to wake up, or fainting. Immediate action can be life-saving. Always use zolpidem exactly as directed, double-check labels on all your medicines, and consult your pharmacist if you are unsure about any ingredient that may increase drowsiness or interact with this medication.

Common side effects:

• headaches
• sleepiness
• dizziness
• diarrhea

Less common but important to monitor:

• nausea
• dry mouth
• back pain
• flu-like symptoms
• chest pain
• feelings of tiredness
• loss of energy
• lightheadedness
• depression
• abnormal dreams
• memory loss
• stomach pain
• constipation
• sinus infection
• sore throat
• rash

Serious side effects:

• dangerous sleep behaviors like sleepwalking or sleep driving
• slowed brain activity leading to excessive sleepiness or confusion
• respiratory issues such as shallow or slow breathing
• severe allergic reaction including hives, shortness of breath, chest tightness, or swelling of the lips, tongue, face, or eyes
• suicidal thoughts or behaviors

Interactions with high risk of serious adverse effects and should be avoided:

• Sodium Oxybate
• Opioid pain relievers (e.g., codeine, hydrocodone)
• Alcohol
• Marijuana (cannabis)
• Sleep or anxiety medications (e.g., Alprazolam, Lorazepam, zopiclone)
• Muscle relaxants (e.g., Carisoprodol, Cyclobenzaprine)
• Antihistamines (e.g., Cetirizine, diphenhydramine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Azole antifungals (such as Ketoconazole)
• Rifampin
• St. John's Wort