Sanofi-Aventis; Ambien is available in generic form (patent expired in 2006); Ambien CR’s market exclusivity expires in 2009 (see “Ambien CR Fact Sheet”).
Indicated for both sleep initiation and sleep maintenance.
A so-called “non-benzodiazepine” in the chemical category called “imidazopyridines.” Binds to the GABA-benzodiazepine receptor complex, like benzodiazepines, but is more selective for the omega-1 receptor subtype than are BZs.
Supplied as 5 mg pink and 10 mg white tablets (breakable).
Start at 5 mg QHS for elderly, 10 mg QHS otherwise. PDR lists maximum dose of 10 mg, but in practice many patients require and tolerate 20 mg QHS dosing.
Most common: drowsiness and dizziness.
Does not alter normal sleep stages.
Anecdotal: uncommonly, can cause black outs (loss of memory of activities) soon after ingested if the patient does not go right to sleep.
Classified as a Schedule IV drug, but abuse potential is likely somewhat less than BZs.
Pregnancy Category C
Additive effect when combined with alcohol and other drugs or medications that have sedative effects.
Zoloft appears to increase Ambien concentrations by about 40%.
Half life is 2.5 hours; duration of action about 10 hours.
Metabolized in the liver.
Works more slowly if taken after eating.
Cut dose in half in hepatic insufficiency. No adjustments needed in renal impairment.
Good, solid sleeping pill for both sleep initiation and sleep maintenance. Generally just as effective as Ambien CR, but much cheaper because it is generic.