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Ambien functions similarly to benzodiazepines, showcasing hypnotic, amnesic, anti-seizure, anxiolytic, and sedative effects. The medication enhances sleep quality, facilitates faster sleep onset, and normalizes the sleep cycle. Generally, patients do not experience drowsiness upon waking. After ingestion, the active substance reaches peak concentration in the bloodstream within 30-180 minutes, depending on the rate of absorption. Ambien predominantly binds to plasma proteins, with approximately 70% bioavailability. Metabolism of the drug occurs in the liver, leading to the formation of three inactive metabolites. About half of these metabolites are excreted in the urine and around 40% in feces. The drug has a half-life of 150 minutes, but in individuals with severe liver impairment, this duration may extend up to 10 hours. Ambien can pass into breast milk. Administration and Dosage Ambien pills should be taken before bedtime. The standard dose is 10 mg. For elderly patients, the initial dose is reduced to 5 mg, and if necessary, it can be increased to 10 mg. The maximum daily dosage of Zolpidem (Ambien) is 10 mg. The drug should not be used for more than one month. Patients with transient insomnia should take the drug for 2-5 days, while those with situational insomnia need to use it for 14-21 days. If the treatment duration has been only a few days, the drug can be discontinued abruptly. However, for those who have been on Ambien for more than a week, the dose should be gradually reduced to avoid undesirable reactions. Contraindications The drug should not be prescribed in the following cases:
  • Severe or acute respiratory failure
  • Sleep apnea
  • Pregnancy and breastfeeding
  • Allergy to Ambien or other benzodiazepines
  • Minor age
  • Severe kidney and liver diseases
  • Lactose intolerance
Patients with a history of depression, drug addiction, alcoholism, or other types of addiction should exercise special caution when taking the drug. Side Effects In most cases, the drug does not cause undesirable effects. However, some patients may experience:
  • Drowsiness, headache, paradoxical insomnia, agitation, and nightmares
  • Nausea, diarrhea, vomiting, and stomachache
  • Anterograde amnesia (the risk of which increases with higher dosages) and vertigo
Less frequent side effects include:
  • Irritability, dysphoria, unusual behavior, and drug dependency
  • Liver disorders, elevated liver enzymes, and muscle weakness
  • Confusion, aggression, and somnambulism (sleepwalking)
  • Skin rash, urticaria (hives), itching, excessive sweating, and Quincke’s edema (angioedema)
  • Reduced libido, ataxia (loss of coordination), drug dependency, and double vision (diplopia)
As with any medication, it’s essential to be vigilant and seek medical advice if any adverse reactions occur. Patients should promptly inform their healthcare provider if they experience any unusual or concerning symptoms while using Ambien. Overdose Abusing Ambien or accidentally ingesting a large number of pills can lead to various symptoms, including ataxia (loss of coordination), confusion, hypotension (low blood pressure), difficulty breathing, lethargy, and even coma. In the event of an overdose, it is advisable to induce vomiting and administer enterosorbents (such as activated carbon) to the patient promptly, preferably within 60 minutes after taking the drug. If the patient is unconscious, gastric lavage (stomach pumping) should be performed, followed by symptomatic treatment. Flumazenil serves as a specific antidote, but it must be used with caution, as it can increase the risk of seizures, particularly in individuals with epilepsy. Dialysis is not an effective method for managing Ambien overdose. Special Instructions Prolonged use of Ambien (beyond 20-30 days) can lead to physical or mental dependence. Patients with a history of drug and alcohol addiction are particularly vulnerable to this potential reaction. It is essential to closely monitor and periodically assess the physical and mental condition of this group of patients. Combining Ambien with other benzodiazepines increases the risk of addiction. It is crucial to ensure that the patient gets 7-8 hours of sleep after taking the drug to prevent anterograde amnesia, a condition in which the patient may not remember events that occurred after drug intake.