Zolpidem (Ambien)

Current FDA labeling recommends 5 mg for women and 5 to 10 mg for men for immediate-release zolpidem, taken immediately before bed with at least 7 to 8 hours of sleep available. Older adults and people with hepatic impairment are started at the lower dose. Your prescriber sets the dose; do not adjust it yourself.

Women eliminate zolpidem more slowly, so the same dose leaves higher morning blood levels. In 2013 the FDA lowered the recommended dose for women after driving-simulation and blood-level data showed next-morning impairment was common at the older dose.

Since 2019, zolpidem carries a boxed warning for complex sleep behaviors: sleepwalking, sleep-driving, and doing other things while not fully awake, sometimes with serious injury or death. Any such episode is a reason to stop the drug and contact your prescriber, not to lower the dose and continue.

Zolpidem is a Schedule IV controlled substance with real potential for tolerance, dependence, and rebound insomnia after stopping. It is intended for short-term use, and longer courses should be a deliberate clinical decision with a plan for reassessment rather than an open-ended refill.

Immediate-release zolpidem has a short half-life of roughly 2 to 3 hours in most adults, which is why it helps with falling asleep more than staying asleep. Clearance is slower in women, older adults, and people with liver impairment, so next-morning effects can persist even when the drug feels worn off.

Alcohol and other central nervous system depressants, including opioids, benzodiazepines, and sedating antihistamines, meaningfully raise the risk of severe sedation and respiratory depression. Strong CYP3A4 inhibitors can raise zolpidem levels. Review your full medication list with your prescriber or pharmacist before starting.