Ambien is a brand-name prescription drug (generic name: zolpidem) used for the short-term treatment of insomnia. An extended-release version, Ambien CR (zolpidem ER), is prescribed to help people fall asleep and stay asleep. The active ingredient in Ambien, zolpidem tartrate, is a sedative-hypnotic, that is, it primarily helps people fall asleep. It is also a central nervous system (CNS) depressant that induces sleep by slowing down the brain. Both Ambien and Ambien CR are taken as a tablet at bedtime.
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Ambien forms and strengths
Ambien and Ambien CR are taken as tablets. Ambien CR, intended to help people fall asleep and stay asleep, is taken in slightly higher doses than Ambien.
Ambien dosage for adults
Ambien is prescribed for the short-term treatment of insomnia as a sleep aid to induce sleep. Ambien CR is also prescribed for the short-term treatment of insomnia but is primarily used in people who have trouble falling asleep and staying asleep through the night. When prescribing Ambien or Ambien CR, healthcare providers will use the lowest possible dose so that people can function in the morning. The higher recommended doses will increase next-day impairment.
| Ambien dosage chart | |||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
| Insomnia | 5 mg tablet taken immediately before bedtime for women or 5 or 10 mg tablet taken immediately before bedtime for men | 5–10 mg tablet taken immediately before bedtime | 10 mg per day immediately before bedtime |
| Ambien CR dosage chart | |||
|---|---|---|---|
| Indication | Starting dosage | Standard dosage | Maximum dosage |
| Insomnia | 6.25 mg tablet taken immediately before bedtime for women or 6.25 or 12.5 mg tablet taken immediately before bedtime for men | 6.25 or 12.5 mg tablet taken immediately before bedtime | 12.5 mg per day immediately before bedtime |
Source: Ambien-Daily Med, Ambien CR-Daily Med
Ambien dosage for children
The U.S. Food and Drug Administration (FDA) has not approved Ambien or Ambien CR for use in anyone younger than 18. In very rare cases, healthcare providers may use zolpidem off-label to improve awareness in children in a vegetative state due to a brain injury.
Ambien dosage restrictions
Because of pre-existing physical conditions, Ambien may not be completely safe for some people to take. Contraindications include people with complex sleep disorders such as sleepwalking or sleep-driving, who drink alcohol regularly, or anyone who has an allergic reaction to Ambien.
Some people may be prescribed Ambien with caution and close monitoring. These include people with myasthenia gravis (a muscle weakening condition), sleep apnea, other breathing problems, and people who take other medicines that cause CNS depression.
Other people may require dosage reductions to take Ambien safely. Older adults or debilitated people will receive lower doses than younger adults. This is because zolpidem is broken down by the liver, and liver function tends to decrease with age. As a result, there is an increased risk of next-morning impairment in older adults.
Likewise, people with mild to moderate liver problems will need a lower dose, too. People with severe liver impairment should not take Ambien. People with kidney disease, however, can take Ambien at standard doses no matter how severe their kidney problems are.
Dosage restrictions are as follows:
Elderly and debilitated patients: 5 mg
Ambien per day or 6.25
Hepatically impaired patients (liver problems):
Mild to moderate liver impairment: 5 mg Ambien per day or 6.25 mg Ambien CR per day taken just before bedtime
Severe liver impairment: Ambien should not be used
Black box warning
Ambien has a black box warning, which is the strongest warning required by the FDA. Ambien may cause people to perform certain activities while not fully awake. Some of these activities include sleepwalking and sleepdriving. These events can result in serious injuries or death. Ambien should be stopped right away if any of these behaviors occur.
Ambien dosage for pets
Ambien should never be given to pets. It is toxic to both dogs and cats. Although zolpidem puts humans to sleep, it tends to make pets hyperactive and speed up their hearts. If a dog or cat has ingested Ambien or Ambien CR, call a pet poison helpline or get emergency veterinary care.
How to take Ambien
Ambien and Ambien CR are taken as tablets right before bedtime.
Take Ambien exactly as prescribed.
This medicine should come with a medication guide. Ask your pharmacist for a copy if you do not have one.
Take Ambien only when needed to fall asleep.
Take Ambien at bedtime and only if you intend to stay in bed for a full night (seven to eight hours) before waking.
Take only one tablet.
Take Ambien on an empty stomach. Food will slow down the sleep-inducing effects of zolpidem.
Do not take Ambien if any alcohol has been consumed within a few hours of bedtime.
Do not take Ambien if another prescription or over-the-counter sleep medication has been taken.
Take Ambien with a glass of water.
Swallow the Ambien CR extended-release tablet whole. Do not crush, break, or chew it.
Store Ambien or Ambien CR in the labeled prescription bottle at room temperature (68°F–77°F). Keep securely out of the reach of children and pets.
Ambien dosage FAQs
Ambien vs. Ambien CR: What’s the difference in doses?
Both Ambien and extended-release Ambien (Ambien CR) treat insomnia. Ambien is prescribed to people who have trouble falling asleep. Ambien CR is prescribed to people who have trouble falling asleep and staying asleep. Both are taken as a single tablet before bedtime, but Ambien CR tablets are released over time to help people both fall asleep and stay asleep.
How long does it take Ambien to work?
As a tablet, Ambien has to pass through the stomach and be absorbed through the intestines before entering the bloodstream. As a result, the effects of zolpidem kick in about 30 minutes after swallowing a tablet and reach peak effects about an hour and a half.
Faster-acting dosage forms are available. Sublingual tablets, sold under the brand names Edluar and Intermezzo, or fast-acting oral spray (Zolpimist) are absorbed directly into the bloodstream in the mouth and induce sleep in less than 30 minutes. Like Ambien, both Edluar and Zolpimist are prescribed to people who have trouble falling asleep. Intermezzo sublingual tablets, however, are prescribed to people who have trouble waking up in the middle of the night and can’t fall asleep again.
How long does Ambien stay in your system?
Both Ambien and Ambien CR
have a half-life of two and a half hours, but because Ambien CR is absorbed by the body more slowly, its concentration in the bloodstream remains higher for a longer time than Ambien. However, eight hours after taking an Ambien or Ambien CR tablet, the amount of zolpidem in the body is about equal, though slightly higher for Ambien CR. In general, it takes about 10 to 12 hours for a dose of Ambien or Ambien CR to be completely cleared from the body. Most of Ambien’s sedative effects such as drowsiness and lightheadedness should clear up by then.
What happens if I miss a dose of Ambien?
Ambien should only be taken right at bedtime. If a dose of Ambien is missed, do not take a dose if wake-up time is less than seven hours away. Otherwise, drowsiness and next-morning impairment may impinge on morning activities such as driving.
How long can you take Ambien?
As a controlled substance, Ambien has a high potential for dependence and drug abuse. Healthcare providers will only use Ambien or Ambien CR over the short term to help improve insomnia. If insomnia has not improved after seven to 10 days of nightly dosing, get medical advice from a healthcare professional.
How do I stop taking Ambien?
Ambien can cause physical dependence. If it has been taken continuously over a long time or taken in large doses, stopping Ambien could cause rebound insomnia and other adverse events such as nausea, vomiting, cramps, sweating, muscle twitching, and convulsions. If zolpidem has been used over a prolonged period, do not stop taking the medicine until consulting with a healthcare provider. The dose will need to be gradually decreased over a period of time to prevent withdrawal symptoms.
There may be good reasons to stop taking Ambien. First, it’s only intended for short-term treatment, so the prescribing healthcare provider will stop prescribing the medication after a while. People will also be taken off Ambien if they experience severe side effects such as allergic reactions, behavior changes, or complex sleep disorders. Some people may have physical conditions that are worsened by Ambien such as respiratory problems, sleep apnea, or depression. Drug interactions may also cause problems that may require Ambien to be discontinued. Of course, some people may opt to stop taking Ambien simply because they can’t live with common side effects such as drowsiness or next-day impairment.
Other drugs besides Ambien (but not in addition to Ambien) can help people with insomnia. Prescription alternatives include benzodiazepines, some types of antidepressants, and a variety of sedatives such as Dayvigo (lemborexant), Belsomra (suvorexant), eszopiclone, and zaleplon. Antihistamines are an often effective short-term over-the-counter alternative. Consult your doctor before using any of these treatments. The most successful long-term treatments, however, involve behavioral therapy and good sleep hygiene.
What is the maximum dosage for Ambien?
The maximum dose for Ambien is 10 mg per day, taken just before bedtime. The maximum dose for Ambien CR is 12.5 mg per day, taken just before bedtime.
Can you overdose on Ambien?
An overdose of Ambien is a medical emergency and could be fatal, especially if too much Ambien is taken along with other CNS depressants like alcohol or opioids. Call a poison helpline or go to an emergency room if an overdose of Ambien is suspected or the person taking Ambien is showing signs of an overdose such as severe drowsiness, loss of consciousness, confusion, lightheadedness, shallow breathing, slowed heartbeat, or coma.
What interacts with Ambien?
Ambien may cause problems when combined with other prescription drugs, over-the-counter medications, and dietary supplements. Before taking Ambien, tell your doctor about all the drugs you take, including Rx, OTC, vitamins, and supplements. This will help your doctor decide if Ambien is safe for you.
CNS depressants such as opioids, barbiturates, sedatives, benzodiazepines, and alcohol will increase the sedative effects of Ambien, increase mental impairment, slow down breathing, and can even cause death when combined with Ambien. Taking Ambien with the antidepressant imipramine or the antipsychotic chlorpromazine could also worsen mental impairment.
A wide spectrum of drugs (like the antifungal ketoconazole) blocks the body’s ability to break down zolpidem. People taking these drugs will experience more severe next-day impairment and drowsiness because higher levels of zolpidem will still be left in their blood.
Some drugs (such as rifampin) and supplements (such as St. John’s wort) have the opposite effect: they speed up the body’s breakdown of zolpidem. People taking these drugs may find that Ambien isn’t helping them with their sleep problems.
Fortunately, healthcare providers are very knowledgeable about Ambien drug interactions. Make sure you keep a list of all medications and supplements being taken and share that list whenever getting or filling a prescription for Ambien.
What happens when you mix Ambien and alcohol?
If alcohol has been ingested within a few hours of bedtime or another sleep medication is taken, do not take Ambien. The combination will increase the sedative effects of Ambien and increase the risk for complex sleep disorders such as sleepwalking and sleep-driving.
Is it safe to take Ambien during pregnancy?
If you are pregnant, think you may be pregnant, or are breastfeeding, consult your doctor before using Ambien. Pregnant women are occasionally prescribed zolpidem for insomnia. There is not a clear association regarding zolpidem and birth defects. However, healthcare providers will avoid prescribing zolpidem in the third trimester because it may cause sedation or respiratory depression in a newborn.
Women should consult their doctor prior to using Ambien when breastfeeding. Zolpidem is present in breast milk at low levels and may cause sedation in the baby. If zolpidem is taken when breastfeeding, women should watch the baby for signs of sedation, loss of muscle tone, and shallow breathing just in case.
Related resources for Ambien dosages:
10 poison pills for pets
Ambien dosing
Ambien
Ambien prescribing information
Ambien CR prescribing information
Intermezzo prescribing information
Management of insomnia and anxiety in myasthenia gravis
Melatonin and zolpidem: Do sleep aids really work?
Zolpidem
Zolpidem
Zolpidem tartrate drug summary
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