Ambien, the brand of zolpidem, is a prescription medication indicated for the treatment of insomnia on a short-term basis. It belongs to the class of medications called the nonbenzodiazepine hypnotics. Ambien is able to reduce the amount of time it takes to fall asleep, reduce awakenings during the night and increase total sleep time. Although the drug is safe and effective, Ambien's metabolism, or breakdown, may cause side effects and drug interactions.
Metabolism
According to DrugLib.com, Ambien is metabolized by cytochrome P450 enzymes, which are found in a high concentration in the liver. The cytochrome P450 3A4 enzyme, simply called CYP 3A4, is the major enzyme that breaks down this medication. CYP1A2, CYP 2C9, CYP 2C19 and CYP 2D6 are also involved in Ambien metabolism but only play a minor role.
Drug Interactions
Medications that act on the CYP 3A4 enzymes may affect the levels of Ambien. CYP 3A4 inhibitors block the actions of enzymes, causing them to be unable to work on Ambien. This may lead to an increase in the levels of the medication in your body. Some CYP 3A4 inhibitors include ketoconazole, econazole, clarithromycin, diclofenac, doxycycline, erythromycin, isoniazid, nicardipine and verapamil. CYP 3A4 inducers enhance the actions of the enzyme and may decrease the level of Ambien, according to the "Drug Information Handbook." Examples of inducers include aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin and rifamycins.
Side Effects
Medications that increase the levels of Ambien may cause side effects. Common side effects include drowsiness, amnesia, dizziness, headache and gastrointestinal side effects, explains "Pharmacotherapy: A Pathophysiologic Approach." Although these may be seen in all patients, if Ambien is combined with a CYP 3A4 inhibitor, they may become severe. High levels of Ambien in the blood may result in low blood pressure and coma. If you feel extreme dizziness, drowsiness and weakness, seek medical attention. On the other hand, if Ambien levels decrease, the medication becomes ineffective.
Prevention
Patients on Ambien should see their doctor to ensure they're being monitored properly. If you go to a new doctor, inform him of all the medications you take, including over-the-counter drugs and herbal supplements. Your physician can determine which medication is safe to use with Ambien. If a new medication is necessary, your physician can adjust the dose of Ambien accordingly. Ask a pharmacist or physician for advice if you're unsure of a side effect or interaction.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- "Pharmacotherapy: A Pathophysilogic Approach"; Joseph T. DiPiro, Robert L. Talbert,et al.; 2008
- Ambien: Drug Interactions, Contraindications, Overdosage
Member Comments