The recommended dosage for insomnia patients is different for men and women. The Food and Drug Administration (FDA) revealed in 2013 that women were at a greater risk of impairments when operating a motor vehicle and more excessive sedation following administration of sleeping tablets such as zolpidem prior to bedtime.
The results showed that the metabolic clearance of the medication was at reduced rates and this subsequently resulted in higher concentrations of the active ingredient in the blood samples of women. In fact, women showed an approximately 35% lower rate of clearance of the medicine from the body than men.
The FDA consequently took action to reduce the advised zolpidem dosage by 50% for women in comparison to men. For chronic insomnia, men are recommended an administration of 10 mg zolpidem, orally and immediately before retiring to bed. This dosage is for the immediate-release formulation of the sleep medicine and is halved for women (5 mg).
For the extended-release form of zolpidem, the active ingredient is slowly released in the body over a period of time. Men are advised to take 12.5 mg orally before bedtime and women should use 6.25 mg of zolpidem slow acting tablets.
If middle-of-the-night awakenings are an issue, men can use 3.5 mg of zolpidem sublingual tablets when they awaken during the night, and only if they have at least 4 hours to sleep before they have to rise in the morning. Women should also halve this dosage when used for the same purposes.
The time taken for a standard zolpidem dosage to start working is around 30 minutes. Once ingested, the medication will be absorbed by the body and the sedative effects will be observable as a calming sensation.
The active ingredient in this sleep medicine will also help relax the muscles and the user will drift asleep. The peak effects of this sleep aid are observable one to 2.5 hours after administration.
Both the fast and slow-releasing tablets will work as they are intended to if they are not consumed with food. If the therapeutic is taken with food, the sedative and hypnotic action can be delayed.
This sleep medicine is also for short-term use. It should be used for no more than four weeks. Administration of this treatment for longer than four weeks increases the potential for tolerance and withdrawal symptoms.
Age, gender, body metabolism and certain foods such as grapefruit, are some of the factors which can affect the effectiveness or longevity of a medicine.
The metabolites of a medication are the by-products after the substances have been metabolised or broken down by the body. These metabolites are removed from the body by the kidneys (through renal excretion) in a stepwise process which includes:
Other than renal excretion, some of the metabolites can be eliminated by the liver into the bile and then ejected from the body through faecal matter.
The half-life of this medication is approximately two to three hours. This means that after this specified duration, half of the active ingredients of the sleep medication will be eliminated from the body. Full elimination can range anywhere from 11 to 16.5 hours. Even if the parent medicine has been removed from the body, the metabolites can still remain until full elimination has occurred.
When using this therapeutic for sleep, improvements can be seen from 7 to 10 days after using the medication.
The presence of metabolites in the body can be affected by the age of the individual, the body weight and the zolpidem dosage administered. Higher amounts of this sleep aid will generally take longer to be removed from the body.
Withdrawal can be defined as the mental and physical effects that one may experience after using certain medications for a long period of time. Medicines can be classified as highly potential for dependency or not. If they have a high potential for dependency then these types of therapeutics will typically be used for short treatment periods.
The type of withdrawal symptoms and duration of withdrawal are dependent on the biological system of the user and the type of medication used.
Sleeping pills such as zolpidem tablets were specifically designed for assisting those with chronic insomnia sleep better. It is not intended for long-term use. Withdrawal from Ambien, if not tapered down, can include these effects:
Ambien withdrawal symptoms lessen or disappear after 1 to 2 weeks. The symptoms which are most acute appear after 3 to 5 days of stopping the medication but the psychological symptoms can last for weeks after the final zolpidem dosage. Most users stop the medication with no unwanted effects, nonetheless.
Medications can affect the brain by increasing the amounts of the neurotransmitters, dopamine and serotonin. This creates feelings of euphoria, and without the substance which creates these feelings, an individual can endure unpleasantness and enter a state of withdrawal.
It has been recorded by the American academy of sleep medicine that 30% of adults have problems sleeping, and at least 10% of these statistics have insomnia is cases where it is detrimental to their everyday life.
It is not considered safe to quit using this treatment abruptly, especially when the medication is used for a long time. More serious complications can occur in these cases. Seizures are a possibility in withdrawal cases but this tends to occur in much less than 1% of patients. Nevertheless, this can be a cause worth noting.
There is a safe way to wean off sleep medications. This is known as gradual tapering. It is an effective way to reduce the possibility of withdrawal symptoms following discontinuation of the therapeutic. It involves a tapered dosing schedule which allows you to lower your regular zolpidem dosage in a safe manner.
Gradual tapering does not eliminate the possibility of withdrawal symptoms but rather, patients may find that with using this process there will be longer symptoms-free periods as time goes by. It also minimises the risk of the serious complications associated with withdrawal.
Updated: 14th January 2021
Review Due: January 2022
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