Zolpidem 443son showed enough cross-tolerance withclorazepatedipotassium that this
chemical could help control withdrawal symptoms caused by zolpidem de-
pendence, indicating that zolpidem shares some characteristics with benzo-
diazepine class depressants. Other reports tell of zolpidem dependence
developing in individuals who had a history of drug abuse. Two clinical stud-
ies giving the drug to persons for four weeks also produced dependence.
Normally dependence is light enough to cause only mild discomfort upon
stopping the drug, but withdrawal seizures are known among persons who
have taken huge doses of zolpidem for months. However, zolpidem’s abuse
liability is low enough that the substance is believed to have special potential
for treating ailments in persons prone to drug abuse.
Drug interactions.The antifungus drug ketoconazole lengthens and in-
creases zolpidem effects. The tuberculosis drug rifampin shortens and de-
creases zolpidem effects.
Cancer.Standard laboratory tests have not indicated that zolpidem causes
cancer. In studies using many times the recommended human dose, no evi-
dence emerged of the drug causing cancer in mice. Rats receiving such high
doses developed tumors with no more frequency than rats receiving no dose
at all.
Pregnancy.Offspring from pregnant rats and rabbits receiving several times
the maximum human therapeutic dosage showed no obvious birth defects,
although there were indications of delayed fetal bone development. Standard
advice for women is to be cautious about using zolpidem during pregnancy.
Although tests have shown only minute quantities of zolpidem to pass into a
mother’s milk (less than 0.02% of a dose taken by a mother), the effect on
infants is unknown.
Additional scientific information may be found in:
Boyle, J.A. “Look Again at Information on Zolpidem Tartrate.”American Journal of
Hospital Pharmacy51 (1994): 1354, 1356–57.
Fleming, J., et al. “Comparison of the Residual Effects and Efficacy of Short Term
Zolpidem, Flurazepam and Placebo in Patients with Chronic Insomnia.”Clinical
Drug Investigation9 (1995): 303–13.
Hoehns, J.D., and P.J. Perry. “Zolpidem: Nonbenzodiazepine Hypnotic for Treatment
of Insomnia.”Clinical Pharmacy12 (1993): 814–28.
Lobo, B.L., and W.L. Greene. “Zolpidem: Distinct from Triazolam?”Annals of Phar-
macotherapy31 (1997): 625–32.
Rush, C.R. “Behavioral Pharmacology of Zolpidem Relative to Benzodiazepines: A Re-
view.”Pharmacology, Biochemistry, and Behavior61 (1998): 253–69.
Toner, L.C., et al. “Central Nervous System Side Effects Associated with Zolpidem
Treatment.”Clinical Neuropharmacology23 (2000): 54–58.
“Zolpidem for Insomnia.”Medical Letter on Drugs and Therapeutics35 (1993): 35–36.