| Short-term treatment of insomnia (label; product-dependent). View labelExact | Adults: recommended initial dose is 1 mg at bedtime; some may need 2 mg (label). | Benzodiazepine hypnotic; GABA-A receptor positive allosteric modulator. | CYP3A | Single-dose range 10–24 h | No | | - Reassess benefit and adverse effects within 1–2 weeks; discontinue if benefit is marginal or impairment emerges.
- Screen for opioid co-prescribing, alcohol use, untreated sleep apnea, and fall risk before renewing.
- Review the medication list for CYP3A inhibitors and additive sedatives before initiation and dose changes.
- If used beyond a short course, create a taper plan and monitor for rebound insomnia and withdrawal symptoms.
| No | 2026-02-23 |
|---|
| Short-term treatment of insomnia (generally 7 to 10 days) (label). View labelExact | Usual adult dose: 15 mg at bedtime; some may require 30 mg (label). | Benzodiazepine hypnotic; GABA-A receptor positive allosteric modulator. | Glucuronidation | Single-dose mean 8.8 h; Single-dose range 3.5–18.4 h | No | | - Reassess insomnia diagnosis and daytime function within 1–2 weeks; discontinue if no meaningful benefit.
- Screen for opioid co-prescribing, sleep apnea/COPD, substance use risk, and fall risk before renewing.
- Monitor for next-day impairment (driving, falls), confusion, and paradoxical agitation after dose changes.
- If used beyond a short course, create and document a gradual taper plan and monitor for withdrawal.
| No | 2026-02-20 |
|---|
zolpidemAdjunctive therapyBrands: AMBIEN, AMBIEN CR | Insomnia (label). View labelExact | Take immediately before bedtime, only when able to remain in bed for a full night.
Food (especially high-fat meals) can delay onset; when rapid sleep onset is the goal, avoid taking with or immediately after a heavy meal. | Non-benzodiazepine hypnotic (“Z-drug”); GABA-A receptor positive allosteric modulator. | CYP3A4 | Single-dose mean 2.5 h; Single-dose range 1.4–4.5 h | No | | - Assess next-day impairment (driving, work, falls) after initiation and dose changes; lower the dose or stop if safety is compromised.
- Screen for complex sleep behaviors and discontinue immediately if they occur.
- Reassess for untreated sleep apnea, substance use, and mood episodes when insomnia persists rather than escalating hypnotics.
- If continued beyond a brief course, plan taper attempts and reinforce CBT-I to reduce rebound insomnia.
| No | 2025-12-28 |
|---|
| Insomnia (label). View labelExact | Take 8 mg within 30 minutes of bedtime (label). | Melatonin receptor agonist (MT1/MT2); hypnotic for sleep onset insomnia. | CYP1A2, CYP3A4, CYP2C9 | Single-dose mean 1.5 h; Single-dose range 1–2.6 h | No | | - Reassess sleep latency and next-day functioning within a few weeks; stop if benefit is minimal rather than escalating.
- Review interacting medications (especially CYP1A2 inhibitors/inducers) and timing with meals when response changes.
- Monitor mood and suicidality in patients with depression or mood instability when insomnia is part of a mood episode.
- Reinforce CBT-I and sleep hygiene and address sleep apnea/substance use when insomnia persists.
| No | 2026-03-31 |
|---|