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Zolpidem Tartrate: What is it and How Much Does it Cost?

According to a 2005 poll by the National Sleep Foundation, more than half of adults in the United States reported experiencing at least one symptom of insomnia several times a week over the course of the previous year. As the boundaries between home and work are increasingly disappearing, it’s no surprise that busy schedules often amount to not enough sleep. An estimated 63 percent of women and 54 percent of men experience insomnia on a regular basis, and for many years, the only medical options were less than ideal. Then, Ambien was released to the market in 1992, offering the first viable insomnia medication since Halcion, which often faced legal challenges. Zolpidem tartrate, the generic form of Ambien, has since become available, allowing millions of people to experience a good night’s sleep for the first time in years, but how much does zolpidem tartrate cost? 

What is zolpidem tartrate?

Zolpidem tartrate is a sedative or hypnotic non-benzodiazepine GABA-A that is FDA approved for the treatment of insomnia. Zolpidem tartrate was first approved by the FDA in 1992 under the brand name Ambien, and today it is manufactured in both a generic form and under numerous brand names, including Ambien, Ambien CR, Intermezzo, Edluar, and Zolpimist. Zolpidem tartrate can be prescribed in the form of immediate release tablets, extended release tablets, sublingual tablets, and an oral spray. The U.S. Drug Enforcement Agency classifies zolpidem tartrate as a controlled substance due to its potential for abuse and dependence, and it is recommended for short term use only.

What is zolpidem tartrate used to treat?

Zolpidem tartrate is one of several different prescription drugs that is intended to treat insomnia, or trouble sleeping. The medication is a central nervous system depressant (CNS depressant), and is most commonly prescribed to people who have tried improving their sleep hygiene through behavior changes or who have already tried counseling. Zolpidem tartrate is helpful for people who have trouble falling asleep, staying asleep, or both. 

Insomnia

Insomnia is a common sleep disorder that is estimated to affect about 10 percent of the population, according to the National Sleep Foundation, while an estimated 30 percent of people suffer from disrupted sleep. People with insomnia commonly experience symptoms that include trouble falling asleep,  waking up too early,  waking up frequently and being unable to fall back asleep, and waking up feeling tired. In order to be diagnosed with insomnia, a patient must experience these symptoms at least a few nights per week over the course of a year. Some people experience acute insomnia, which is short term insomnia that lasts anywhere from one night to several weeks, while other people have a chronic form of the condition, which is defined as experiencing symptoms on three or more nights per week for three months or more. 

When insomnia cannot be linked to any other medical condition or problem, it is called primary insomnia. Insomnia is considered secondary insomnia when it is linked to a health condition or substance abuse. There are many different factors that can contribute to insomnia, including both environmental factors and health issues. Significant life events, stress, the noise level, lighting, and temperature in the room where you’re trying to sleep can all contribute to insomnia, as can changes to your sleep schedule and jet lag. Consuming alcohol, nicotine, caffeine, or a heavy meal can also cause a disruption in sleep, and it’s also possible that some people are biologically predisposed to the condition.

How does zolpidem tartrate work to treat insomnia?

Zolpidem tartrate affects the chemicals in the brain that impact sleep; these chemicals are often unbalanced in people who suffer from insomnia. The medication works by binding to the neurotransmitter, GABA, and triggering additional activity. This extra activity works by counteracting the neuron activity that is associated with insomnia. Put more simply, zolpidem tartrate slows down the brain without disturbing psychomotor activity, allowing people to fall asleep more quickly. The immediate release form of the medication is designed to help people fall asleep quickly, while the extended release version uses two layers: one to help you fall asleep quickly and a second that dissolves slowly to help you stay asleep. 

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How much does zolpidem tartrate cost?

Zolpidem tartrate is a generic medication, which helps keep costs low. When purchased in its brand name form, Ambien, the costs of the medication are significantly higher. The costs of Ambien and zolpidem tartrate are compared below for reference. Zolpidem tartrate is available in an immediate release oral tablet, a sublingual tablet, an extended release oral tablet, and an oral spray. Most commercial insurance plans, as well as Medicare and Medicaid, cover the generic form of the medication, but regardless of your insured status, pharmacy discount cards can offer savings as well. Manufacturers coupons and patient assistance programs may be available for the brand name version of the drug through the manufacturer’s website.

Approximate Costs of Ambien and Zolpidem tartrate

Ambien

Zolpidem tartrate

Per Pill

30 Day Supply

Per Pill

30 Day Supply

5 mg tablet immediate release

$19.51

$585.30

$1.19

$35.70

10mg tablet immediate release

$19.51

$585.30

$0.56

$16.80

6.25 mg extended release 

$19.51

$585.30

$1.22

$36.60

12.5 mg extended release

$8.98

$269.32

$1.22

$36.60

What are the benefits of using zolpidem tartrate?

People who struggle to fall asleep or sleep through the night may benefit from the use of zolpidem tartrate. The medication was first introduced in 1992 under the brand name Ambien, and it has been carefully studied and tested in clinical trials to see how it helps people overcome insomnia. The benefits of zolpidem tartrate include:

  • Zolpidem tartrate works to initiate the sleep process
  • The medication begins to take effect within 30 minutes 
  • Many patients see their sleep problems improve in just seven to ten days when taking the medication.

What side effects are associated with zolpidem tartrate?

Zolpidem tartrate is a commonly used medication, but it is associated with many side effects, some of which can be serious and may require you seek medical help. Common side effects of zolpidem tartrate use include:

  • Weakness
  • Lightheadedness
  • Sore throat
  • Nausea
  • Constipation
  • “Drugged” feeling
  • Stuffy nose
  • Nasal irritation
  • Daytime drowsiness
  • Dizziness
  • Muscle pain
  • Confusion
  • Insomnia
  • Dry mouth
  • Tiredness
  • Loss of coordination
  • Diarrhea
  • Stomach upset
  • Headache
  • Euphoria
  • Ataxia (balance problems)
  • Visual changes

Serious but rare adverse effects associated with zolpidem tartrate include:

  • Symptoms of depression, such as:
    • Lack of energy or general sleepiness
    • Weight loss or weight gain
    • Suicidal thoughts or thoughts of harming yourself
    • Loss of interest in activities you enjoy
    • Feelings of worthlessness or guilt
    • Trouble concentrating or thinking
  • Doing activities while asleep in the middle of the night that you have no memory of the next morning or next day, including:
    • Sleep-Driving
    • Having sex
    • Eating or preparing food
    • Making phone calls
    • Sleep walking
  • Abnormal thoughts or behaviors, as indicated by:
    • Increased agitation
    • Being more outgoing than normal
    • Hallucinations
  • Trouble breathing/breathing problems, as demonstrated by:
    • Tiredness
    • Shallow breathing
    • Slowed breathing
    • Decreased oxygen in your blood
  • Amnesia
  • Allergic reactions, as evidenced by:
    • Swelling of the tongue or face
    • Trouble breathing

Are there any warnings associated with zolpidem tartrate use?

There are several warnings associated with the use of zolpidem tartrate, particularly as people are first getting used to how the medication affects them. Zolpidem tartrate comes with the following warnings for use:

  • Make sure to get a full night of sleep (7-8 hrs minimum) any time that you take zolpidem tartrate. People who do not get enough sleep while taking the medication can experience possible side effects such as somnolence, slower reaction times, and decreased awareness, which can be particularly dangerous when driving. 
  • The medication has been known to cause abnormal behaviors, including hallucinations,  increased agitation, and an “out of body” feeling. If you experience any of these side effects, you should talk to your healthcare provider about your experiences. 
  • When use of zolpidem tartrate is stopped abruptly, it can cause withdrawal symptoms. It’s recommended that patients gradually taper down their usage of the drug under a doctor’s supervision. Withdrawal symptoms associated with zolpidem tartrate can include sweating, reddening or warming of the skin,  muscle cramps, vomiting, and emotional changes. Rebound insomnia is also possible. 
  • Make sure to take zolpidem tartrate on an empty stomach to maximize the effectiveness of the medication.
  • Drinking alcohol when taking zolpidem tartrate can dangerously increase your risk of sedation and drowsiness. Do not drink alcohol while taking zolpidem tartrate. 
  • Patients who have had an allergic reaction to any of the ingredients in zolpidem tartrate should not take the medication, as it can trigger a severe allergic reaction. A second allergic reaction to the medication or its ingredients could be fatal.
  • People under the age of 18 should not take zolpidem tartrate, as no studies have been done to determine the effects of the medication on children. Keep the medication out of the reach of children at all times. 
  • People with liver problems or liver disease should take a lower dose of the medication in order to reduce their risk of side effects, as they may have difficulty processing zolpidem tartrate.
  • Zolpidem tartrate should not be taken by women who are pregnant or nursing as it may pass to the baby or to breast milk
  • Zolpidem tartrate tablets should only be used for the short term treatment of insomnia, as the sedative-hypnotic medication can be habit-forming.
  • Drug interactions according to zolpidem tartrate's medication guide include ketoconazole (a potent CYP3A4 inhibitor and anticonvulsant) and St. john's Wort (a CYP3A4 inducer)--the dose of zolpidem may need to be altered because of these metabolization changers. 
  • Patients with myasthenia gravis, sleep apnea, or mental illness should consult a healthcare professional for medical advice to see if this drug would be appropriate or if the risk for adverse events may be too high. 

Sources:

https://www.webmd.com/drugs/2/drug-8862-8110/zolpidem-oral/zolpidem-oral/details 

https://www.drugs.com/zolpidem.html 

https://www.rxlist.com/ambien-drug/patient-images-side-effects.htm 

Published September 30th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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