Primary Brand Names and Formulations
Zolpidem tartrate is marketed under several brand names, with Ambien being the most widely recognized in the United States. The medication is available in the following formulations:
- Ambien - immediate-release tablets (5mg and 10mg) 1
- Ambien CR - controlled-release/extended-release formulation 3
- Edluar - sublingual tablet formulation 1
- Zolpimist - oral spray formulation 1
- Intermezzo - lower-dose sublingual tablet for middle-of-the-night awakening 1
- Stilnox - brand name used in some countries outside the US 2
- Myslee - brand name used in some countries outside the US 2
Formulation Differences
Different zolpidem formulations are designed for specific insomnia patterns:
Standard immediate-release tablets (Ambien) - designed for sleep initiation difficulties, reducing sleep onset latency by approximately 15-18 minutes 4, 5
Extended-release formulation (Ambien CR) - designed for both sleep initiation and maintenance, with CGI ratings of "much or very much improved" favoring zolpidem ER over placebo (85% versus 48%) 4
Sublingual formulation (Edluar, Intermezzo) - designed for faster absorption; sublingual zolpidem reduced sleep onset latency after middle-of-the-night awakenings by 18 minutes compared with placebo 4
Clinical Considerations
When prescribing zolpidem products, important considerations include:
Gender differences: Women clear zolpidem more slowly than men, with 45% higher blood levels, hence the lower recommended starting dose for women 5
Age considerations: The American Academy of Sleep Medicine suggests avoiding zolpidem in elderly patients due to increased risk of falls, confusion, and complex sleep behaviors 5
Administration timing: For faster sleep onset, zolpidem should not be administered with or immediately after a meal, as food decreases mean AUC and Cmax by 15% and 25% respectively 1
Safety concerns: Zolpidem may cause complex sleep behaviors that have caused serious injury and death, including sleep-driving, making and eating food, talking on the phone, or having sex while not fully awake 1
Remember that zolpidem is a federally controlled substance (C-IV) because it can be abused or lead to dependence 1. It should be prescribed for short-term treatment of insomnia according to FDA guidelines.