Side Effects of Sublinox (Zolpidem)
Sublinox (zolpidem) can cause serious side effects including complex sleep behaviors that have caused serious injury and death, such as sleep-driving, sleep-eating, having phone conversations, or having sex while not fully awake and with no memory of the event the next day. 1
Common Side Effects
- Drowsiness, dizziness, and daytime sleepiness 1, 2
- Diarrhea and gastrointestinal upset 1
- Headache and grogginess 1
- Feeling drugged or sedated 1
- Dry mouth 3
- Memory impairment, particularly during the first few hours after administration 3
Serious Side Effects
Complex Sleep Behaviors
- Sleep-driving (driving while not fully awake) 1
- Sleep-eating (making and eating food while not fully awake) 1
- Sleep-walking 2
- Having phone conversations or sex while not fully awake 1
- These behaviors can occur with no memory of the events the next day 1
Psychiatric and Cognitive Effects
- Abnormal thoughts and behavior 1
- More outgoing or aggressive behavior than normal 1
- Confusion and agitation 1
- Hallucinations 1
- Worsening of depression 1
- Suicidal thoughts or actions (OR 2.08; 95% CI 1.83-2.63) 2
- Anxiety 1
Physical Risks
- Increased risk of falls, especially in hospitalized and elderly patients (OR 4.28) 2
- Increased risk of hip fractures (RR 1.92; 95% CI 1.65-2.24) 2
- Severe allergic reactions including swelling of the tongue, throat, and difficulty breathing 1
Special Population Considerations
Elderly Patients
- Increased sensitivity to effects, requiring lower dosing (5 mg recommended) 4
- Higher risk of falls and cognitive impairment 2
- Slower drug clearance 4
Women
- Women have higher plasma concentrations than men after 8 hours (28 vs. 20 ng/mL for 10mg immediate-release) 2
- FDA recommends lower starting doses for women (5 mg immediate-release) due to slower drug clearance 4
Pregnancy and Breastfeeding
- May cause breathing difficulties or excess sleepiness in newborns if taken late in pregnancy 1
- Associated with increased incidence of low birth weight (OR = 1.39), preterm delivery (OR 1.49), and small for gestational age babies (OR = 1.34) 2
- Passes into breast milk 1
Withdrawal and Discontinuation Effects
- Rebound insomnia after stopping zolpidem (sleep onset latency increased by 13.0 minutes; 95% CI 4.3-21.7) 2
- Withdrawal symptoms lasting 1-2 days may include: 1
- Trouble sleeping
- Nausea and vomiting
- Flushing and lightheadedness
- Uncontrolled crying
- Stomach cramps
- Panic attacks
- Nervousness
- Seizures have been reported following withdrawal, particularly at high doses 2
Drug Interactions
- Increased sedative effects when combined with:
- May interact with medications that are metabolized by the liver 1
- Do not take with or within 14 days of monoamine oxidase inhibitors (MAOIs) 1
Administration Considerations
- Should be taken immediately before bedtime, not sooner 1
- Should be taken only when able to get a full 7-8 hours of sleep 1
- More effective when taken on an empty stomach 4
- Do not take after a meal as this may delay its effect 4
Remember to stop taking zolpidem and contact your healthcare provider immediately if you experience any complex sleep behaviors or serious side effects 1.