Interactions between Ambien and Ambien CR, including alcohol and additional substances
Ambien and Ambien CR (zolpidem), commonly prescribed sleep aids, can interact dangerously with a variety of substances, particularly central nervous system (CNS) depressants, opioids, and antidepressants.
Interactions with CNS Depressants
Concurrent use of Ambien and Ambien CR with CNS depressants, such as diazepam, can significantly increase sedative effects like drowsiness, dizziness, lethargy, and the risk of respiratory depression. Combining zolpidem with benzodiazepines increases the risk of excessive CNS depression [1][2][3].
Interactions with Opioids
Combining zolpidem with opioids, such as fentanyl, heightens the risk of respiratory depression, profound sedation, coma, and potentially fatal overdose due to additive CNS and respiratory depressant effects [1][3][5].
Interactions with Antidepressants
Amitriptyline, a tricyclic antidepressant with sedative properties, can intensify zolpidem’s sedative effects, increasing risks of dizziness, impaired cognitive and motor skills, and CNS depression [1].
Potential Interaction Risks
| Drug Type | Example | Interaction Effect | |------------------------|------------------|--------------------------------------------------------| | CNS Depressants | Diazepam | Additive sedation, increased drowsiness, respiratory depression risk | | Opioids | Fentanyl | Increased risk of profound sedation, respiratory depression, coma, death | | Antidepressants | Amitriptyline | Enhanced sedation, dizziness, cognitive impairment |
These interactions can be dangerous and potentially life-threatening, requiring close medical supervision, dose adjustments, or alternative treatments when possible [1][2][3][5].
Other Interactions
Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), can cause drowsiness and dizziness when taken with Ambien and Ambien CR. While there are no specific reports of vitamins interacting with Ambien or Ambien CR, it's still essential to check with a doctor or pharmacist before taking these products during treatment.
Special Considerations
Ambien and Ambien CR can interact with a variety of medications, including benzodiazepines, opioids, tricyclic antidepressants, sleeping pills, antipsychotics, sedating antihistamines, trazodone, gabapentin, CYP3A4 inducers, CYP3A4 inhibitors, selective serotonin reuptake inhibitors (SSRIs), and bupropion.
Certain medical conditions and factors may increase the risk of interactions with Ambien and Ambien CR. These include unusual behaviors while sleeping, older age, breathing problems, liver problems, history of drug or alcohol misuse or dependence, pregnancy, breastfeeding, allergic reaction, mental health conditions, and a history of suicidal thoughts or actions.
Importance of Communication
It is critical to inform healthcare providers of all medications being taken to manage these risks safely. Sharing information about supplements, herbs, and vitamins with a doctor or pharmacist may help prevent possible interactions with Ambien or Ambien CR.
Taking the herb St. John's wort with Ambien or Ambien CR can make the drugs less effective than usual. If cannabis products increase the activity of CYP3A4, it may lower the level of Ambien or Ambien CR in the system, making the drugs less effective. Conversely, if cannabis products decrease the activity of CYP3A4, it may raise the level of Ambien or Ambien CR in the body, increasing the risk of side effects.
Prescription Guidelines
Ambien and Ambien CR are used to treat insomnia but should only be used on a short-term basis. Ambien should not be taken with alcohol due to the risk of central nervous system depression, confusion, coma, seizures, and increased risk of side effects the day after taking the medication.
[1] Drugs.com. (2021). Ambien CR. Retrieved from https://www.drugs.com/mbc/ambien-cr.html [2] Drugs.com. (2021). Ambien. Retrieved from https://www.drugs.com/mbc/ambien.html [3] Mayo Clinic. (2021). Zolpidem (oral route). Retrieved from https://www.mayoclinic.org/drugs-supplements/zolpidem-oral-route/description/drg-20074651 [5] FDA. (2021). Public Health Advisory - Important Safety Information about Ambien and Ambien CR. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/public-health-advisory-important-safety-information-about-ambien-and-ambien-cr
- Combining Ambien or Ambien CR with sleeping pills, antipsychotics, sedating antihistamines, trazodone, gabapentin, CYP3A4 inducers, CYP3A4 inhibitors, selective serotonin reuptake inhibitors (SSRIs), or bupropion can potentially increase the risk of side effects and requires careful medical supervision.
- In addition to prescription medications, it's crucial to consider the potential interactions between Ambien or Ambien CR and herbs, such as St. John's wort, which may make these drugs less effective or increase the risk of side effects.
- Vitamins and cannabis products, particularly cannabidiol (CBD), should also be carefully monitored when taken with Ambien or Ambien CR, as they may cause drowsiness, dizziness, or alter the effectiveness of the sleep aids.
- Mental health conditions, such as a history of suicidal thoughts or actions, should be discussed with a healthcare provider when considering the use of Ambien or Ambien CR, as these drugs may have implications for mental health-and-wellness.
