Zolpidem tartrate (Ambien) alternatives: What can I take instead of zolpidem tartrate?

Compare zolpidem tartrate alternatives | Lunesta | Zaleplon | Belsomra | DayVigo | Quviviq | Natural alternatives | How to switch meds

Zolpidem tartrate is a commonly used prescription medication used to treat insomnia. The brand name of this medication is Ambien. Symptoms of insomnia disorders include not being satisfied with the quantity or quality of sleep due to difficulty falling asleep, maintaining sleep, or not returning to sleep. As a result, people may have trouble with daytime functioning, such as fatigue, low energy, daytime sleepiness, lack of concentration, behavioral changes, or mood disturbances. The Centers for Disease Control and Prevention (CDC) recently reported that 14.5% of adults had trouble falling asleep, and 17.8% had difficulty staying asleep. Falling asleep becomes easier with zolpidem tartrate because it suppresses the part of the central nervous system that maintains wakefulness.

Zolpidem is typically used for short-term treatment of insomnia, which takes about two to six weeks. Zolpidem is available as immediate-release tablets, extended-release tablets (Ambien CR), sublingual tablets, and capsules. Depending on the form of zolpidem, the immediate-release form is prescribed to help people fall asleep at night (sleep onset), while the extended-release form is used to help people fall asleep and stay asleep through the night (sleep maintenance).

While an effective treatment for some people, zolpidem may not be the best or safest option for all people managing insomnia. Common side effects of zolpidem include next-day drowsiness, dizziness, headaches, and decreased mental alertness. The risk of these adverse reactions is often why zolpidem is used cautiously or is not recommended for older adults. This drug can cause driving impairment or accidental injury, such as motor vehicle accidents, falls, or bone fractures. Additionally, zolpidem has a boxed warning that using this medication may cause complex sleep behaviors. Complex sleep behaviors may occur following use of zolpidem, including sleepwalking, sleep-driving, and engaging in other activities while not fully awake.

RELATED: How much is zolpidem tartrate (Ambien) without insurance?

What can I take in place of zolpidem tartrate?

Zolpidem belongs to a group of medications called Non-benzodiazepine Benzodiazepine Receptor agonists (sometimes called Non-benzodiazepine Hypnotics) that have a sedating effect by slowing down the nerve signals in the brain, which leads to a calming effect. This happens by targeting a chemical in the body called gamma-aminobutyric acid (GABA). As a chemical that calms nerve excitability in the brain, when GABA’s action is boosted, sleep improves. Long-term use of zolpidem should be limited.

Other options are available to treat insomnia and sleep disorders that do not improve with zolpidem. These alternative medications include other Non-benzodiazepine Hypnotics, Orexin Receptor Antagonists, Benzodiazepines, a Tricyclic Antidepressant (TCA) called doxepin, and the Melatonin Receptor Agonist called ramelteon. These options may suit certain individuals due to their different uses, side effect profiles, and dosages.

Other alternatives to zolpidem tartrate

Other alternatives to help treat insomnia include over-the-counter medications (OTCs) that may be useful for milder cases of sleep problems. OTC sleep medications do not require a prescription, and some options include:

• Diphenhydramine (ZzzQuil)
• Doxylamine (Unisom Sleep)
• Melatonin

RELATED: Is it safe to take OTC sleep aids every night?

Top 5 zolpidem tartrate alternatives

The following are some of the most common alternatives to zolpidem tartrate.

1. Lunesta

Lunesta is a brand-name medication available as a generic medication called eszopiclone. This alternative belongs to the same medication class as zolpidem and works similarly to help people fall asleep and stay asleep through the night. Lunesta is an effective treatment option for insomnia, as clinical trials have shown that compared to a placebo, Lunesta was shown to reduce time to fall asleep by about 12 minutes and wake time after sleep onset by about 17 minutes, resulting in about a half-hour increase of total sleep time per night. Lunesta carries the same boxed warning for complex sleep behaviors and can cause side effects like zolpidem, including headaches, dizziness, and drowsiness. However, Lunesta has the unique side effect of an unpleasant taste in the mouth. The generic and brand names are available as tablets and typically dosed with 1 to 3 mg at bedtime.

RELATED: Lunesta vs. Ambien: Differences, similarities, and which is better for you

2. Zaleplon

Zaleplon is a generic medication (formerly known as the brand-name Sonata) that belongs to the same medication class as zolpidem and is only used for helping people fall asleep, as zaleplon has a quick onset of action. The better action on sleep induction rather than maintenance could be explained by its short half-life and quick onset of action. The American Academy of Sleep Medicine recommends zaleplon as a treatment option for sleep-onset insomnia, so this may be a well-suited alternative for people only experiencing difficulty falling asleep. Zaleplon carries the same boxed warning for complex sleep behaviors and can cause potential side effects like zolpidem, including headache, dizziness, and drowsiness. Zaleplon is available as capsules and is typically dosed with 5 to 10 mg at bedtime.

3. Belsomra

Belsomra (suvorexant) is currently only available as a brand name medication and belongs to a different class of medications than zolpidem. Belsomra is an Orexin Receptor Antagonist that can help improve sleep onset and maintenance and was the first medication in this drug class. These medications work by blocking the binding of wake-promoting neuropeptides orexin A and orexin B which is thought to suppress wake drive. Studies have shown that consistent use of Belsomra for one month will decrease the time to fall asleep from an average of 65 to 69 minutes to 32 to 35 minutes. Additionally, Belsomra can help people stay asleep longer than a placebo, as patient diaries show a total sleep time increase of 39 to 43 minutes per night. This alternative may be a great option for people who have not had improved sleep with zolpidem or other Non-benzodiazepine Hypnotics. Belsomra is available as tablets and is usually dosed 10 to 20 mg at bedtime.

RELATED: Belsomra vs. Ambien: Differences, similarities, and which is better for you

4. DayVigo

DayVigo (lemborexant) is a brand-name medication and belongs to the Orexin Receptor Antagonist drug class. DayVigo can help improve sleep onset and maintenance and works by blocking the binding of wake-promoting neuropeptides orexin A and orexin B, which are thought to suppress wake drive. Clinical studies have shown that DayVigo can lead to faster sleep onset and decreased nighttime awakenings. Compared to zolpidem, DayVigo has shown a modest improvement over zolpidem in waking after sleep onset, as DayVigo gave an additional 7 to 9 minutes of sleep before first awakening. This alternative may be a well-suited option for people struggling with sleep problems after trying zolpidem or other Non-benzodiazepine Hypnotics. DayVigo is available as tablets and is usually dosed 5 to 10 mg at bedtime.

5. Quviviq

Quviviq (daridorexant) is a brand-name medication and is the most recently approved drug in the Orexin Receptor Antagonist medication class. Working to suppress the wake drive like the other drugs in this class, Quviviq helps people fall asleep and stay asleep through the night. In clinical studies, people taking Quviviq reported sleeping better after one week, and improvements continued over 3 to 4 weeks. Like other Orexin Receptor Antagonists, Quviviq may be a good option for people who have not experienced relief from zolpidem or other Non-benzodiazepine Hypnotics. Quviviq is available as a tablet and is typically dosed with 25 to 50 mg at bedtime.

Natural alternatives to zolpidem tartrate

Alternative remedies for zolpidem include certain supplements, sleep hygiene improvements, and diet modifications to help make falling and staying asleep easier.

Some supplements have evidence of helping treat insomnia, including melatonin, valerian root, and magnesium. Melatonin is a natural hormone made in the body that helps control the sleep-wake cycle. The hormone gets released by the pineal gland in the brain as daylight fades in the evening, which causes tiredness and relaxation. Melatonin is available as a supplement in a variety of formulations, including tablets, gummies, and liquids. Valerian root is an herbal sleep remedy that is available over-the-counter. Several clinical studies have shown that valerian is effective in the treatment of insomnia, most often by reducing the amount of time it takes to fall asleep. Magnesium is a mineral found in the body that is also found in many foods and is available as a supplement. While magnesium supplements can be used for treating a variety of conditions, insomnia treatment has limited available evidence. However, magnesium supplementation for sleep problems may be a suitable option for those who are deficient in magnesium.

According to The American Academy of Sleep Medicine (AASM), sleep hygiene is a series of healthy sleep habits that can improve the ability to fall asleep and stay asleep. Sleep hygiene is an important part of cognitive behavioral therapy (CBT), the most effective long-term treatment for people with chronic insomnia. CBT for insomnia helps with the thoughts and behaviors that prevent good sleep, stress reduction, relaxation, and sleep schedule management. For diet modifications, the AASM also recommends avoiding caffeine and alcohol in the evening and reducing fluid intake before bedtime.

RELATED: 21 ways to sleep better tonight

How to switch to a zolpidem tartrate alternative

1. Discuss all health conditions with a healthcare provider

Before switching from zolpidem to an alternative, it’s important that the prescribing doctor be aware of all medical conditions. Some alternatives should be used with caution or avoided with certain medical conditions.

2. Do not suddenly stop taking zolpidem without medical advice

Only stop taking zolpidem if the prescribing doctor has been consulted and has decided stopping the medication is safe. If zolpidem is stopped suddenly, there may be sudden withdrawal symptoms and rebound insomnia symptoms. It’s important for a therapy plan to be established prior to stopping zolpidem suddenly. The zolpidem dose should be gradually reduced rather than stopped abruptly whenever possible. Zolpidem withdrawal symptoms include seizures, agitation, tremors, trouble sleeping, and anxiety.

3. Discuss all prescription and over-the-counter medications with a healthcare provider

Before switching from zolpidem to an alternative, it’s important that the prescribing doctor has reviewed a patient’s medication list, including prescription drugs and over-the-counter medications. Some alternative sleeping pills have dangerous drug interactions that must be avoided.

4. Continue to improve sleep hygiene

It’s important for people treating insomnia and other sleep problems to follow healthy sleep habits. Healthcare providers and pharmacists can help give useful sleep hygiene advice, which may include the following tips:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations, to maintain sleep patterns.
• Set a bedtime that is early enough for at least 7-8 hours of sleep.
• Exercising regularly and maintaining a healthy diet can aid in improving overall wellness and mental health affected by sleep difficulties.
• Turn off electronic devices at least 30 minutes before bedtime.
• Avoid consuming caffeine and alcohol in the afternoon or evening. Reduce fluid intake before bedtime.