Non-benzodiazepine hypnotic (Z-drug)
Zolpidem with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Zolpidem (Zolpidem). Most antibiotics do not interfere meaningfully with Zolpidem at 5mg, 10mg, 6.25mg CR, 12.5mg CR, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Non-benzodiazepine hypnotic (Z-drug) agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Zolpidem at 5mg, 10mg, 6.25mg CR, 12.5mg CR.
Practical guidance
According to the prescribing information for Zolpidem, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Zolpidem is co-administered. Adjusted 5mg, 10mg, 6.25mg CR, 12.5mg CR dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Zolpidem during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Zolpidem is metabolised and may need a temporary 5mg, 10mg, 6.25mg CR, 12.5mg CR adjustment. The prescribing pharmacist should review any new antibiotic against the existing Zolpidem regimen.
Will antibiotics make Zolpidem stop working? ▾
Most antibiotics do not affect Zolpidem efficacy. Rifampicin and a few others can lower Zolpidem levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Zolpidem
More on Zolpidem
- With alcoholZolpidem and alcohol — is it safe to drink?
- With foodShould Zolpidem be taken with food?
- Side effectsZolpidem side effects: common, rare and warning signs
- Dosage guideZolpidem dosage guide: how much to take and when
- OnsetHow fast does Zolpidem start working?
- DurationHow long does Zolpidem last?
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