Ambien- FDA Recommendations

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Specializes in ICU.

Hi all,

My facility has recently instituted a new policy that ambien may only be prescribed/given in doses =

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Interesting information. I currently work in a pacu so I don’t administer zolpidem to my patients. I worked med-surg a few years back and I would give 10 mg to patients

If the patient didn’t have any contraindications, their condition permitted it and they weren’t planning on driving the next morning I would administer 10mg according to our current guidelines. (The majority of my patients would not be getting behind the wheel of a car the next morning and my primary concern would be that they got a good night's sleep).

Perhaps the guidelines will change, I'll keep an eye out :yes:

I’m very interested to know what everyone else has to say on the subject.

Slightly off topic, I actually prefer zopiclone over zolpidem. Patients generally seem to report having slept better and despite zopiclone's longer half-life they seem (very unscientific and subjective opinion from yours truly) less “hung-over”.

However I don’t think that zopiclone is used in the U.S.?

Here’s a link discussing the risk for next-morning impairment after taking zolpidem.

I wonder if this is the rationale for the dosage change in your facility OP?

FDA Drug Safety Communication: Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist)

and one more about a lowered recommended dosage:

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm334738.htm

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

more government interference in the practice of medicine. :no:

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Specializes in Critical Care.

Ambien has actually always carried the FDA recommendation that it is not indicated for long term use for instance, yet it's frequently prescribed long term. This is because FDA recommendations aren't enforceable which is why "off-label" use is so prevalent. Restricting the dosage is really more of your facility's choice than being due to the FDA, although the recommendation for 5mg is only for women.

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Specializes in ICU.

Ok, I didn't know if something had changed, because as far as I know this is a new policy. Thanks for the info everyone.

Also, I've never heard of zopiclone, I don't think we have it here.

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My facility has recently instituted a new policy that ambien may only be prescribed/given in doses =In my opinion, this sucks.

There are plenty of people - me included - who use Ambien on a routine basis - either in split 5 mg doses or a single 10 mg dose, - without any difficulty.

I say, let the clinicians and patients work out what's best on a case-by-case basis and not saddle them with blanket policies that can inhibit optimal patient care.

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Specializes in ICU.
In my opinion this sucks. There are plenty of people - me included - who use Ambien on a routine basis - either in split 5 mg doses or a single 10 mg dose, - without any difficulty. I say, let the clinicians and patients work out what's best on a case-by-case basis and not saddle them with blanket policies that can inhibit optimal patient care.[/quote'] Same- patients are getting pi$$ed and I can only be honest with them- they've been up not sleeping, at least not well, for god knows how long, sick, in the ER, end up in the noisy, bright, ICU with us in and out every 5 seconds and they can't even take what they always take at home to sleep because of pharmacy's policy. I'D be pi$$ed- I'm a girl, and I take 10mg nightly (k in my case daily- night shift)- clearly I can handle it...ugh. No chance of changing it though:/ Sorry..rant over.
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Specializes in Psychiatry, Mental Health.
[...]

Slightly off topic, I actually prefer zopiclone over zolpidem. Patients generally seem to report having slept better and despite zopiclone's longer half-life they seem (very unscientific and subjective opinion from yours truly) less “hung-over”.

However I don’t think that zopiclone is used in the U.S.?

No, I don't think they have zopiclone (zolpidem isomer) in the US. We have both in Israel, and based on my very small anecdotal study of n=1 (me), I agree with you. Better sleep, more functional mornings, no craziness during the night.

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Specializes in Med-Surg.

No, I don't think they have zopiclone (zolpidem isomer) in the US. We have both in Israel, and based on my very small anecdotal study of n=1 (me), I agree with you. Better sleep, more functional mornings, no craziness during the night.

Um, yes, they absolutely do give Ambien/zolpidem in the US. Don't know where you get your info from to think they don't.

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Specializes in Psychiatry, Mental Health.
No, I don't think they have zopiclone (zolpidem isomer) in the US. We have both in Israel, and based on my very small anecdotal study of n=1 (me), I agree with you. Better sleep, more functional mornings, no craziness during the night.

Um, yes, they absolutely do give Ambien/zolpidem in the US. Don't know where you get your info from to think they don't.

I think you misread my post. I said that they don't have zopiclone, which is an isomer of zolpidem, in the US. I think that is still the case, but I'm willing to be corrected. I was not talking about zolpidem; I was talking about zopiclone. Does that clear it up?

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Specializes in Med-Surg.

Sure, that's fine. I did misunderstand, and apologize for doing so.

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Specializes in Psychiatry, Mental Health.

No problem. Happens to all of us. :)

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