Zolpidem (Stilnoct and generics)
Zolpidem (Stilnoct® and generics) is an imidazopyridine hypnotic with pharmacodynamic activity similar to that of benzodiazepines, indicated for the short-term treatment of insomnia in adults in situations where insomnia is debilitating or causes severe distress to the patient.
As with all hypnotics, long-term use of zolpidem is not recommended. Treatment should be as short as possible. Generally, the duration of treatment ranges from a few days to 2 weeks, with a maximum of 4 weeks, including the withdrawal period.
Treatment should not be extended beyond the maximum recommended period without reassessment of the patient’s condition, as the risk of abuse and dependence increases with the duration of treatment.
Despite measures aimed at reducing their use (Pdf), the consumption of zolpidem and benzodiazepines remains very high, particularly in Luxembourg (Pdf). These medicines are subject to significant medical shopping. They are sometimes misused and obtained through forged prescriptions (zolpidem being the most common active ingredient on forged prescriptions identified in Luxembourg in 2024).
In this context, the DPM wishes to highlight the risks and the correct use of these medicines
Despite a limited prescription duration, consumption often extends over several months or even years. However, beyond a few weeks, the risks of adverse effects increase:
- Daytime drowsiness,
- Falls,
- Road traffic accidents (driving),
- concentration and memory problems.
Patients are rarely aware of the risks associated with prolonged use and the risks of dependence on benzodiazepines or related medicines such as zolpidem (also known as a Z-drug).
Interactions are also often underestimated. Warnings have been issued in recent years regarding serious adverse effects (respiratory depression, coma, death) when opioids are combined with benzodiazepines or Z-drugs, or other sedative substances (including alcohol).
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