Ambien drug class
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Ambien Drug Class: Understanding Zolpidem and Its Uses
Introduction to Ambien (Zolpidem)
Zolpidem, commonly known by its brand name Ambien, is a medication primarily used for the treatment of insomnia. It belongs to a class of drugs known as nonbenzodiazepine hypnotics. These medications are designed to help individuals fall asleep more quickly and stay asleep longer, thereby improving sleep quality and duration1.
Chemical Structure and Function
Zolpidem is classified as an imidazo[1,2-a]pyridine-3-acetamide. This specific chemical structure is crucial for its function as a sleep aid. Interestingly, the structure of zolpidem is similar to that of certain antitubercular agents, which has led researchers to explore its potential beyond treating insomnia1.
FDA Black Box Warnings
The US Food and Drug Administration (FDA) has issued black box warnings for zolpidem and other similar sleep medications, such as eszopiclone (Lunesta) and zaleplon (Sonata). These warnings are the FDA's most stringent and are used to highlight serious or life-threatening risks. The warnings were prompted by reports of complex sleep behaviors in patients, including activities performed unconsciously, such as driving, cooking, and even self-harm, which resulted in serious injuries or death2.
Potential Antituberculosis Activity
Recent research has uncovered that zolpidem may have antituberculosis activity. When tested against Mycobacterium tuberculosis (Mtb) H37Rv, zolpidem showed a minimum inhibitory concentration (MIC) of 10-50 µM. Further structural manipulation of zolpidem, creating isomers known as "anagrams," significantly improved its potency against various strains of tuberculosis, including drug-resistant strains1. This discovery opens new avenues for the use of zolpidem beyond its traditional role as a sleep aid.
Conclusion
Zolpidem (Ambien) is a nonbenzodiazepine hypnotic used primarily for treating insomnia. Despite its effectiveness in improving sleep, it carries significant risks, as highlighted by the FDA's black box warnings. Additionally, emerging research suggests that zolpidem and its structural analogs may have promising applications in treating tuberculosis, showcasing the potential for repurposing existing drugs for new therapeutic uses.
Sources and full results
Most relevant research papers on this topic
Putting Tuberculosis (TB) To Rest: Transformation of the Sleep Aid, Ambien, and “Anagrams” Generated Potent Antituberculosis Agents
Zolpidem, a sleep aid, can be transformed into potent antituberculosis agents by transforming its structure into structural isomers.
FDA issues black box warnings on common insomnia drugs
The FDA has issued black box warnings for common insomnia drugs eszopiclone, zaleplon, and zolpidem, citing 66 cases of patients who suffered serious injury or death due to unconsciously performing complex sleep behaviors, such as turning on ovens, driving cars, and shooting themselves with
Rigorous JournalMechanistic investigation of the negative food effect of modified release zolpidem
Combining biorelevant dissolution testing and modeling approaches can help understand the absorption of zolpidem from various formulations, potentially reducing the negative food effect.
In Vitro StudyAcute overdose of zolpidem.
A fatal overdose of zolpidem (Ambien) occurred in a 68-year-old female who ingested at least 30 tablets of 10 mg (300 mg) and was found dead at home.
Case ReportZolpidem: a review of its use in the management of insomnia.
Zolpidem is a useful short-term treatment for insomnia with favorable tolerability and minimal rebound insomnia, making it a useful therapeutic option for insomnia management.
Literature Review
Highly CitedThe misuse of Ambien among adolescents: prevalence and correlates in a national sample.
Ambien misuse is prevalent among adolescents (1.4%), with factors such as age, race, income, religiosity, delinquency, depression, social bonding, peer substance use, attitudes, strain, and other substance use as significant risk factors.
Observational StudyA New Class of Hypnotic Compounds for the Treatment of Insomnia: The Dual Orexin Receptor Antagonists
Dual orexin receptor antagonists (DORAs) show promise in improving sleep latency and quantity for insomnia patients, with potential for better tolerability and less cognitive impairment than GABAA receptor allosteric modulators.
Estimating the cost of strategic entry delay in pharmaceuticals: The case of Ambien CR
Strategic entry delay in pharmaceuticals, such as Ambien CR, can lead to large gains in consumer surplus and revenue, but also increases the risk of generic competition.
Zolpidem and Zolpidem Carboxylic Acid Results from Medication Monitoring.
Monitoring zolpidem and its metabolite, zolpidem 4-phenyl carboxylic acid (ZCA), in urine may result in even higher levels of positivity, with females showing significantly higher levels than males.
Observational Study