Zoldem Drug Interactions

Alcohol: Concomitant use with zolpidem tartrate is not recommended. The sedative effect may be enhanced when zolpidem tartrate is used in combination with alcohol. This affects the ability to drive or use machines.
Imipramine: Concomitant use of imipramine and zolpidem tartrate produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine; however, there was an additive effect of decreased alertness.
Chlorpromazine: Concomitant use of chlorpromazine and zolpidem tartrate produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance.
Fluoxetine: After multiple doses of zolpidem tartrate and fluoxetine, an increase in the zolpidem tartrate half-life (17%) was observed. There was no evidence of an addictive effect in psychomotor performance.
Sertraline: Concomitant use of zolpidem tartrate and sertraline increases exposure to zolpidem tartrate. After five consecutive nightly doses at bedtime of oral zolpidem tartrate 10 mg in the presence of sertraline 50 mg, zolpidem tartrate C_max was significantly higher (43%) and T_max was significantly decreased (-53%) This interaction may cause increased drowsiness. Also, isolated cases of visual hallucinations were reported.
Rifampicin: Zolpidem tartrate plasma concentrations and effects are significantly reduced by rifampicin.
Ketoconazole: Increased pharmacodynamic effects of zolpidem tartrate.
Consideration should be given to using lower dose of zolpidem tartrate when ketoconazole and zolpidem tartrate are given together.
Patients should be advised that the use of zolpidem tartrate with ketoconazole may enhance the sedative effects.
Itraconazole: Concomitant use resulted in 34% increase in AUC_0-∞ of zolpidem. There were no significant pharmacodynamic effects of zolpidem tartrate on subjective drowsiness, postural sway, or psychomotor performance.
Haloperidol: Concomitant use showed no effect of haloperidol on the pharmacokinetics and pharmacodynamics of zolpidem tartrate. The lack of a drug interaction following single-dose administration does not predict the absence of an effect after chronic administration.
Cimetidine and ranitidine: Concomitant use of zolpidem tartrate with cimetidine or ranitidine showed no significant pharmacokinetic interactions.
Digoxin: Zolpidem tartrate had no effect on digoxin pharmacokinetics and did not affect prothrombin time when given with warfarin in healthy subjects.