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Overdose Symptoms: European post-marketing reports on zolpidem overdose report a violation of consciousness (from drowsiness to mild coma). Fixed one case of cardiovascular and respiratory disorders. There was a complete recovery after taking doses of zolpidem tartrate to 400 mg (40 times greater than MPDH).Cases of overdose caused by the simultaneous administration of many drugs, depressing the central nervous system, including zolpidem, led to more severe consequences, up to lethal outcomes.Treatment: induction of vomiting or immediate gastric lavage (depending on the condition), the purpose of activated charcoal. The monitoring of vital functions (breathing, pulse, blood pressure, etc.) is shown, if necessary, symptomatic and supportive therapy. It should be abandoned the use of any sedatives (even with pronounced stimulation). Hemodialysis is ineffective. A specific antidote is a benzodiazepine receptor antagonist flumazenil.
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Alcohol enhances the sedative effect of zolpidem, joint use is not recommended. Drugs that act depressingly on the central nervous system (neuroleptics, barbiturates, other sleeping pills, anxiolytics / sedatives, antidepressants with sedative action, narcotic analgesics, antitussive central action), antiepileptic drugs, general anesthetics, antihistamines with sedative effect, antihypertensive central action; baclofen; thalidomide; pizotifen - when combined, there is an intensification of the oppressive effect on the central nervous system and the risk of respiratory depression increases; buprenorphine - risk of respiratory depression; ketoconazole (a powerful inhibitor of CYP3A4) reduces the clearance of zolpidem, in connection with which it is possible to increase its sedative effect; itraconazole (inhibitor CYP3A4) - a slight, clinically insignificant change in the pharmacokinetics and pharmacodynamics of zolpidem. Rifampicin (inducer CYP3A4) accelerates metabolism, reduces the concentration and effectiveness of zolpidem.
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