Before taking this medication, the patient should inform the doctor about all the medications he takes, including purchased without a doctor’s prescription.
The simultaneous use of ethanol is testosterone enanthate powder not recommended due to the possible increase in sedative zolpidem.
With the simultaneous use of zolpidem with drugs (medicines), depressing the central nervous system ( neuroleptics, barbiturates, other hypnotics, anxiolytics / sedatives, antidepressants with sedative, narcotic analgesics, central action antitussive), antiepileptic drugs, drugs for general anesthesia, blockers of H. 1 histamine receptors with sedation, centrally acting antihypertensives; baclofen; thalidomide;pizotifenom marked increased inhibitory action on the central nervous system and the risk of respiratory depression, drowsiness, psychomotor functions, including decreased ability to control the vehicle.Also reported some cases of visual hallucinations while the use of antidepressants (bupropion, desipramine, fluoxetine, sertraline, venlafaxine).
Concomitant use with fluvoxamine, ciprofloxacin is not recommended due to the possible increase in zolpidem plasma concentrations.
While the use of narcotic analgesics may increase euphoria, which leads to an increase in psychological dependence.
while the use of buprenorphine, there is an increase risk of respiratory depression, until death. It is necessary to warn the patient of the strict observance of the doctor’s recommendations for dosage regimen.Inhibitors and inducers Since the metabolism of zolpidem tartrate is happening in the liver with the participation of several enzymes of the family of cytochrome , the main of which is with the participation of isoenzyme, should take into account possible interactions Zolpidem with medicinal drugs that are substrates or isoenzyme inducers:
•ketoconazole), 200 mg 2 times a day, and ritonavir increased T 1/2 , and AUC zolpidem reduces clearance. Correction of dosage regimen is not required, but it should warn patients of a possible strengthening of sedative zolpidem; • itraconazole- a small, clinically insignificant changes in the pharmacokinetics and pharmacodynamics of zolpidem; • rifampicin accelerates metabolism, reduces the concentration and, consequently, the effectiveness of zolpidem. Flumazenil eliminates the sedative effect of the drug testosterone enanthate powder. Interaction with selective serotonin reuptake inhibitors (SSRIs), warfarin, digoxin, ranitidine, cimetidine is not clinically significant.
In all cases, before prescribing sleeping pills should establish the cause of sleep disorders and to carry out the correction (including medication) underlying causes.
Saving insomnia within 7 – 14 days of treatment indicates the presence of primary psychiatric disorders and / or disorders of the nervous system . Therefore, to identify these disorders reassess the patient’s condition should be regularly carried out. Mental illness Hypnotics such as zolpidem are not recommended as the primary treatment for mental illness. Depression The use of zolpidem in patients with symptoms of depression, as well as other drugs with sedative / hypnotic effect, requires compliance with special care. Such patients should be carried out the treatment of depression and should not be prescribed benzodiazepines, and close to them on the effects of drugs in monotherapy, due to the fact that these drugs may mask the symptoms of depression, which their background may continue maintaining or increasing suicidal tendencies. As the that the cause of insomnia may be a depression, in the case of persistent insomnia conservation should reassess the patient’s mental state in order to identify possible depression. amnesia Sedative / hypnotic drugs such as zolpidem may induce anterograde amnesia.
This state is most frequently observed in a few hours after ingestion, and thus to reduce the risk of its development, patients should have provision for uninterrupted 7 -. 8-hour sleep Mental and “paradoxical” reactions It is known that the application of sedative / hypnotic, in Vol. h. and zolpidem, may occur following states: increased insomnia, nightmares, agitation, anxiety, delusions, hallucinations, confusion and onirizm, psychotic symptoms, disinhibition with impulsiveness, euphoria, anxiety, anterograde amnesia, heightened suggestibility, aggressiveness. This syndrome may be accompanied by the following potentially hazardous to the patient or others behavioral disorders: an unusual patient behavior, self-injurious behavior or aggression towards others who are trying to prevent the dangerous actions of the patient; automatic behavior with its subsequent amnesia. intake of zolpidem should be discontinued If you have any of these effects. The testosterone enanthate powder likelihood of these effects is higher in elderly patients. Sleepwalking and associated complex behavior Some people benzodiazepines and close them drugs can cause a syndrome of combined disorders of consciousness behavior and memory of different severity.