How does it work?
Stilnoct tablets contain the active ingredient zolpidem, which is a type of medicine called a non-benzodiazepine hypnotic. It acts in the brain to aid sleep. (NB. Zolpidem is also available without a brand name, ie as the generic medicine.)
Zolpidem works by acting on receptors in the brain called GABA receptors, specifically the GABA-A receptors. This causes the release of a neurotransmitter called GABA in the brain.
GABA is a neurotransmitter that acts as a natural 'nerve-calming' agent. It helps keep the nerve activity in the brain in balance, and is involved in inducing sleepiness, reducing anxiety and relaxing muscles.
Zolpidem can be used as a short-term treatment for insomnia.This includes difficulty falling asleep, waking in the night, waking early in the morning and sleeping problems that are causing severe distress.
Zolpidem decreases the time taken to fall asleep and night-time awakenings, as well as increasing the total amount of time spent sleeping. However, it is only suitable for short-term treatment of insomnia (up to four weeks), as when used for longer periods it has a potential for dependence and addiction.
The medicine should be taken just before going to bed at night, or in bed.
What is it used for?
- Short-term treatment of insomnia.
- This medicine causes drowsiness and impairs concentration and alertness. These effects may continue into the following day and are made worse by drinking alcohol. If you are affected you should avoid potentially hazardous tasks such as driving or operating machinery. Do not drink alcohol when taking this medicine.
- You should only take this medicine before going to bed at night. If you forget to take it at bedtime dont take it at any other time, or you may end up feeling drowsy, dizzy and confused during the day.
- There have been reports of people doing things while they are asleep after taking this medicine that they do not remember when they wake up. These include sleepwalking, sleep driving, making phone calls and preparing and eating food. These events may be more likely if you drink alcohol, or take other medicines with sedative effects (see end of factsheet) in combination with this medicine. If you think this could be happening to you, you should let your doctor know.
- This medicine is generally only suitable for short-term use (less than four weeks). If it is used for longer periods or in high doses, dependence upon the medicine may develop and withdrawal symptoms such as headaches, muscle pain, sweating, tremor, anxiety, tension, restlessness, confusion and irritability and may then occur if treatment is stopped suddenly. Your body may also become tolerant to the medicine, with higher doses needed to achieve the same effect. For this reason, you should not exceed the dose of this medicine prescribed by your doctor, or take it for longer than recommended. If you are still having trouble sleeping after this time you should consult your doctor for further advice.
- Depending on how long you have been taking this medicine for, your doctor may suggest that you stop taking it gradually to avoid withdrawal effects or a return in your sleeping problems. Follow the instructions given by your doctor.
Use with caution in
- Elderly people.
- History of alcoholism or drug abuse.
- Decreased liver function.
- People with breathing problems.
- History of psychiatric disorders.
- People suffering from depression.
Not to be used in
- Children and adolescents under 18 years of age.
- Abnormal muscle weakness (myasthenia gravis).
- Severely decreased liver function.
- People with sudden or severe breathing difficulties (respiratory depression).
- Syndrome involving short spells when breathing stops during sleep (sleep apnoea syndrome).
- People with psychotic illnesses, such as schizophrenia.
- Stilnoct tablets contain lactose and are not suitable for people with rare hereditary disorders of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- The safety of this medicine during pregnancy has not been established. The manufacturer recommends that it is not used during pregnancy. This is particularly important during the third trimester of pregnancy and prior to or during labour. Regular use of this medicine during the latter stages of pregnancy can cause withdrawal symptoms in the baby. Seek further medical advice from your doctor.
- If you suspect that you could be pregnant or are planning a pregnancy while taking this medicine, you should speak to your doctor about stopping treatment with this medicine.
- Small amounts of this medicine may pass into breast milk. It should not be used by breastfeeding mothers as it may be harmful to the nursing infant. Seek medical advice from your doctor.
- This medication causes drowsiness which may continue the next day. If affected do not drive or operate machinery. Avoid alcoholic drink.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, does not mean that all people using this medicine will experience that or any side effect.
Common (affect between 1 in 10 and 1 in 100 people)
- Memory loss.
- False perceptions of things that are not really there (hallucinations).
Uncommon (affect between 1 in 100 and 1 in 1000 people)
- Double vision.
- Muscle weakness.
- Aggression and anger with disturbance in behaviour.
- Sleep disorders, eg sleep walking, sleep-driving.
- Skin rashes.
- Change in sex drive.
- Elevated levels of liver enzymes.
- Change in ability to walk normally.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.
For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you use this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while using this one, to ensure that the combination is safe.
The sedative effect of this medicine will be increased if this medicine is taken with any of the following, which can also cause drowsiness:
- antiepileptics, such as sodium valproate
- antipsychotics, eg chlorpromazine, haloperidol
- barbiturates, eg phenobarbital, amobarbital
- benzodiazepines, eg diazepam temazepam
- MAOI antidepressants, eg phenelzine
- other sleeping tablets
- sedating antihistamines, eg chlorphenamine, hydroxyzine, promethazine
- strong opioid painkillers, eg morphine, codeine
- tricyclic and related antidepressants eg amitriptyline, mirtazapine.
The following medicines may increase the amount of zolpidem in your blood and this could increase its sedative effect, as well as increase the risk of side effects. As a result your doctor may need to prescribe a lower dose of zolpidem if you are taking any of these:
The following medicines may decrease the amount of zolpidem in your blood and so could make it less effective. As a result your doctor may need to prescribe you a higher than normal dose of zolpidem if you are taking any of these:
- St John's wort (Hypericum perforatum).
If zolpidem is used with strong opioid painkillers such as morphine, this can result in an increase in the euphoric effect that these painkillers can have. This could lead to an increased risk of psychological dependence on the painkiller.
Other medicines containing the same active ingredient
Zolpidem tablets are also available without a brand name, ie as the generic medicine.