Background Zolpidem is used for the short term treatment of insomnia. Recently, new recommendations about its normal recommended daily dose have been published: 10 mg in adults and 5 mg in older patients and those with reduced liver function, in order to minimise the risk of adverse events.
Purpose To analyse the use of zolpidem in hospitalised patients, considering the daily dose they were taking before admission and during hospitalisation.
Material and methods Retrospective observational study conducted over 3 months in a tertiary level hospital. All patients receiving treatment with zolpidem were included. A pharmacist reviewed the daily dose the patient was taking and identified possible adverse effects which could be related to the drug treatment.
Two subgroups were made to evaluate the results: adults (age <65 years) and older patients (age >65 years).
Results 68 patients were included (21 adults, 47 older patients). In adults, doses were: 10 mg in 17 (80.9%), 5 mg in 3 (14.3%) and 20 mg in 1 (4.8%). In older patients doses were: 10 mg in 32 (68.1%) and 5 mg in 11 (23.4%). The rest of the older patients (8,5%) took more than one different dose. No patient had reduced liver function.
Adverse events such as dizziness, weakness and/or drowsiness were described in 10.3% of hospitalised patients (7.4% older patients). 71.4% of them were taking higher than the recommended doses of zolpidem.
67.6% of patients had been prescribed zolpidem before admission, 32 older patients (90.6% with the 10 mg dose). 8.8% of all patients were admitted to an emergency unit after a dizziness episode or a fall, a cardiovascular aetiology being rejected. All of them were taking zolpidem before admission and 66,67% were older patients with higher than the recommended dose.
Conclusion A high rate of older patients were taking higher than recommended doses of zolpidem. In some cases it happened at the same time that symptoms occurred which could be related to the adverse effects of zolpidem on the CNS when higher than recommended doses are taken. The latest recommendations about dosage should be considered to prevent possible adverse events.
No conflict of interest.
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