Hypnogen

Hypnogen (zolpidem) is a drug used to treat insomnia. Zolpidem belongs to a class of medications known as hypnotics or hypnotics. It works by targeting chemicals in the brain that may be disrupted in people with insomnia and helps improve sleep quality.

Zolpidem is usually taken before bed and helps reduce the time it takes to fall asleep. The drug may also help reduce waking up during the night. Typically, the drug is used only for a short period of time to avoid developing dependence or decreasing effectiveness over time.

Although zolpidem may be effective in treating insomnia, it should be taken under medical supervision and dosage instructions strictly followed to avoid side effects or dependence.

Indications Hypnogen

1. Insomnia: Hypnogen is used to help people who have difficulty falling or staying asleep fall asleep. This may include taking more than 30 minutes to fall asleep, waking up in the middle of the night, and difficulty returning to sleep.
2. Short-term sleep problems: Zolpidem may be useful for treating short-term sleep problems, such as stress, changes in daily routine, or travel, which may temporarily disrupt sleep.
3. Sleeping Disorders: Hypnogen may also be recommended for those who have a diagnosed sleep disorder, such as restless legs syndrome or obstructive sleep apnea.

Release form

Hypnogen containing zolpidem is usually available in oral tablet form.

Pharmacodynamics

Zolpidem belongs to a class of hypnotic drugs used to treat insomnia. It is a benzodiazepine-type receptor agonist that acts on one of the GABA-A receptor subtypes.

GABA-A receptors are receptors for gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the central nervous system. Activation of these receptors leads to an increase in inhibitory activity of neurons and a decrease in excitation.

Zolpidem enhances the inhibitory effect of GABA, reduces the time to fall asleep, increases sleep duration and improves its structure, reduces the time of awakening at night and increases the total duration of sleep.

Pharmacokinetics

1. Absorption: Zolpidem is rapidly and completely absorbed from the gastrointestinal tract after oral administration. Maximum plasma concentrations are usually achieved within 1 hour after administration.
2. Metabolism: Zolpidem is metabolized in the liver to form active metabolites. The main metabolite is α-hydroxyzolpidem, which also has hypnotic properties.
3. Excretion: Metabolites of zolpidem and zolpidem itself are excreted primarily by the kidneys. Elderly patients and patients with impaired renal function may experience slower elimination of the drug.
4. Half-life: The half-life of zolpidem from the body is approximately 2-3 hours, and for its metabolites - about 2.5-4.5 hours.
5. Interactions: Zolpidem may interact with other centrally acting drugs, alcohol, and CNS depressants, which may increase its sedative effects. It is also important to consider possible interactions with drugs metabolized through the cytochrome P450 system.
6. Clinical aspects: The dosage of zolpidem is usually selected individually, taking into account age, gender, the presence of concomitant diseases and other factors. It is important to follow your doctor's recommendations and not exceed the recommended dose.

Dosing and administration

1. Method of application:

   • Hypnogen tablets are taken orally, whole, with a small amount of water.
   • The drug should be taken immediately before bedtime or slightly before the planned time of sleep.
   • The tablet should not be chewed, divided or broken, as this may affect the rate and extent of absorption of the drug.

2. Dosage:

   • The dosage of Hypnogen (zolpidem) may vary depending on the individual characteristics of the patient, the severity of insomnia and the doctor’s recommendations.
   • It is usually recommended to start with the lowest effective dose to reduce the risk of side effects.
   • Usually for adults, the starting dose is 5-10 mg at bedtime.

3. Duration of treatment:

   • The duration of treatment with Hypnogen is usually short, usually no more than 1-2 weeks.
   • The drug should be used only for medical reasons and under the supervision of a physician.

Use Hypnogen during pregnancy

Use of Hypnogen during pregnancy may increase the risk of some negative pregnancy outcomes, but data are variable and require a cautious approach to the use of this drug.

1. Placental transfer: Hypnogen is able to cross the placenta and reach the fetal circulation, which can potentially affect the fetus. The study noted that pregnant women with psychiatric illnesses taking zolpidem had less optimal obstetric outcomes, although the exact reason for this was not determined (Jurić et al., 2009).
2. Risk of birth defects: A study was conducted to evaluate the association between zolpidem use in the first trimester of pregnancy and specific birth defects. No significant increase in risk was found, but small increases in risk for certain defects cannot be ruled out (Howley et al., 2023).
3. Increased risk of adverse pregnancy outcomes: Some studies show an increased risk of preterm birth, low birth weight babies, and other complications in women taking zolpidem during pregnancy (Wang et al., 2010).

Contraindications

1. Hypersensitivity: People with a known hypersensitivity to zolpidem or other ingredients of the drug should avoid its use.
2. Allergic reactions: If you have previously had an allergic reaction to zolpidem or similar drugs such as zolpidem tartrate, you should avoid its use.
3. Breathing problems: Taking zolpidem may worsen breathing problems, especially in people with obstructive sleep apnea (stopping breathing during sleep) or obstructive sleep apnea syndrome.
4. Liver problems: Zolpidem is metabolized by the liver, so its use may be contraindicated in people with severe liver impairment.
5. Intoxication with alcohol or other drugs: Use of zolpidem in combination with alcohol or other centrally acting drugs may increase the risk of complications and increase central nervous system depression.
6. Pregnancy and breast-feeding: Zolpidem is not recommended for use during pregnancy or breast-feeding unless the benefit outweighs the potential risk to the baby.
7. Mental health problems: In people with a history of drug or alcohol addiction or mental illness, the use of zolpidem may not be advisable or requires special caution.

Side effects Hypnogen

1. Daytime sleepiness: This is one of the most common side effects of zolpidem. After using the drug, some people may continue to feel drowsy during the day, which may make it difficult to perform daily tasks.
2. Dizziness or feeling dizzy: Some patients may experience dizziness after taking zolpidem.
3. Difficulty with motor coordination: Zolpidem may cause loss of motor coordination and impairment of motor skills.
4. Restless dreams or nightmares: Some people may experience unusual dreams, including restless dreams or nightmares, after taking zolpidem.
5. Problems with memory and concentration: Some patients may experience problems with memory and concentration after taking zolpidem.
6. Increased appetite or changes in taste preferences: In rare cases, some people may experience an increased appetite or changes in taste preferences.
7. Slowness or depression of breathing: This side effect is rare but may occur, especially in people with breathing problems or in patients taking other drugs that may suppress breathing.

Overdose

Symptoms of zolpidem overdose may include:

1. Extreme drowsiness or fainting.
2. Deep and prolonged sleep from which it is difficult to awaken.
3. Slows breathing and heart rate.
4. Lethargy, depression of the central nervous system.
5. Loss of consciousness or coma.

Interactions with other drugs

1. Centrally acting drugs and alcohol: The combined use of zolpidem with other centrally acting drugs or alcohol may enhance its sedative and depressant effect on the central nervous system. This may increase the risk of drowsiness, lethargy, respiratory depression, and other adverse effects.
2. CNS depressant drugs: Drugs that also have a central nervous system depressant effect, such as opioids, benzodiazepines, antidepressants, and antihistamines, may enhance the sedative effect of zolpidem.
3. Drugs metabolized via the cytochrome P450 system: Zolpidem is metabolized in the liver via cytochrome P450 enzymes. Therefore, drugs that are also metabolized via this system (e.g., some antibiotics, antifungals, antiepileptics, and antifungals) may affect the blood concentration of zolpidem and its effectiveness.
4. Drugs that affect gastrointestinal pH: Drugs or substances that alter gastrointestinal pH (e.g., antacids, antiulcer drugs, prokinetics) may alter the rate and extent of absorption of zolpidem, which may affect its effectiveness.
5. Drugs that increase urine formation: Diuretics may increase the elimination of zolpidem from the body, which may decrease its effectiveness.