Ambien (zolpidem) is a prescription drug used to treat insomnia (trouble sleeping) in adults. You can take this medication if you have trouble falling asleep or staying asleep. Like other drugs, Ambien may have interactions.
Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ambien’s possible interactions, including a list of drugs that you should not mix with Ambien. And for more information about Ambien, including details about its uses, see this article.
Ambien is available in two forms: Ambien and Ambien CR. Both of these drugs contain the same active ingredient, zolpidem. But Ambien CR is a controlled-release form of Ambien. This means the drug is released slowly over time.
Because Ambien and Ambien CR contain the same active drug, they have the same interactions. However, this article focuses on the interactions of Ambien only. To learn more about Ambien CR, talk with your doctor.
Certain health conditions or other factors could raise your risk of harm if you take Ambien. In that case, your doctor may not prescribe Ambien for you. This is known as a contraindication. The list below includes contraindications of Ambien.
If you’ve had unusual sleep behaviors from taking Ambien. Tell your doctor if you’ve experienced unusual sleep behaviors, such as sleepwalking, sleep-driving, or other unusual behaviors after taking Ambien. These behaviors can be serious and even life threatening to you or others. If you’ve experienced these side effects from Ambien, your doctor will recommend a different treatment option for you. For more information on unusual sleep behaviors, see the “Boxed warning” section at the beginning of this article.
If you’ve had an allergic reaction. If you have had an allergic reaction to Ambien or any of its ingredients, your doctor likely won’t prescribe Ambien. You can ask them about other treatments that may be better options for you.
If any of the factors above apply to you, talk with your doctor before you start taking Ambien. Your doctor can determine whether Ambien is safe for you to take.
Yes, Ambien interacts with alcohol. You should not drink alcohol with Ambien. Both Ambien and alcohol can cause sleepiness or dizziness. So, drinking alcohol with Ambien could raise your risk of these side effects. Or it could make these side effects worse if you do experience them.
In addition, combining alcohol and Ambien can raise your risk of a serious side effect called CNS depression. This can cause confusion, loss of consciousness, low heart rate, seizures, or abnormal breathing. Drinking alcohol can also raise your risk of unusual sleep behaviors, such as sleepwalking or sleep driving.*
If you have questions about drinking during your Ambien treatment, talk with your doctor or pharmacist.
* Ambien has a
Before you start taking Ambien, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The chart below lists drugs that may interact with Ambien. Keep in mind that this chart does not include all drugs that may interact with Ambien. For more information about some of these interactions, see the “Drug interactions explained” section below.
Drug group or drug name | Drug examples | What can happen |
Benzodiazepines | · diazepam (Valium) · clonazepam (Klonopin) · lorazepam (Ativan) | Can increase the risk of side effects from Ambien and benzodiazepines |
Opioids | · buprenorphine or buprenorphine/naloxone (Suboxone) · oxycodone (Roxicodone) · hydrocodone (Hysingla ER) | Can increase the risk of side effects from Ambien and opioids |
imipramine (Tofranil) | — | Can raise the risk of side effects from Ambien and imipramine |
chlorpromazine | — | Can increase the risk of side effects from Ambien and chlorpromazine |
Selective serotonin reuptake inhibitors (SSRIs) | · sertraline (Zoloft) · escitalopram (Lexapro) · fluoxetine (Prozac) | Can raise the risk of side effects from Ambien |
CYP3A4 inducers | · rifampin (Rifadin) · carbamazepine (Tegretol) · efavirenz (Sustiva) | Can make Ambien less effective |
CYP3A4 inhibitors | · ketoconazole (Nizoral) · erythromycin (Eryc) · itraconazole (Sporanox) | Can increase the effects of Ambien and the risk of side effects from Ambien |
Tricyclic antidepressants (TCAs) | · desipramine (Norpramin) · amitriptyline · nortriptyline (Pamelor) | Can raise the risk of side effects from Ambien and TCAs |
Sedative-hypnotic drugs | · eszopiclone (Lunesta) · suvorexant (Belsomra) · zaleplon (Sonata) | Can increase the risk of side effects from Ambien and sedative-hypnotic drugs |
Certain antihistamines | · promethazine (Promethegan) · diphenhydramine (Benadryl) · hydroxyzine (Vistaril) | Can raise the risk of side effects from Ambien and antihistamines |
trazodone | — | Can increase the risk of side effects from Ambien and trazodone |
bupropion (Wellbutrin SR) | — | Can increase the risk of side effects from Ambien and bupropion |
Serotonin norepinephrine reuptake inhibitors (SNRIs) | · venlafaxine (Effexor XR) · duloxetine (Cymbalta) · desvenlafaxine (Pristiq) | Can raise the risk of side effects from Ambien and SNRIs |
Atypical antipsychotics | · aripiprazole (Abilify) · olanzapine (Zyprexa) · quetiapine (Seroquel) | Can increase the risk of side effects from Ambien and atypical antipsychotics |
gabapentin (Neurontin) | — | Can increase the risk of side effects from Ambien and gabapentin |
pregabalin (Lyrica) | — | Can increase the risk of side effects from Ambien and pregabalin |
Learn more about certain drug interactions that can occur with Ambien.
Interaction with selective serotonin reuptake inhibitors
Ambien can interact with a group of drugs called selective serotonin reuptake inhibitors (SSRIs), which are used to treat certain mood conditions such as depression. Taking an SSRI with Ambien can raise your risk of side effects from Ambien.
What could happen | Examples of SSRIs | What you can do |
SSRIs may cause Ambien to stay in your system longer. This can raise your risk of side effects from the drug. | · sertraline (Zoloft) · escitalopram (Lexapro) · fluoxetine (Prozac) | Before taking Ambien, tell your doctor if you’re taking any SSRIs. They can determine the drugs are safe to take together. |
Interaction with CYP3A4 inducers
Before starting Ambien, talk with your doctor about all other drugs you take. They can help determine if one of your medications is a CYP3A4 inducer, and if it may interact with Ambien.
What could happen | Examples of CYP3A4 inducers | What you can do |
CYP3A4 is an enzyme responsible for breaking down Ambien. CYP3A4 inducers cause this enzyme to work faster than usual. This may make the drug less effective. | · rifampin (Rifadin) · carbamazepine (Tegretol) · efavirenz (Sustiva) | Tell your doctor about any other medications you take. Taking Ambien with a CYP3A4 inducer is not usually recommended. Your doctor may recommend a different drug to treat one of your conditions. |
Interaction with benzodiazepines
Benzodiazepines may interact with Ambien. You may have a higher risk of side effects from both Ambien and your benzodiazepine if you take these drugs together.
What could happen | Examples of benzodiazepine medications | What you can do |
Can increase your risk of central nervous system (CNS) side effects, such as slowed breathing or sleepiness. | · diazepam (Valium) · clonazepam (Klonopin) · lorazepam (Ativan) | Your doctor may lower your dose of either Ambien or your benzodiazepine to reduce the risk of side effects. |
Ambien may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details.
Does Ambien interact with supplements, herbs, or vitamins?
Before you start taking Ambien, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
Ambien interactions with supplements
Ambien interacts with the supplement melatonin, which can also be used to aid sleep. Melatonin and Ambien can both cause drowsiness. So, taking them together may make you too drowsy and increase your risk of serious side effects. Your doctor will likely recommend that you avoid taking melatonin while you’re taking Ambien.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ambien interactions with herbs
Ambien can interact with the herbal supplements valerian and St. John’s wort.
Valerian and Ambien can both cause drowsiness. So, taking them together may make you too drowsy and increase your risk of serious side effects.
St. John’s Wort is a CYP3A4 inducer. CYP3A4 is an enzyme that is responsible for breaking down Ambien. CYP3A4 inducers cause this enzyme to work faster than usual. This may make Ambien less effective.
Taking valerian or St. John’s Wort with Ambien is not usually recommended. If you take one of these supplements, talk with your doctor about your options.
Ambien and vitamins
There are currently no reports of Ambien interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before using any of these products while taking Ambien.
Does Ambien interact with food?
No, there are currently no reports of Ambien interacting with food. If you have questions about eating certain foods during your treatment with Ambien, talk with your doctor.
Does Ambien interact with vaccines?
There haven’t been any interactions reported between Ambien and vaccines. If you have questions about getting certain vaccines before or during your Ambien treatment, talk with your doctor.
Does Ambien interact with lab tests?
No, Ambien isn’t known to interact with lab tests. If you’d like more information about whether certain lab tests may be safe to get during your Ambient treatment, talk with your doctor.
Does Ambien interact with cannabis or CBD?Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Ambien. Cannabis may affect CYP3A4, which is an enzyme responsible for breaking down Ambien. CYP3A4 inducers cause this enzyme to work faster than usual. And CYP3A4 inhibitors can prevent your body from breaking down Ambien. This could make Ambien less effective or raise your risk of side effects from the drug.
Also, both cannabis and Ambien can cause drowsiness. So, using them together may make you too drowsy and raise your risk of serious side effects.
Before you start treatment with Ambien, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ambien. Before taking Ambien, talk with your doctor about your health history. They’ll determine whether Ambien is right for you.
Health conditions or other factors that might interact with Ambien include:
- Unusual sleep behaviors. Ambien has a
boxed warning for the risk of unusual sleep behaviors, such as sleepwalking or sleep-driving. If you’ve had unusual sleep behaviors while taking Ambien, your doctor will have you stop taking it and switch to a different treatment. For more information, see the “Boxed warning” section above. - Depression or mental health conditions. If you have a mental health condition, including depression, talk with your doctor before taking Ambien. In rare cases, Ambien may cause changes in behavior or mood, including worsening depression. Due to this risk, your doctor may monitor you closely during your treatment for symptoms of depression. In some cases, they may recommend a different treatment option for you.
- Liver problems. If you have liver problems, you may have a higher risk of side effects while taking Ambien. The drug could also make your liver problems worse. Before taking Ambien, tell your doctor if you have any liver problems. They can determine whether Ambien is safe for you to take. They may also consider prescribing you a lower dose of the drug.
- History of drug or alcohol misuse. Ambien is a controlled substance, which means it carries a risk of misuse (also called abuse) and dependence. Your risk of misuse or dependence with Ambien may be higher if you’ve misused or been dependent on alcohol or drugs before. Due to this risk, your doctor may recommend a different treatment for you. Talk with your doctor to see if Ambien may be safe for you.
- Lung or breathing problems. If you have lung problems or breathing problems, including sleep apnea, tell your doctor before taking Ambien. In rare cases, this drug can cause slower breathing, which could be dangerous. If you already have lung or breathing problems, taking Ambien may worsen your condition. Talk with your doctor about whether Ambien is safe for you to take.
- Older age. People ages 65 years and older may have a higher risk of side effects from Ambien. Ambien can cause drowsiness, which can increase your risk of falling. If you’re age 65 years or older, your doctor may prescribe a lower dose of Ambien for you.
- Pregnancy. It ‘s unknown if Ambien is safe to take during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before starting your Ambien treatment.
- Breastfeeding. It’s usually not recommended to take Ambien while breastfeeding. The drug passes into breast milk, and exposure to the drug may cause harm to a breastfed child. If you’re breastfeeding or planning to breastfeed, talk with your doctor before taking Ambien. They will discuss the risks and benefits of taking Ambien with you.
- Allergic reaction. If you’ve had an allergic reaction to Ambien or any of its ingredients, your doctor will likely not prescribe Ambien. You can ask them about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Ambien and possible interactions.
Does Ambien interact with blood pressure medications?
No, blood pressure medications aren’t known to interact with Ambien. If you’re concerned about taking your blood pressure medications with Ambien, talk with your doctor or pharmacist.
Ambien and blood pressure medications can cause some of the same side effects, such as dizziness. Taking these drugs together may raise your risk of these side effects, or it could make these side effects worse if you do experience them.
If you have questions about how Ambien may interact with your blood pressure medication, talk with your doctor or pharmacist.
Is it safe to take Ambien with Adderall?
Yes, it’s likely safe to take Ambien if you’re also taking Adderall. Adderall is a stimulant medication that can be used for attention deficit hyperactivity disorder (ADHD) or narcolepsy. It increases your attention and alertness.
Ambien is a sedative-hypnotic. It treats insomnia by helping you to fall asleep and stay asleep.
Even though it’s likely safe to take both Ambien and Adderall, your doctor will likely recommend that you don’t take these drugs at the same time. Doing so could make the drugs less effective. But it should be safe, for example, to take Adderall in the morning and Ambien in the evening.
If you have questions about which treatments are right for you, talk with your doctor.
Taking certain steps can help you avoid interactions with Ambien. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list. - What to do if you start taking a new drug during your Ambien treatment.
It’s also important to read Ambien’s
Taking Ambien exactly as prescribed can also help prevent interactions.
If you still have questions about Ambien and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does my risk of interactions depend on my Ambien dosage?
- Should I let you know if I make any lifestyle changes, such as my diet or exercise routine?
- Do other drugs that could treat my condition have similar interactions?
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.