Published on 01 October 2022

Zolpidem Vs Belsomra: Which Is The Best For Insomnia?

Zopiclone (Imovane) belsomra-vs-ambien
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It may be challenging to stay asleep if you have insomnia or sleep disorders. Insomniacs frequently have insufficient sleep or sleep of low quality. According to recent research, some pharmacological treatments for insomnia seem to work better than others. Some medications are more effective for short-term treatment, while others can have significant side effects.

Two popular sleep aid drugs commonly used to treat insomnia are Belsomra and Ambien. The U.S. Food and Drug Administration has approved Belsomra and Ambien (FDA). These drugs are Schedule IV controlled substances, as they pose the risk of abuse and dependence.

Belsomra is classified as an orexin receptor antagonist, whereas Ambien is a sedative-hypnotic. Even though both pills are for treating insomnia, are they the same? Which is more effective?

What Is Ambien?

Ambien (zolpidem) is a non-benzodiazepine used in insomnia in adults. It improves sleep onset and duration of sleep by acting on GABA receptors. If you want to order Ambien online, you must have a prescription because Ambien is a controlled substance in the USA.

In contrast to conventional benzodiazepines, zolpidem is a selective agonist of the? 1 receptor of the GABA-A receptor complex. The elimination half-life of zolpidem is 2.5 hours. It is indicated for insomnia, migraine headaches, and various neurologic conditions.

Mechanism of Ambien

Ambien works as a sedative-hypnotic, causing the GABA neurotransmitters to become active, slowing down the brain and the Central Nervous System (CNS). As a result of the reduced brain activity, you fall asleep quickly.

What is Belsomra?

The first drug in the orexin inhibitor family, suvorexant (Belsomra), is an antagonist of both orexin receptors and provides a novel mechanism for treating insomnia. The medication enhances sleep by inhibiting the function of orexin. It has a 10-hour half-life. Treatment of insomnia in adults difficulty with sleep onset and maintenance

Mechanism of Belsomra

Belsomra is an orexin receptor antagonist. It promotes sleep by inhibiting the neuropeptides orexin A and orexin B, thereby promoting wakefulness. The perifornical lateral hypothalamus contains 70,000 orexin neurons communicating with other brain and spinal cord parts.

Dose and Dosage Forms

Dosing is crucial for medications that can reduce severe morbidity or extend life. If administered incorrectly, patients may be given the wrong doses due to human error or loss after administration. Therefore, optimizing the proper dose before a drug is approved for use in everyday medicine is necessary.

Ambien comes in extended-release, immediate-release, sublingual tablets, and oral sprays. Ambien has 5 and 10 mg tablets, while the extended-release is available in 6.25 mg and 12.5 mg pills. Take Ambien before bedtime, and the patient should have 7-8 hours of sleep. The initial dose for women is 5 mg, and 5 mg or 10 mg for men. The maximum dose of Ambien is 10 mg once daily.

Belsomra comes in 5 mg, 10 mg, 15 mg, and 20 mg tablets. It is recommended to take 10 mg daily by mouth 30 minutes before bedtime. One should have at least 7 hours to sleep after taking suvorexant. The maximum daily dose is 20mg.

Possible Side Effects



Daytime drowsiness







Abnormal dreams



Stuffy nose, nasal irritation


Dry mouth, sore throat

Allergic reaction


Sleep paralysis

Constipation, diarrhea


Muscle pain, ataxia

Muscle weakness

Confusion, memory loss

Upper respiratory tract infection


Suicidal thoughts

Visual changes


Zolpidem Vs Belsomra: Which Is More Effective?

Suvorexant considerably improves the quality and length of sleep when compared to zolpidem.
In addition to having better efficacy, suvorexant does not cause withdrawal symptoms when stopped compared to other available therapies for insomnia.

Suvorexant use may be superior to first-line therapy for some populations, including older people. In addition to contributing to falls, benzodiazepines frequently produce vertigo and loss of balance. Suvorexant's mechanism of action does not result in dizziness; as a result, there is a chance to reduce dangerous falls in older people.

Patients who are obese also frequently experience insomnia. Obese women experience slower clearance of suvorexant and greater peak levels than non-obese women. And this could have worse consequences for obese women.

Studies Related To Zolpidem And Belsomra In Sleep Disorders

A survey by Michelson and his colleagues examined the Safety and effectiveness of suvorexant over one year, followed by a two-month cessation phase. They found that suvorexant significantly improved Total Sleep Time, TSO (total time from lying in bed to sleep initiation), and other sleep quality measures throughout therapy compared to placebo.

In a randomized, double-blinded, placebo-controlled trial with adult male volunteers in a noise-simulated setting, Bettina and colleagues compared the effectiveness of suvorexant with zolpidem (a non-BZD). The total sleep time they were increased by 17 and 31 minutes with suvorexant 10 mg and 30 mg, respectively, compared to 11 minutes with zolpidem.

Additionally, zolpidem medication lowered REM sleep while suvorexant treatment boosted it. The trial demonstrated that adverse effects following suvorexant were more prevalent than side effects following zolpidem. It is due to differences in their pharmacological activity.

Precautions You Should Follow Before Taking Ambien And Belsomra

Precautions are necessary steps taken before administering a drug. This is done to prevent any undesirable effects after taking the medication.

Before you take Ambien:

  • Take AMBIEN precisely as directed.
  • Do not take AMBIEN earlier than right before bed.
  • Refrain from consuming alcohol while taking Ambien.
  • Go over your prescriptions with your doctor.
  • Tell your doctor about depression, mental illness, lung or kidney problems, or drug dependence.
  • Before taking AMBIEN, ensure you can spend 7-8 hours in bed without getting up.
  • Call your doctor if your insomnia worsens or does not get better within 7 to 10 days.
  • Avoid driving or engaging in other risky activities until you feel fully alert after taking AMBIEN.

Before you take Belsomra:

  • Never exceed the recommended dosage of BELSOMRA.
  • BELSOMRA should not be used if you cannot spend the entire night in bed (at least 7 hours) before you resume your normal activities.
  • BELSOMRA should be taken 30 minutes before bed.
  • Avoid driving or engaging in hazardous activities after taking Belsomra.
  • Inform your physician before beginning BELSOMRA if you have
  • depression, a mental illness, or suicidal thoughts
  • a history of drug or alcohol addiction
  • muscle weakness in the past
  • narcolepsy or excessive daytime sleepiness
  • lung or liver issues

Interactions of Ambien and Belsomra

Ambien and Belsomra should not be taken at the same time. It might raise the likelihood of unfavorable side effects.

Interactions of Ambien

  • When alcohol and other CNS depressants are also taken with zolpidem, the risk of CNS depression increases.
  • Concurrent use of opioids with zolpidem increases the risk of respiratory depression.
  • Imipramine and Ambien combined reduce alertness.
  • Combining zolpidem and chlorpromazine may cause a decrease in alertness and psychomotor performance.
  • Benzodiazepines increase the risk of central nervous system CNS side effects, such as slowed breathing or sleepiness.
  • Combining zolpidem and sertraline improves zolpidem exposure.
  • Combining these drugs with Ambien, Rifampin, or St. John's wort may reduce their effects.

Interactions of Belsomra

  • Concurrent use of BELSOMRA and alcohol can cause additive psychomotor impairment.
  • It is not advised to take BELSOMRA with potent CYP3A inhibitors. E.g., telithromycin, conivaptan, itraconazole, posaconazole, ritonavir, or ketoconazole.
  • BELSOMRA with digoxin increases digoxin levels due to the inhibition of intestinal P-glycoprotein.
  • Avoid drinking alcohol while taking BELSOMRA as it could have additive effects.
  • The risk of CNS depression increases when other CNS depressants, such as benzodiazepines, opioids, tricyclic antidepressants, and alcohol, are co-administered.

Bottom Line From Practical Anxiety Solutions

People with insomnia experience significant adverse effects on their quality of life. Getting proper treatment can contribute to a happier and healthier lifestyle. Both Belsomra and Ambien are used to treat insomnia. Although both drugs are quite effective in treating sleep disorders, they both carry the risk of addiction and abuse.

It may be challenging to treat insomnia with difficulties falling and staying asleep. Unlike zolpidem, suvorexant does not affect GABA, and its mode of action differs from that of zolpidem. It decreases wakefulness rather than promoting sleep.

Evidence suggests that this medicine benefits patients with symptoms of chronic insomnia over the long term. A healthcare provider can determine the most effective drug by considering a patient's medical condition, history, and current medications.

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