Zolpidem Interactions

Zolpidem (Ambien) and alcohol both increase activity at the GABA-A receptor, producing additive sedation, impaired psychomotor performance, and an elevated risk of complex sleep behaviors, falls, and — at higher levels of intoxication — respiratory depression. The combination is an additive pharmacodynamic effect; the FDA interaction study found no change in zolpidem blood levels from alcohol.

Zolpidem and melatonin are both used to help with sleep, so people sometimes take them together. On paper their sedative effects could add up, but the only controlled study to test the combination directly found that adding melatonin did not measurably worsen next-morning alertness, coordination, or driving compared with zolpidem alone. The realistic concern is mild additive grogginess in sensitive people, especially older adults.

Zolpidem is a Z-drug hypnotic that acts on the GABA-A receptor, and valerian's valerenic acid also has GABA-related sedative activity. In theory the two could add to each other's drowsiness, so it is sensible not to layer them. The best available review of valerian, however, found no evidence of clinically relevant interactions, and there is no human study of this specific combination.