Zolpidem Ranitidine

Clinicians should be aware of a few drug interactions with Zolpidem. Flumazenil acts as an antagonist to the hypnotic effects of zolpidem. There is decreased alertness when zolpidem is combined with cimetidine. There is an increase in anterograde amnesia in volunteers treated with a combination of imipramine and zolpidem. Haloperidol, ranitidine, chlorpromazine, warfarin, and digoxin, along with cimetidine and flumazenil, do not alter the pharmacokinetics of zolpidem (Salva and Costa, 1995). 

The serum levels of many of the benzodiazepines and related drugs are raised by cimetidine, but normally this appears to be of little or no clinical importance and only the occasional patient may experience an increase in the effects (sedation). The interactions with midazolam, zaleplon, and Zolpidem may be more significant, but this is not established. Famotidine, nizatidine and ranitidine do not normally appear to interact with most benzodiazepines. Increased sedation appears to occur with clomethiazole and cimetidine. 

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