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Zolpidem side effects: what 134,336 FDA adverse event reports show

Zolpidem Tartrate · 1,161 reaction terms · 556,378 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Label matched

Zolpidem Tartrate (Zolpidem Tartrate)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

134,336 reports · 69% serious · 15,992 with death outcome · 64% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Zolpidem tartrate extended-release tablets, USP are indicated for the short-term treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance (as measured by wake time after sleep onset). The clinical trials performed i.

FDA label, Indications and Usage

What it is

Zolpidem is an imidazo[1,2-a]pyridine compound having a 4-tolyl group at the 2-position, an N,N-dimethylcarbamoylmethyl group at the 3-position and a methyl substituent at the 6-position.

PubChem CID 5732 (ChEBI)

Boxed warning

COMPLEX SLEEP BEHAVIORS Complex sleep behaviors including sleep-walking, sleep-driving, and engaging in other activities while not fully awake may occur following use of zolpidem tartrate extended-release tablets. Some of these events may result in serious injuries, including death.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 4Labeled (related wording) 7Likely indication confounding 1Reporting / coding artifact 1Outcome field, not a reaction 1Not in label — unassessed 26
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,121 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Pharmaceutical nomadism218130.3
108.8–156.1ROR 130.5 · calibrated p 2e-8 ✓
70.4 EB05 62.9 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=218 · 100% cliniciannot reported in cached trials
Neurologic neglect syndrome20288.1
74.1–104.7ROR 88.2 · calibrated p 3e-7 ✓
56.0 EB05 49.8 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=202 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Sleep-related eating disorder28066.2
57.6–76.2ROR 66.4 · calibrated p 2e-6 ✓
46.4 EB05 42.0 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious n=197not reported in cached trials
Abnormal sleep-related event39165.2
58.0–73.4ROR 65.4 · calibrated p 3e-6 ✓
45.9 EB05 42.2 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=317not reported in cached trials
Carotid artery thrombosis20649.5
42.3–57.9ROR 49.6 · calibrated p 2e-5 ✓
37.5 EB05 33.4 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=206 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Somnambulism1,49445.6
43.1–48.3ROR 46.1 · calibrated p 2e-5 ✓
35.4 EB05 33.9 · IC025 +5.0
3/3 methods agree
Labeled adverse reaction
exact term
serious n=1,132not reported in cached trials
Prescription form tampering14235.2
29.3–42.3ROR 35.3 · calibrated p 1e-4 ✓
28.7 EB05 25.0 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=142 · 100% cliniciannot reported in cached trials
Parasomnia11931.8
26.1–38.7ROR 31.8 · calibrated p 2e-4 ✓
26.4 EB05 22.6 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=92 · ♀ 0% (drug 64%)not reported in cached trials
Chronic kidney disease-mineral and bone disorder12720.8
17.3–25.0ROR 20.8 · calibrated p 0.002 ✓
18.4 EB05 15.8 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=127not reported in cached trials
Hyperparathyroidism secondary25617.5
15.3–19.9ROR 17.5 · calibrated p 0.004 ✓
15.8 EB05 14.2 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=256not reported in cached trials
Personality disorder26017.0
14.9–19.3ROR 17.0 · calibrated p 0.004 ✓
15.4 EB05 13.9 · IC025 +3.7
3/3 methods agree
Labeled adverse reaction
exact term
serious n=258 · ♀ 100% (drug 64%) · 100% cliniciannot reported in cached trials
Nephrogenic anaemia46016.9
15.4–18.7ROR 17.0 · calibrated p 0.004 ✓
15.3 EB05 14.2 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=460not reported in cached trials
Sleep talking16016.0
13.6–18.9ROR 16.1 · calibrated p 0.006 ✓
14.6 EB05 12.8 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=121not reported in cached trials
Homicide16215.3
13.0–18.0ROR 15.3 · calibrated p 0.007 ✓
14.0 EB05 12.2 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=155 · ♀ 0% (drug 64%)not reported in cached trials
Rebound acid hypersecretion21711.8
10.3–13.6ROR 11.8 · calibrated p 0.018 ✓
11.0 EB05 9.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=216not reported in cached trials
Osteosclerosis949.8
8.0–12.1ROR 9.8 · calibrated p 0.036 ✓
9.1 EB05 7.6 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=94 · ♀ 100% (drug 64%) · 100% consumernot reported in cached trials
Gun shot wound1069.2
7.5–11.2ROR 9.2 · calibrated p 0.045 ✓
8.5 EB05 7.2 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=105 · ♀ 0% (drug 64%) · 100% consumernot reported in cached trials
Drug withdrawal convulsions938.5
6.9–10.5ROR 8.5 · calibrated p 0.057
7.9 EB05 6.6 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=93 · ♀ 0% (drug 64%) · 100% cliniciannot reported in cached trials
Completed suicide (death by suicide)4,3018.4
8.1–8.6ROR 8.6 · calibrated p 0.053
8.0 EB05 7.8 · IC025 +2.9
3/3 methods agree
Outcome field, not a reaction
boxed warning mentions mortality
age-adj. PRR 7.0 · serious PRR 6.6 · 94% cliniciannot reported in cached trials
Sopor6708.2
7.6–8.8ROR 8.2 · calibrated p 0.061
7.8 EB05 7.3 · IC025 +2.8
3/3 methods agree
Not in label — unassessedage-adj. PRR 6.9 · serious PRR 6.5 · 91% cliniciannot reported in cached trials
Hangover1687.7
6.6–9.0ROR 7.7 · calibrated p 0.075
7.3 EB05 6.4 · IC025 +2.6
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Pre-existing condition improved2997.7
6.9–8.7ROR 7.7 · calibrated p 0.075
7.3 EB05 6.7 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=144not reported in cached trials
Psychomotor retardation1297.5
6.3–9.0ROR 7.5 · calibrated p 0.082
7.1 EB05 6.1 · IC025 +2.5
3/3 methods agree
Labeled adverse reaction
exact term
serious n=128 · 100% cliniciannot reported in cached trials
Initial insomnia4657.4
6.8–8.1ROR 7.4 · calibrated p 0.083
7.1 EB05 6.5 · IC025 +2.7
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
age-adj. PRR 7.3 · serious n=175not reported in cached trials
Diabetic neuropathy2257.3
6.4–8.4ROR 7.4 · calibrated p 0.087
7.0 EB05 6.2 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=222not reported in cached trials
End stage renal disease8217.2
6.7–7.8ROR 7.3 · calibrated p 0.089
6.9 EB05 6.5 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious PRR 5.8not reported in cached trials
Amnesia (memory loss)2,8817.2
6.9–7.4ROR 7.3 · calibrated p 0.088
6.9 EB05 6.7 · IC025 +2.7
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 5.3 · serious PRR 6.4not reported in cached trials
Poisoning deliberate4107.2
6.5–7.9ROR 7.2 · calibrated p 0.093
6.8 EB05 6.3 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious PRR 5.7 · 100% cliniciannot reported in cached trials
Excoriation1127.1
5.8–8.5ROR 7.1 · calibrated p 0.099
6.6 EB05 5.7 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=99not reported in cached trials
Spinal osteoarthritis3776.9
6.2–7.7ROR 6.9 · calibrated p 0.102
6.6 EB05 6.1 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious PRR 5.7not reported in cached trials
Bradypnoea1146.9
5.7–8.3ROR 6.9 · calibrated p 0.106
6.5 EB05 5.5 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=114 · 100% cliniciannot reported in cached trials
Exposure via ingestion1086.9
5.7–8.3ROR 6.9 · calibrated p 0.108
6.4 EB05 5.5 · IC025 +2.4
3/3 methods agree
Reporting / coding artifactserious n=108 · 100% cliniciannot reported in cached trials
Sensory loss3176.3
5.7–7.1ROR 6.4 · calibrated p 0.130
6.1 EB05 5.5 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious PRR 5.7 · ♀ 88% (drug 64%)not reported in cached trials

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Suicidality8,6815.75.6–5.8signal
Depression5,3173.02.9–3.1signal
Hyponatraemia1,3962.72.6–2.9signal
Fall / fracture5,9472.52.4–2.5signal
Extrapyramidal1,4852.22.1–2.3signal
Kidney injury6,0712.12.0–2.1signal
Arrhythmia / qt2,4752.01.9–2.1raised
Dependence / withdrawal3,6351.91.9–2.0raised
Rhabdomyolysis / myopathy9861.91.8–2.0raised
Pancreatitis9421.81.7–2.0raised
Anaemia3,4941.81.8–1.9raised
Venous thromboembolism2,4171.81.7–1.8raised
Gi bleeding1,9971.71.6–1.8raised
Seizure2,0001.61.5–1.7raised
Thrombocytopenia2,1911.61.5–1.6raised
Heart failure1,7771.61.5–1.6raised

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Zolpidem as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (0 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)8,7411.0
1.0–1.1ROR 1.0 · calibrated p 0.332
1.0 EB05 1.0 · IC025 +0.0Reporting / coding artifactage-adj. PRR 1.1 · serious PRR 1.0not reported in cached trials
Nausea8,5481.7
1.7–1.7ROR 1.7 · calibrated p 0.797
1.7 EB05 1.7 · IC025 +0.7Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.8NCT00608985: 4/168 (2.4%) on Zolpidem; 7/177 (4.0%) control
Fatigue (tiredness)8,3011.7
1.6–1.7ROR 1.7 · calibrated p 0.781
1.7 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
age-adj. PRR 1.4 · serious PRR 1.6NCT00608985: 6/168 (3.6%) on Zolpidem; 2/177 (1.1%) control
Pain6,4891.7
1.6–1.7ROR 1.7 · calibrated p 0.761
1.6 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
age-adj. PRR 1.7 · serious PRR 1.6NCT02783729: 1/263 (0.4%) on Zolpidem (serious AE)
Insomnia (trouble sleeping)6,3393.8
3.7–3.9ROR 3.9 · calibrated p 0.394
3.7 EB05 3.6 · IC025 +1.8
3/3 methods agree
Labeled — boxed warning
exact term
age-adj. PRR 3.3 · serious PRR 3.3not reported in cached trials
Headache6,3331.6
1.5–1.6ROR 1.6 · calibrated p 0.715
1.6 EB05 1.5 · IC025 +0.6Labeled adverse reaction
exact term
age-adj. PRR 1.4 · serious PRR 1.6NCT02783729: 14/263 (5.3%) on Zolpidem; 13/209 (6.2%) control
Diarrhoea (diarrhea)5,9691.5
1.4–1.5ROR 1.5 · calibrated p 0.624
1.4 EB05 1.4 · IC025 +0.5Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.4NCT00608985: 2/168 (1.2%) on Zolpidem; 1/177 (0.6%) control
Fall5,6342.7
2.6–2.7ROR 2.7 · calibrated p 0.714
2.6 EB05 2.6 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.3 · serious PRR 2.3not reported in cached trials
Anxiety5,5253.1
3.0–3.1ROR 3.2 · calibrated p 0.579
3.0 EB05 3.0 · IC025 +1.6
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 3.0 · serious PRR 3.0NCT00608985: 2/168 (1.2%) on Zolpidem
Dizziness5,2921.7
1.6–1.7ROR 1.7 · calibrated p 0.765
1.7 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.7NCT00608985: 3/168 (1.8%) on Zolpidem; 10/177 (5.6%) control
Dyspnoea (shortness of breath)5,2571.5
1.4–1.5ROR 1.5 · calibrated p 0.624
1.5 EB05 1.4 · IC025 +0.5Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.3not reported in cached trials
Vomiting4,9811.7
1.6–1.7ROR 1.7 · calibrated p 0.763
1.7 EB05 1.6 · IC025 +0.7Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.6not reported in cached trials
Depression4,5353.1
3.1–3.2ROR 3.2 · calibrated p 0.560
3.1 EB05 3.0 · IC025 +1.6
3/3 methods agree
Labeled — boxed warning
exact term
age-adj. PRR 2.8 · serious PRR 2.9not reported in cached trials
Asthenia (weakness)4,5291.9
1.8–1.9ROR 1.9 · calibrated p 0.900
1.9 EB05 1.8 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.6 · serious PRR 1.7NCT00608985: 1/168 (0.6%) on Zolpidem; 2/177 (1.1%) control
Completed suicide (death by suicide)4,3018.4
8.1–8.6ROR 8.6 · calibrated p 0.053
8.0 EB05 7.8 · IC025 +2.9
3/3 methods agree
Outcome field, not a reaction
boxed warning mentions mortality
age-adj. PRR 7.0 · serious PRR 6.6 · 94% cliniciannot reported in cached trials

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Zolpidem ↔ Amnesia.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Zolpidem?

In FDA FAERS, the most frequently co-reported reaction terms for Zolpidem are nausea, fatigue, pain, insomnia, headache, diarrhoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Zolpidem have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: COMPLEX SLEEP BEHAVIORS Complex sleep behaviors including sleep-walking, sleep-driving, and engaging in other activities while not fully awake may occur following use of zolpidem tartrate extended-release tablets. Some of these events may result in serious injuries, including death.

Do FAERS signals prove that Zolpidem causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.