If you are struggling to sleep despite taking a sleeping tablet, you may wonder whether zopiclone can be taken with zolpidem to improve sleep. Both medicines are prescription sleeping pills, but taking them together is generally not recommended unless specifically instructed by a qualified healthcare professional.
Zopiclone and zolpidem are both medicines used for the short-term treatment of insomnia. Combining two medicines with sedative effects can increase the overall effects on the central nervous system, potentially increasing drowsiness, impaired alertness and other adverse effects. The NHS advises people taking zolpidem not to take other medicines that cause sleepiness, including medicines for sleep problems, without appropriate medical advice. (nhs.uk)
What Are Zopiclone and Zolpidem?
Zopiclone and zolpidem belong to a group of medicines commonly called Z-drugs. They are hypnotic medicines used to help manage insomnia for short periods.
Zopiclone is used for problems such as difficulty falling asleep, waking during the night or waking too early. NHS guidance states that it usually begins working within around 30 to 60 minutes.
Zolpidem is also prescribed for insomnia and generally starts working relatively quickly. NHS guidance states that it is normally used for a short period because the body can become accustomed to it and dependence can develop.
Can You Take Zopiclone and Zolpidem Together?
You should not combine zopiclone and zolpidem unless your doctor or another qualified prescriber has specifically told you to do so.
Although they are different medicines, both have sedative effects. Taking them together could result in excessive sedation and impaired alertness.
NHS guidance specifically advises people taking zolpidem to speak to a doctor or pharmacist if they are taking medicines for sleep problems. Similarly, the NHS zopiclone guidance lists other medicines used for sleep or anxiety among medicines that may not mix well with zopiclone.
There is also little reason for someone to routinely take both medicines together. FDA guidance recommends that hypnotic medicines such as zolpidem and zopiclone should be used for short periods and states that people who have not responded to one of these hypnotics should not simply be prescribed another.
Why Is Combining Zopiclone and Zolpidem a Concern?
The main concern is additive sedation.
Taking two sedative medicines can potentially increase problems such as:
- Excessive sleepiness
- Dizziness
- Reduced alertness
- Poor coordination
- Confusion
- Impaired judgement
- Memory problems
- Increased risk of falls
- Difficulty waking up
The effects can be particularly concerning in older adults and people who already have breathing problems or sleep apnoea.
For this reason, combining sleeping medicines should never be used as a self-directed strategy for treating insomnia.
Can Zopiclone and Zolpidem Be Taken on the Same Night?
Taking both on the same night should only happen if it has been specifically prescribed or approved by your healthcare professional.
Do not assume that because one sleeping tablet has not worked quickly, taking another will make it work better.
If your prescribed sleeping medicine does not seem to be helping, speak with your doctor or pharmacist rather than taking an additional sleeping tablet.
If you’re experiencing ongoing difficulty falling asleep or staying asleep, our guide on [What Is Insomnia?] explains common causes, symptoms and treatment approaches.
What If Zopiclone Isn’t Working?
If zopiclone is no longer helping you sleep, there can be several possible reasons.
For example, insomnia may be related to:
- Anxiety or stress
- Depression
- Irregular sleep schedules
- Caffeine or alcohol
- Certain medicines
- Pain or other health conditions
- Sleep apnoea
- Restless legs syndrome
- Long-term dependence or tolerance to sleeping medication
Taking a second sleeping tablet does not necessarily address the underlying cause.
NICE recommends considering non-drug measures before hypnotic treatment and emphasizes that hypnotics should generally be prescribed for short periods when they are appropriate.
If anxiety is making it difficult to sleep, read our related guide on [Can Anxiety Cause Insomnia?] to learn more about the relationship between anxiety and sleep problems.
Can You Drink Alcohol With Zopiclone or Zolpidem?
Alcohol should be avoided when taking these medicines.
Alcohol can increase the sedative effects of sleeping medicines and make excessive drowsiness and other dangerous effects more likely. NHS guidance specifically advises avoiding alcohol with zopiclone.
You should also tell your doctor or pharmacist about other medicines you take, particularly other medicines that can cause drowsiness.
These can include certain anxiety medicines, opioid painkillers, sedating antihistamines and other sleeping medicines.
Can Zopiclone or Zolpidem Cause Dependence?
Yes. Both medicines are intended for short-term treatment, rather than routine long-term use.
NICE recommends that hypnotic treatment for insomnia should generally be limited to short periods. Its guidance also highlights the potential for tolerance, dependence and withdrawal with these medicines.
This is one reason why you should not increase your dose, combine sleeping medicines or continue treatment for longer than recommended without medical supervision.
If you have been taking zopiclone or zolpidem regularly and want to stop, speak with your healthcare professional about the safest approach.
What Should You Do If You Accidentally Take Both?
If you accidentally take zopiclone and zolpidem together, do not take any additional sleeping medicine.
The appropriate response depends on the medicines, doses, other substances involved and your individual health circumstances. Contact a pharmacist, doctor or appropriate urgent medical service for advice.
Seek emergency medical assistance if you develop severe symptoms such as difficulty breathing, become extremely difficult to wake, lose consciousness or experience another serious reaction.
Do not drive yourself to seek emergency care if you are significantly drowsy or impaired.
Zopiclone vs Zolpidem: Which Is Better?
There is no single sleeping tablet that is best for everyone.
Zopiclone and zolpidem are both Z-drugs used for insomnia, and NICE found no compelling evidence that one should routinely be preferred because of superior effectiveness or safety.
The appropriate treatment depends on factors such as the type of insomnia, other medicines, medical conditions, previous treatment response and the potential risks for the individual.
Your healthcare professional can determine whether medication is appropriate and which option is most suitable.
Frequently Asked Questions
Can I take zopiclone and zolpidem together?
Do not take them together unless your doctor or pharmacist specifically advises you to. Both are sedative sleeping medicines, and combining them can increase unwanted sedative effects.
Is zolpidem stronger than zopiclone?
It is not appropriate to describe one as simply “stronger.” They are different medicines, and their effects vary between individuals.
Can I switch from zopiclone to zolpidem?
A switch should be discussed with your prescriber. Do not add zolpidem to your existing zopiclone treatment without professional advice.
Can I take another sleeping pill if zopiclone doesn’t work?
Do not automatically take another sleeping pill. Speak with a doctor or pharmacist about why your treatment is not working.
Can zopiclone and zolpidem cause dependence?
Yes. Both are intended for short-term treatment, and prolonged use can lead to tolerance and dependence.
Can I drink alcohol while taking zopiclone or zolpidem?
Alcohol should be avoided because it can increase sedation and other risks associated with these medicines.
Final Thoughts
Zopiclone and zolpidem should not normally be taken together without medical advice. Both are hypnotic medicines used for insomnia, and combining them can increase sedative effects without necessarily providing better sleep.
If one medicine is not working, the safer approach is to discuss the problem with a healthcare professional rather than adding another sleeping tablet. The underlying cause of insomnia should also be considered, particularly when sleep problems continue for several weeks.
Medical disclaimer: This article is for general educational purposes and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. Always take prescription medicines exactly as directed.
