Xanax vs Ambien: How do they compare?

Key Points

• Xanax (alprazolam) is a benzodiazepine, and Ambien (zolpidem) is a non-benzodiazepine sedative-hypnotic.
• Both Xanax and Ambien enhance the effects of a neurotransmitter in the brain called GABA, but they are used to treat different health conditions.
• Xanax and Ambien have similar side effects. Complex sleep behaviors are more common with Ambien.

What is Xanax?

Xanax (alprazolam) is a benzodiazepine. It is FDA approved to treat generalized anxiety disorder and panic disorder in adults. It’s sometimes used off-label (not FDA approved) to treat sleeping problems, premenstrual syndrome, and depression.

Xanax is classified as a Schedule IV controlled substance due to its risk of abuse, addition, and dependence.

What is Ambien?

Ambien belongs to a group of medications called non-benzodiazepine sedative-hypnotics. It is sometimes referred to as a “Z-drug.”

Ambien is FDA approved for the short-term treatment of insomnia (trouble sleeping) in adults. The immediate-release versions are approved for difficulty falling asleep, while an extended-release tablet is approved for difficulty falling asleep or staying asleep. A sublingual tablet is specifically FDA approved for use as needed to treat middle-of-the-night awakenings that are followed by trouble falling asleep again.

Because of its risks of abuse and dependence, Ambien is classified as a Schedule IV controlled substance.

Xanax and Ambien come in different dosage forms

Xanax and Ambien come in some similar dosage forms, while others are different. Xanax comes in an oral tablet (both immediate-release and extended-release), a liquid, and orally disintegrating tablets. Ambien is available as immediate-release and extended-release oral tablets, sublingual tablets, and immediate-release capsules.

Some forms of Xanax and Ambien are only approved for certain health conditions. For example, Xanax XR (extended-release tablets) is only approved for the treatment of panic disorder. Only certain sublingual tablets of zolpidem are approved for middle-of-the-night awakening.

How do you take Xanax and Ambien?

The recommended dosages of Xanax and Ambien are different. In addition, the dosage can differ between dosage forms and medical conditions.

Xanax Dosing

• Xanax XR (extended release): The recommended starting dosage is 0.5 mg to 1 mg by mouth once a day in the morning.
• Xanax (immediate release): The recommended starting dosage is 0.25 mg to 0.5 mg by mouth three times a day for generalized anxiety disorder, and 0.5 mg three times a day for panic disorder.

Ambien Dosing

• Ambien (immediate release) and Edluar sublingual tablets: The recommended starting dose is 5 mg for women and 5 mg or 10 mg for men by mouth immediately before bedtime.
• Ambien CR (extended release): The recommended dose is 6.25 mg for women and 6.25 mg or 12.5 mg for men by mouth immediately before bedtime.
• Zolpidem sublingual tablets: The recommended dose is 1.75 mg for women and 3.5 mg for men dissolved under the tongue once per night as needed.

The recommended dose for Xanax and Ambien may be lower than what is listed above for people who are elderly or have certain medical conditions, like liver problems. Additionally, the dose might be lower in people taking medications that interact with Xanax or Ambien.

How do Xanax and Ambien work?

Even though Xanax and Ambien don’t belong to the same family of medications, they have similar effects on the brain. They both work by enhancing the effects of a chemical in the brain called gamma-aminobutyric acid (GABA). GABA calms down the nervous system, making you feel relaxed and sleepy.

Related questions

• How long does Xanax last for / stay in your system?
• Valium vs Xanax: Which is better?
• Does Xanax help you sleep?

What are the side effects of Xanax and Ambien?

Xanax and Ambien can cause some similar and some different side effects. Side effects may vary depending on which dosage form you take.

Side Effects: Ambien

In clinical trials lasting up to 10 nights, people taking Ambien 10 mg or less reported the following side effects:

• Headache (7% vs. 6% placebo)
• Drowsiness (2% vs. 0% placebo)
• Dizziness (1% vs. 0% placebo)
• Diarrhea (1% vs. 0% placebo)

Patients taking the sublingual version reported nausea, feeling tired, and headache as side effects.

One unique side effect Ambien can cause is complex sleep behaviors. This means that after taking Ambien you might get out of your bed and perform activities while not being fully awake. You might not remember doing anything during the night when you wake up the next morning.

Side Effects: Xanax

Side effects from Xanax can depend on the reason you are taking it and the dose. In clinical trials, the following side effects were reported by people taking immediate-release Xanax for generalized anxiety and panic disorder:

• Drowsiness (up to 77%)
• Fatigue (up to 49%)
• Impaired coordination (up to 40%)
• Irritability (up to 33%)
• Memory problems (up to 33%)
• Larger appetite (up to 33%)
• Trouble with thinking (up to 29%)
• Smaller appetite (up to 28%)
• Weight gain (up to 27%)
• Weight loss (up to 23%)
• Difficulty with speech (up to 23%)
• Light-headedness (up to 21%)
• Dry mouth (up to 15%)

Sedation, drowsiness, trouble with speech, abnormal coordination, tiredness, depression, and memory problems were commonly-reported side effects by people taking Xanax extended-release tablets.

Can you take Xanax and Ambien together?

It is generally not recommended to take multiple CNS depressants at the same time. Both Xanax and Ambien have sedating effects, and it can be dangerous if you take them together. Taking Xanax and Ambien too close together could cause more intense side effects, like sleepiness and problems thinking. You may also experience slowed breathing. Talk to your healthcare provider about the safest way to treat your medical conditions.

How many hours after taking Xanax can you take Ambien?

Ask your healthcare provider how long you should wait to take Ambien after taking Xanax. Each person’s body processes medications differently. In healthy people, it usually takes a little over two days for Xanax to completely leave the body. It could take longer in people with liver problems or who are taking medications that interact with Xanax.

Taking multiple CNS depressants at the same time can cause you to feel extremely drowsy, dizzy, and lead to breathing problems. Follow your healthcare provider’s instructions carefully when taking more than one CNS depressant close together.

This is not all the information you need to know about Xanax (alprazolam) and Ambien (zolpidem) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.