Drug Interactions, Kratom Guides

What Happens If You Mix Kratom & Zolpidem (Ambien)?

Zolpidem or Ambien is a prescription drug used for the treatment of insomnia.

Kratom is made from the leaves of a tropical tree from Southeast Asia. In higher doses, it’s also considered an effective supplement for insomnia.

Is it safe to take kratom with zolpidem? Is it a viable alternative?

In this handy guide, you’ll find the knowledge you need to make an informed decision.

Last updated 3 months ago by Dr. Devin Carlson

What Happens If You Mix Kratom & Zolpidem (Ambien)?

Does Kratom Interact With Zolpidem (Ambien)?

Kratom is unlikely to result in adverse reactions in combination with zolpidem. However, because of the severity of side effects from this medication, and the lack of safety information available, it’s wise to avoid using kratom in combination with all Z-drugs (including Zolpidem).

Kratom is a potent inhibitor of cytochrome P450 enzymes which are responsible for breaking down and metabolizing just about all medications.

The enzymes responsible for breaking down kratom include CYP2D6, CYP2C19, and CYP3A4.

Zolpidem only has a mild interaction with these enzymes, and is mainly metabolized by the CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 [6]. Therefore, there’s a small possibility kratom could interfere with the metabolism of zolpidem — potentially leading to side effects.

Zolpidem is also a powerful sedative. If combined with other sedatives, such as high dose kratom, it could lead to serious side effects including fainting, seizures, respiratory depression, and more.

Zolpidem (Ambien) Specs:

Drug Name Zolpidem
Trade Name Ambien
Other Names (other generics) Edluar, Intermezzo, Zolpimist  
Classification Nonbenzodiazepine Z drug
CYP Metabolism Cytochrome P450 3A4 (61%), 2C9 (22%), 1A2 (14%), 2D6 (2.5%), C19 (0.5%)
Interaction With Kratom Antagonistic or Agonistic (depending on kratom dosage)
Risk of Interaction Low to Moderate

Is It Safe to Take Kratom With Zolpidem (Ambien)?

Experts don’t consider zolpidem and kratom a safe combination. The chances of side effects increase when mixing these substances. Because of the severity of some of the potential side effects, it’s wise to give this combo a pass unless you speak with your doctor first.

Aside from the potential for metabolic competition between zolpidem (Ambien) and kratom and the problems that can arise, there are also other considerations.

In terms of effects, zolpidem and kratom can counteract each other depending on the dosage of kratom. Kratom is a stimulant when consumed in low doses, which means it can have the opposite effect of zolpidem, which promotes sleep.

Additionally, zolpidem is fast-acting and taken before bed — it makes little sense to combine these two drugs if you’re taking kratom as a stimulant.

Taking kratom at a higher dose increases the effect on the metabolism of zolpidem, therefore increasing the risk.

The only scenario where combining these drugs could make plausible sense is if a stimulant dose of kratom is preventing you from going to sleep. However, as we have seen, there is a metabolic risk.

In general, you should try to avoid this combination. At the very least, consult your doctor before attempting it.

What Is Zolpidem (Ambien)?

Zolpidem — commonly sold under the brand name Ambien — is classified as a nonbenzodiazepine Z drug. More generally, it falls under the umbrella of sedative-hypnotic medications.

“Z drugs” like zolpidem are very close to benzodiazepines in structure and function and are used to promote sleep. They work by increasing the effects of GABA neurotransmitters which help to inhibit neuron activity.

Essentially, zolpidem works by slowing down activity in the brain.

Due to its potential for misuse and physical and psychological dependence, zolpidem is a Schedule IV controlled substance. Nevertheless, it is still one of the most prescribed medications for sleep-related problems in the United States.

What Is Zolpidem (Ambien) Used For?

Zolpidem (Ambien) is prescribed for the treatment of a wide range of sleep-related issues. Although it can improve the latency and duration of sleep, it’s most effective at fixing difficulties related to sleep initiation [2].

Several official institutions such as the European Sleep Research Society and the American College of Physicians recommend that zolpidem and similar medications only be an option after exhausting non-pharmacological treatments [3].

Zolpidem is only a short-term treatment strategy. It’s generally not prescribed for more than a period of six weeks. Only ingest zolpidem as instructed by your physician.

What’s the Dose of Zolpidem (Ambien)?

As a prescription medication, zolpidem (Ambien) should only be taken after consultation with a doctor. Always take zolpidem according to your prescription.

As usual, an assortment of factors can alter the proper dosage recommendations for a drug like zolpidem. Some important considerations are age, whether the user is hepatically impaired, or using other prescription medication like antidepressants.

Zolpidem is fast-acting — effects usually take about 30 minutes. Make sure to take it on an empty stomach.

The proper time to take zolpidem is always just before going to bed.

Do not take zolpidem unless you can get 7-8 hours of sleep, as you may feel excessively tired and lethargic otherwise.

Generic & Brand Name Versions

Zolpidem is sold under the following brand names:

  • Ambien
  • Ambien CR
  • Edluar
  • Intermezzo
  • Zolpimist

What Are the Side Effects of Zolpidem (Ambien)?

Some of the side effects of zolpidem (Ambien) include:

  • Drowsiness
  • Allergy
  • Sinusitis
  • Back pain
  • Diarrhea
  • Dry mouth
  • Lethargy
  • Sore throat
  • Abdominal pain
  • Constipation
  • Heart palpitations

Zolpidem can also increase the risk of more serious adverse effects like depression, suppressed respiration, respiratory infections, and memory loss [4].

There are other important factors to consider. Zolpidem users have been reported to engage in sleep-walking and other activities like driving, cooking, and eating while sleeping. Obviously, this behavior carries an inherent risk of accidents that can become fatal.

Zolpidem impairs cognitive function. Users should not engage in activities that require complete focus, like driving, if zolpidem was used the night before.

Additionally, there have been reports of zolpidem triggering symptoms of withdrawal when stopped abruptly.

What Is Kratom?

Fast becoming popular due to its wide range of medicinal properties, kratom is a natural herbal compound extracted from the leaves of the Mytragana speciosa evergreen tree.

Native to Southeast Asia, kratom has been used for centuries by the native peoples for its wide range of medicinal properties — not unlike the coca leaf in Latin America.

Kratom works by binding to opiate receptors in the central nervous system. This mechanism has led to several comparisons between opiates and kratom, although kratom is the safer alternative.

The effects of kratom derive from the many plant-based alkaloids contained within it. The two main alkaloids are mitragynine and 7-hydroxymitragynine.

What Is Kratom Used for?

One of the most remarkable aspects of kratom is the spectrum of effects it can produce.

When taken at low doses, it provides stimulant and nootropic properties. At higher doses, it can promote analgesic, sedative, and even anxiolytic benefits.

Many people take it in the mornings to feel a burst of energy and focus — it’s a great replacement for coffee. Those dealing with chronic pain have also turned to kratom as an alternative to unsafe long-term treatments like opiates.

Additionally, kratom is effective at helping users deal with opiate, benzo, and alcohol withdrawal symptoms [5].

What’s the Dose of Kratom?

The generally recommended kratom dosages are the following:

  • Low dose (1-4g) — this kratom dosage is optimal for stimulating nootropic benefits and focus.
  • Medium dose (4-8g) — this amount of kratom is best for anxiolytic properties and pain relief.
  • High dose: (8-12g) — This can cause strong sedative effects and helps treat severe pain and anxiety. However, this dose is not for beginners. You should never mix kratom with another substance at these dosage levels. 

Just keep in mind that everybody’s body is different; go slow.

Related: Can You Overdose on Kratom?

What Are the Side Effects of Kratom?

Kratom is an unregulated substance. This means that the FDA has largely blocked wide-scale controlled studies of it, so there is much more to learn. Like with any other substance, there are side effects to be aware of.

The most common side effects of kratom include:

  • Nausea
  • Dizziness
  • Constipation
  • Anxiety
  • Brain fog

Also, kratom can cause physical dependence when taken in large doses for an extended period.

Lastly, you should always buy your kratom from a trusted source to remove the risk of contaminants.

What Are the Different Types of Kratom?

Kratom comes in a variety of strains. Although these strains all have roughly the same effects, they concentrate more heavily on different aspects of the kratom plant.

This allows kratom users to choose a more targeted kratom experience.

Strains mainly vary according to their “type” (white, red, green, or yellow). They also grow in different areas of Southeast Asia, allowing for a wide selection of varying kratom profiles.

There are many strains to choose from, so make sure to do your research.

1. White Vein Kratom

White vein kratom strains are known to promote the nootropic and stimulant aspects of kratom more vigorously. If you’re looking for a boost, then the white-veined strains are your best choice.

White vein users report a burst of creativity and mental clarity.

2. Red Vein Kratom

The red-veined kratom strains are more on the analgesic, sedative side of things. They also have anxiolytic benefits.

Those dealing with chronic pain or taking kratom for anxiety relief usually gravitate to the red-veined strains. Many users also take them as sleep support.

3. Green Vein Kratom

Green vein kratom is best if you happen to be looking for a more general kratom experience. Green-veined strains have a healthy balance of the properties found in white and red kratom.

If you’re just starting with kratom, then this strain is probably best for you.

However, if you want to take kratom to deal with a specific ailment or to promote a certain kind of benefit, you’re probably better off going with the targeted experience of a white or red vein. 

4. Yellow Vein Kratom

Yellow vein kratom is considered the odd one out in the kratom family. This is because it is a subcategory arising from the mixture of red and white kratom strains.

The general agreement in the kratom community is that yellow vein kratom is closest to the green-veined strains.

Yellow vein strains are milder than the average green-vein kratom strain, making them an excellent choice for first-time users.

Key Takeaways: Is It Safe to Mix Kratom & Zolpidem (Ambien)?

Kratom and zolpidem (Ambien) are metabolic competitors, and their mixture can lead to an increased rate of negative side effects.

However, when done rarely and in low doses, mixing kratom and zolpidem will most likely not trigger any adverse effects.

Nevertheless — due to the nature of the two compounds and their effects — there are few situations where this combination makes sense. The mixing of these two drugs corresponds most likely with a situation of misuse. In this respect, one should never mix kratom and zolpidem.

If you believe you need to use this combination for medical reasons, consult your physician beforehand.

References

  1. Wyss, P. A., Radovanovic, D., & Meier-Abt, P. J. (1996). Acute overdose of zolpidem (Stilnox). Schweizerische Medizinische Wochenschrift, 126(18), 750-756.
  2. Bouchette, D., Akhondi, H., & Quick, J. (2021). Zolpidem. StatPearls [Internet].
  3. National Institute for Clinical Excellence. Guidance on the use of zaleplon, zolpidem, and zopiclone for the short-term management of insomnia. 2004. Technology Appraisal Guidance, 77.
  4. Kripke, D. F. (2016). Mortality risk of hypnotics: strengths and limits of evidence. Drug safety, 39(2), 93-107.
  5. Boyer, E. W., Babu, K. M., Adkins, J. E., McCurdy, C. R., & Halpern, J. H. (2008). Self‐treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction, 103(6), 1048-1050.
  6. von Moltke, L. L., Weemhoff, J. L., Perloff, M. D., Hesse, L. M., Harmatz, J. S., Roth‐Schechter, B. F., & Greenblatt, D. J. (2002). Effect of zolpidem on human Cytochrome P450 activity, and on transport mediated by P‐glycoprotein. Biopharmaceutics & drug disposition, 23(9), 361-367.