| Primary Insomnia
Ambien CR vs Belsomra
Side-by-side clinical, coverage, and cost comparison for primary insomnia.Deep comparison between: Ambien vs Belsomra with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsBelsomra has a higher rate of injection site reactions vs Ambien based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Belsomra but not Ambien, including UnitedHealthcare
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Category
Ambien
Belsomra
At A Glance
Oral
Once nightly
GABA-A receptor positive modulator
Oral
Once nightly
Orexin receptor antagonist
Indications
- Primary Insomnia
- Primary Insomnia
Dosing
Primary Insomnia - Adults Women: 6.25 mg once nightly immediately before bedtime; men: 6.25 or 12.5 mg once nightly immediately before bedtime; max 12.5 mg/day; swallow tablets whole; do not take with or immediately after a meal.
Primary Insomnia - Elderly / Hepatic Impairment 6.25 mg once nightly immediately before bedtime for men and women; avoid use in severe hepatic impairment.
Primary Insomnia Recommended dose 10 mg once nightly within 30 minutes of going to bed (at least 7 hours before planned awakening); may increase to maximum 20 mg once nightly if 10 mg is well-tolerated but not effective. Reduce to 5 mg once nightly with moderate CYP3A inhibitors (max 10 mg); not recommended with strong CYP3A inhibitors.
Contraindications
- Previous complex sleep behaviors (e.g., sleep-driving) after taking AMBIEN CR
- Known hypersensitivity to zolpidem or any excipient (observed reactions include anaphylaxis and angioedema)
- Narcolepsy
Adverse Reactions
Most common (>=1%) Headache, somnolence, dizziness, nausea, hallucinations, back pain, myalgia, memory disorders, visual disturbance, anxiety, depression
Serious Complex sleep behaviors, CNS-depressant effects and next-day impairment, severe anaphylactic and anaphylactoid reactions, abnormal thinking and behavior changes, withdrawal effects
Postmarketing Acute hepatocellular, cholestatic, or mixed liver injury with or without jaundice; delirium
Most common (>=5%) somnolence, headache
Serious CNS depressant effects and daytime impairment, worsening of depression/suicidal ideation, complex sleep behaviors, sleep paralysis, hypnagogic/hypnopompic hallucinations, cataplexy-like symptoms, respiratory depression in patients with compromised respiratory function
Postmarketing palpitations, tachycardia, nausea, vomiting, psychomotor hyperactivity, anxiety, pruritus
Pharmacology
Zolpidem is a GABA-A receptor positive modulator of the imidazopyridine class that binds selectively to the benzodiazepine site of alpha-1 subunit-containing GABA-A receptors, increasing chloride channel opening frequency and inhibiting neuronal excitation; it has no appreciable affinity for dopaminergic, serotonergic, adrenergic, histaminergic, or muscarinic receptors.
Orexin receptor antagonist; suvorexant blocks the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R (Ki= 0.55 and 0.35 nM, respectively), suppressing wake drive to facilitate sleep onset and maintenance.
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Most Common Insurance
Anthem BCBS
Ambien
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (0/12) · Qty limit (10/12)
Belsomra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (12/12)
UnitedHealthcare
Ambien
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (3/8)
Belsomra
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (7/8)
Humana
Ambien
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Belsomra
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (1/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Ambien.
No savings programs available for Belsomra.
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AmbienView full Ambien profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.