Ambien vs. Restoril

See how Ambien and Restoril compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ambien is a non-benzodiazepine approved specifically for trouble falling asleep, while Restoril is a benzodiazepine approved for insomnia more broadly.

  • Both are Schedule IV controlled substances meant for short-term use only, but Restoril carries boxed warnings for abuse risk and dangerous opioid interactions that Ambien's label does not.

  • Ambien's typical dose range (5-10 mg) and generic price are lower than Restoril's (7.5-30 mg), which also has a much higher typical monthly list price.

Ambien vs. Restoril Drug Summary

Ambien

Ambien (zolpidem) is a non-benzodiazepine GABA-A receptor agonist used for short-term treatment of insomnia when the main problem is trouble falling asleep. It is taken as a single tablet on an empty stomach right before bed, at 5 mg or 10 mg depending on sex and liver function. It has been FDA-approved since 1992.

Restoril

Restoril (temazepam) is a benzodiazepine hypnotic approved for short-term treatment of insomnia in general, not just difficulty falling asleep. It is taken as a single capsule at bedtime, with doses ranging from 7.5 mg to 30 mg depending on age and response. It has been FDA-approved since 1981.

Ambien vs. Restoril Side Effects

Ambien

Most common
dizziness (up to 23.5%)
headache (up to 19%)
diarrhea (1% to 10%)
nausea (1% to 10%)

Restoril

Most common
drowsiness (up to 9.1%)
headache (up to 8.5%)
fatigue (up to 4.8%)
nervousness (up to 4.6%)

Ambien vs. Restoril Dosage

Ambien

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once nightly At the start
Maximum dose 10 mg once nightly If needed
Dose changes 1 increase As tolerated

Restoril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 7.5 mg once daily At the start
Maximum dose 30 mg once daily If needed
Dose changes 3 increases As tolerated

Ambien vs. Restoril Indications

Ambien

Ambien is FDA-approved for the short-term treatment of insomnia when the main symptom is difficulty falling asleep. It is not approved for long-term nightly use or for use in children.

  • Difficulty falling asleep (sleep onset insomnia)

  • Short-term use only, typically days to a few weeks

  • Not approved for chronic nightly use

  • Not approved for pediatric patients

Restoril

Restoril is FDA-approved for the short-term treatment of insomnia in general, without specifying whether the problem is falling asleep or staying asleep. It is intended for very brief use, typically no more than 7 to 10 days.

  • General insomnia symptoms

  • Short-term use only, typically 7 to 10 days

  • Not approved for anxiety disorders

  • Not approved for long-term routine use

Ambien vs. Restoril Pros and Cons

Ambien

Ambien's non-benzodiazepine mechanism and lower typical dose range make it a common first-line choice for sleep-onset insomnia. It is generally less expensive at generic pricing than Restoril, though brand pricing can be very high.

Pros

  • Non-benzodiazepine, may carry less stigma

  • Lower typical dose range (5-10 mg)

  • Generic pricing often $15 to $90 per month

  • No boxed warning for abuse or opioid interaction

Cons

  • Only approved for sleep-onset insomnia specifically

  • Risk of complex sleep behaviors like sleep-walking

  • Higher dose (10 mg) linked to more next-day impairment

  • Still a controlled substance with dependence risk

Restoril

Restoril's benzodiazepine mechanism and broader dosing range can address a wider range of insomnia symptoms, but it carries boxed warnings absent from Ambien's label. Its typical list price is substantially higher than Ambien's generic price.

Pros

  • Approved for general insomnia, not just onset

  • Longer duration of action may aid staying asleep

  • Wider dose range (7.5-30 mg) allows titration

  • Long track record since 1981 approval

Cons

  • Boxed warning for abuse, misuse, and addiction risk

  • Boxed warning for danger when combined with opioids

  • Contraindicated in pregnancy

  • Typical cost of $920 to $1,270 per month, far above Ambien's generic price

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