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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Restoril and Ambien are two prescription medications used in the treatment of insomnia. Insomnia is a sleeping disorder characterized by having trouble falling asleep, staying asleep, or getting good quality sleep. A lack of sleep can leave patients feeling sleepy and unrested, making daily activities difficult.
Insomnia can be categorized two ways: short-term insomnia can last a few days or weeks and is typically brought on by a change in schedule or stressors, and chronic insomnia occurs three or more nights per week over three or more months and cannot be explained by a life change, medication, or other known cause. Healthcare providers may suggest environmental changes and cognitive behavioral therapy prior to beginning sleep aid medications.
Restoril and Ambien both treat forms of insomnia, though they are not the same. We will discuss their differences here.
What are the main differences between Restoril and Ambien?
Restoril (temazepam) is a prescription drug that is used in the treatment of short-term insomnia. It is a benzodiazepine used as a sedative-hypnotic. Benzodiazepines are central nervous system (CNS) depressants. CNS depressants result in many effects including sedation, hypnosis, anticonvulsant, and muscle relaxation. These effects are brought on by non-specific binding to gamma-aminobutyric acid-A (GABA-A) receptors that have multiple omega subunits, each responsible for various effects. Restoril is available as an oral capsule in strengths of 7.5 mg, 15 mg, 22.5 mg, and 30 mg. Restoril is considered a controlled substance by the Drug Enforcement Agency (DEA) because it can be habit-forming and have the potential for abuse.
Ambien (zolpidem) is a prescription drug that is used in the treatment of short-term insomnia, particularly in patients for whom initiating sleep and maintaining sleep is the obstacle. Ambien is a positive modulator at the GABA-A receptor as well but is different from benzodiazepines in that it has a higher affinity specifically for the omega-1 subunit of the GABA-A receptor. Ambien is a non-benzodiazepine sedative-hypnotic. This is thought to explain why Ambien has a somnolent effect, but no effects related to muscle relaxation, anxiety, or seizure activity. Ambien is available as an oral immediate-release tablet in 5 mg and 10 mg, as well as extended-release tablets in 6.25 mg and 12.5 mg. Ambien is also characterized as a controlled substance by the DEA.
| Main differences between Restoril and Ambien | ||
|---|---|---|
| Restoril | Ambien | |
| Drug class | Benzodiazepine | Non-benzodiazepine sedative |
| Brand/generic status | Brand and generic available | Brand and generic available |
| What is the generic name? | Temazepam | Zolpidem |
| What form(s) does the drug come in? | Oral capsule | Oral immediate- and extended-release tablets |
| What is the standard dosage? | 30 mg at bedtime | 10 mg at bedtime |
| How long is the typical treatment? | A few days to weeks | Months |
| Who typically uses the medication? | Adults | Adults |
Conditions treated by Restoril and Ambien
Restoril is indicated in the treatment of short-term insomnia. Short-term insomnia typically lasts a few days or weeks and is generally related to a particular stressor or change in sleep schedule.
Ambien, in its immediate-release form, is used in short-term insomnia characterized by difficulty initiating sleep, or falling asleep. Ambien CR, the extended-release formulation, is used to treat insomnia characterized by trouble initiating sleep and/or sleep maintenance or staying asleep.
| Condition | Restoril | Ambien |
| Short-term insomnia | Yes | Yes |
| Chronic insomnia (with trouble initiating or staying asleep) | No | Yes |
Is Restoril or Ambien more effective?
Restoril and Ambien were compared in a placebo-controlled clinical trial. This trial included more than 600 patients with transient, or short-term, insomnia. While both drugs were shown to improve the efficiency of sleep as compared to placebo, Ambien was superior in reducing the number of awakenings after sleep onset. In other words, patients were less likely to wake up through the night with Ambien as compared to Restoril. Given this information, and taking into consideration that Ambien avoids unwanted effects on muscle relaxation and seizure activity, your prescriber may choose Ambien for your short-term insomnia.
Only your physician can determine which medication is best for you and your particular sleep disorder. This is not intended to be medical advice.
Coverage and cost comparison of Restoril vs. Ambien
Restoril is typically covered by commercial insurance plans, but generally not covered by Medicare drug plans. The out-of-pocket price for Restoril is around $60, but with a coupon from SingleCare, you can lower the generic price to approximately $10 at participating pharmacies.
Ambien is also typically covered by commercial insurance plans, but generally not covered by Medicare drug plans. The out-of-pocket price for brand-name Ambien can run up to $600-$700. SingleCare’s coupon for generic Ambien (zolpidem tartratean) can lower the price to $14 at many pharmacies.
| Restoril | Ambien | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare Part D? | No, exceptions are plan dependent | No, exceptions are plan dependent |
| Quantity | 30, 30 mg capsules | 30, 10mg immediate-release tablets |
| Typical Medicare copay | n/a | n/a |
| SingleCare cost | $10-$37 | $14-$29 |
Common side effects of Restoril vs. Ambien
Restoril and Ambien have a significant number of potential side effects. Headache, fatigue, and nervousness are possible with both drugs. Both drugs have the potential to leave patients with a hangover effect or drugged feeling, which can affect daily functioning. It is important to plan to get a minimum of eight hours of sleep after taking these medications in order to help avoid this effect.
Nightmares, vivid dreams, and abnormal dreams are possible with Restoril and Ambien. In some instances, there have been reports of binge eating, sexual activity, and other abnormal activities while patients are reportedly still asleep (sleepwalking). These potential adverse effects should be discussed with your doctor.
This is not intended to list all potential effects of these medications. Your doctor may discuss other possible adverse effects.
| Restoril | Ambien | |||
| Side effect | Applicable? | Frequency | Applicable? | Frequency |
| Drowsiness | Yes | 9.1% | Yes | 8% |
| Headache | Yes | 8.5% | Yes | Not defined |
| Fatigue | Yes | 4.8% | Yes | Not defined |
| Nervousness | Yes | 4.6% | Yes | Not defined |
| Lethargy | Yes | 4.5% | Yes | 3% |
| Dizziness | Yes | 4.5% | Yes | 5% |
| Abnormal Dreams | No | n/a | Yes | 1% |
| Nausea | Yes | 3.1% | Yes | Not defined |
| Hangover | Yes | 2.5% | Yes | 3% |
| Anxiety | Yes | 2.0% | Yes | Not defined |
| Depression | Yes | 1.7% | No | n/a |
| Dry Mouth | Yes | 1.7% | Yes | 3% |
| Diarrhea | Yes | 1.7% | Yes | 3% |
| Abdominal Pain | Yes | 1.5% | Yes | 2% |
| Constipation | No | n/a | Yes | 2% |
| Euphoria | Yes | 1.5% | Yes | Not defined |
| Weakness | Yes | 1.4% | No | n/a |
| Confusion | Yes | 1.3% | Yes | Not defined |
| Blurred vision | Yes | 1.3% | No | n/a |
| Nightmares | Yes | 1.2% | No | n/a |
| Vertigo | Yes | 1.2% | Yes | Not defined |
| Allergy | No | n/a | Yes | 4% |
Source: Restoril (DailyMed) Ambien (DailyMed)
Drug interactions of Restoril vs. Ambien
Restoril and Ambien both have CNS depressant effects, and their concomitant use with other CNS depressants may lead to an additive effect, which could be dangerous. Most notably, use with opiate pain relievers can lead to severe respiratory depression and possibly even death. Common opiate pain relievers include codeine, hydrocodone, and oxycodone.
Caffeine, especially if consumed in the time shortly before taking Restoril or Ambien, may counteract the desired effects of Restoril and Ambien. Caffeine is pharmacologically opposite of Restoril and Ambien in that it stimulates the central nervous system.
Commonly used antihistamines, such as Benadryl (diphenhydramine), may also cause significant sleepiness and should not be given with Restoril and Ambien as the additive effect could be dangerous.
This is not intended to be an all-inclusive list of potential drug interactions. Please consult your pharmacist or healthcare professional for a complete list.
| Drug | Drug class | Restoril | Ambien |
| Codeine Hydrocodone Morphine Hydromorphone Oxycodone |
Opioid pain relievers | Yes | Yes |
| Caffeine | Simulant | Yes | Yes |
| Aripiprazole Olanzapine Quetiapine |
Atypical antipsychotics | Yes | Yes |
| Brompheniramine Chlorpheniramine Diphenhydramine Hydroxyzine Cetirizine |
Antihistamines | Yes | Yes |
| Carisoprodol Metaxalone Cyclobenzaprine |
Muscle relaxants | Yes | Yes |
| Clonidine | Alpha agonist | Yes | No |
| Tramadol | Mu-opioid pain reliever | Yes | Yes |
| Trazodone | Antidepressant | Yes | Yes |
| Amitriptyline Doxepin Nortriptyline Imipramine |
Tricyclic antidepressants | Yes | Yes |
| Citalopram Escitalopram Fluoxetine Sertraline |
Selective serotonin reuptake inhibitors (SSRIs) | No | Yes |
Warnings of Restoril and Ambien
The use of Restoril and Ambien with other CNS depressants, such as opioid pain relievers, may lead to profound sedation, respiratory depression, coma, and even death. The use of Restoril and Ambien together should be avoided for the same reason.
It is important to note that if insomnia does not improve within seven to 10 days of taking medication, patients should be evaluated for underlying psychiatric disorders that may be contributing to sleep problems if untreated.
Restoril and Ambien should be avoided if a patient has consumed alcohol within a few hours of bed, or does so on a regular basis. The combination leads to psychomotor impairment that can last into the next day, and may impair driving and reflex times.
Before taking Ambien or Restoril, please alert your doctor to any medical conditions or other medications you are taking, including over-the-counter medications and other sleep medications.
Do not suddenly stop taking Restoril or Ambien without consulting your healthcare provider. You might experience withdrawal symptoms such as agitation, anxiety, and depression.
Frequently asked questions about Restoril vs. Ambien
What is Restoril?
Restoril is a prescription medication used in the treatment of short-term insomnia. It is classified as a benzodiazepine and is also considered a controlled substance by the DEA due to its potential for abuse. It is available as an oral capsule in strengths of 7.5 mg, 15 mg, 22.5 mg, and 30 mg.
What is Ambien?
Ambien is a prescription medication used to treat insomnia. It is a non-benzodiazepine sedative drug but is still considered a controlled substance by the DEA because of its potential for abuse. It is available in immediate-release tablet form in 5 mg and 10 mg strengths. It is also available in extended-release tablet form (Ambien CR) in strengths of 6.25 mg and 12.5 mg.
Are Restoril and Ambien the same?
While both Restoril and Ambien treat insomnia, they are not the same. Restoril is a benzodiazepine that also has effects on muscle relaxation, convulsions, and anxiety. Ambien is not a benzodiazepine and has a more specific receptor target and avoids these effects while targeting insomnia.
Is Ambien or Restoril better?
While both Restoril and Ambien are capable of improving the efficiency of sleep, Ambien has been shown to be significantly better at reducing the number of awakenings after falling asleep. Given this, and the more specific activities toward sleep, Ambien may be preferred over Restoril.
Can I use Restoril or Ambien while pregnant?
Restoril is categorized by the Food and Drug Administration (FDA) as pregnancy category X. It is contraindicated in pregnancy and should not be used. Ambien is pregnancy category C indicating that there have been no well-controlled studies to prove safety and efficacy. Ambien should only be used when benefits clearly outweigh the risks.
Can I use Restoril or Ambien with alcohol?
Patients should avoid taking Restoril or Ambien if they have consumed alcohol in the hours leading up to sleep. Significant psychomotor impairment can result from concomitant use.
What sleeping pill works better than Ambien?
Lunesta (eszopiclone) offers some advantage over Ambien in that it is considered safe to be used long term, whereas Ambien is intended for relatively short-term use. Lunesta has been shown to be highly effective for sleep maintenance.
Does Restoril help with anxiety?
Restoril is a benzodiazepine and does possess anxiolytic effects, making it an effective anti-anxiety medication.
How fast does Restoril work?
Temazepam works within 15 to 30 minutes of taking it and should be taken 15 to 30 minutes prior to the desired time to be asleep.
