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Content

  1. What Is Belsomra?
  2. What Is Ambien?
  3. Ambien vs Belsomra: Differences
  4. Is Belsomra Similar to Ambien?
  5. Side Effects
  6. Belsomra vs. Ambien: Effectiveness
  7. What Is Safer, Ambien or Belsomra?
  8. Warnings and Precautions
  9. Can You Take Belsomra and Ambien Together?
  10. Switching Between Ambien and Belsomra
  11. Alternatives
  12. How to Get Help for Insomnia
  13. Conclusion
  14. FAQs
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Belsomra vs. Ambien for Insomnia: Which One Is Better?

Wafaa Amjad Dar
Written by:
Wafaa Amjad Dar
 Medical Writer
Dr. Henry Bradford
Medical Reviewer:
Dr. Henry Bradford
 MD
Evidence Based
The medications listed on this website are provided for informational purposes only.

Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more

Ambien has a boxed warning[1] CloseTrusted SourceDailyMedThe database containing labeling for FDA-approved products and additional products regulated but not approved by the FDA.Go to source, the most serious type of warning from the Food and Drug Administration (FDA). Ambien’s active ingredient zolpidem has a risk of complex sleep behaviors that may result in serious injuries and even death. Zolpidem (Ambien) and suvorexant (Belsomra) are controlled substances, indicating their potential for misuse or dependence. Specific federal and state laws limit the amount of this medication that can be prescribed or dispensed within a certain period of time.

Highlights

  • Belsomra (suvorexant) and Ambien (zolpidem) are sleep medicines prescribed by healthcare professionals for insomnia treatment.
  • Although both are used to help manage sleep difficulties, they do so through distinct mechanisms. Belsomra inhibits orexin, and Ambien stimulates GABA receptors.
  • Each medication has its own pros and cons. The choice of better sleep medicine for you out of these two can be best made by a qualified healthcare professional after careful evaluation.
  • Note that Belsomra and Ambien may not be suitable for everyone, and your healthcare provider may prescribe another medication or suggest non-pharmacological treatments.

Insomnia is a rising health concern with approximately 10% of adults[2] CloseTrusted SourcePubMedA free resource of the National Institute of Health containing over 35M biomedical literature citations, life science journals, & online books.Go to source being diagnosed with it, and the number is increasing each year. Some may develop insomnia due to their specific lifestyle or unhealthy sleep habits, while for others it may be comorbid with specific physical or mental health conditions.

Among the many sleep medications available, Belsomra and Ambien are some of the most common ones. The question you may have is “Which of these two is better?” Let’s find that out by exploring similarities, differences, and other details.

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What Is Belsomra?

Belsomra[3] CloseTrusted SourceU.S. Food and Drug AdministrationThe organization safeguarding public health through the safety and security of drugs, food, biologics, medical devices, cosmetics, and other products.Go to source is a sleep medication originally approved by the FDA in 2014 and is only available by prescription. Its active ingredient is suvorexant, belonging to a class of sedative medications known as dual orexin receptor antagonists (DORAs[4] CloseTrusted SourcePubMedA free resource of the National Institute of Health containing over 35M biomedical literature citations, life science journals, & online books.Go to source). It can be prescribed for individuals who experience sleep problems since it helps to fall asleep easier. It is usually administered in the form of an oral tablet that is ingested orally.

What Is Ambien?

Ambien[5] CloseTrusted SourceU.S. Food and Drug AdministrationThe organization safeguarding public health through the safety and security of drugs, food, biologics, medical devices, cosmetics, and other products.Go to source was originally approved by the FDA in 1992. It is also a sedative used as a prescription sleep aid to help patients with insomnia. In some cases, it can be prescribed off-label for anxiety management.

Ambien contains the active ingredient zolpidem which is a non-benzodiazepine[6] CloseTrusted SourceScienceDirectThe premier global hub for peer-reviewed scientific, technical, and medical research. Journals, books, and more than 19M articles and chapters.Go to source, just like the above-mentioned suvorexant. It is available in multiple dosage forms and helps patients to fall asleep faster and stay asleep for longer periods.

Ambien vs Belsomra: Differences

Ambien and Belsomra do share a prominent similarity being both indicated for the management of insomnia. But they are not entirely the same. Listed below are some of the differences.

Belsomra

Ambien

Availability

Brand only

Brand and generic

Active Ingredient

Suvorexant

Zolpidem

Drug Class

Dual orexin receptor antagonist

Nonbenzodiazepine sedative-hypnotic

Dosage Forms & Strengths

5, 10, 15, 20 mg oral tablets
  • 5, 10 mg oral tablets
  • 6.25, 12.5 mg extended-release oral tablets (Ambien CR)

Approved for

Adults

Adults

Cost

~$550 for 30 tablets (20 mg)

Brand: ~$770 for 30 tablets (10 mg)
Generic: ~$65 for 30 tablets (10 mg)

Working Mechanism

Being an orexin receptor antagonist, Belsomra[7] CloseTrusted SourcePubMedA free resource of the National Institute of Health containing over 35M biomedical literature citations, life science journals, & online books.Go to source blocks the action of orexin, a neuropeptide that causes wakefulness. As a result of this inhibition, the brain transitions into a state of calmness and, ultimately, sleep.

On the other hand, Ambien[8] CloseTrusted SourcePubMed Central (PMC)PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM).Go to source, classified as a sedative-hypnotic, stimulates the effects of the chemical messenger in the brain called gamma-aminobutyric acid (GABA). It generally slows down the signals to the brain, enabling it to reach a state of relaxation.

"Many prescription sleep aids are available, but choosing the right one requires identifying the factors disrupting sleep. Providers often start with non-controlled medications, reserving controlled substances (e.g., zolpidem, suvorexant) for cases where conservative treatments have failed and the potential benefits outweigh the risks."
Dr. Henry Bradford, MD
Dr. Henry Bradford, MD
Medical provider at MEDvidi

Dosage Forms and Generics

Ambien’s extended-release form Ambien CR[9] CloseTrusted SourceU.S. Food and Drug AdministrationThe organization safeguarding public health through the safety and security of drugs, food, biologics, medical devices, cosmetics, and other products.Go to source and generic medication zolpidem are available. In contrast, Belsomra doesn’t have a generic version suvorexant or an extended-release alternative as of yet.

Dosage

Ambien is available in 5 mg and 10 mg tablets, as well as extended-release (Ambien CR) in 6.25 mg and 12.5 mg. The dosage[1] CloseTrusted SourceDailyMedThe database containing labeling for FDA-approved products and additional products regulated but not approved by the FDA.Go to source prescribed for women starts at 5 mg before bedtime, while for men, it starts at 5 mg or 10 mg before bed.

Belsomra is available in 5 mg, 10 mg, 15 mg, and 20 mg tablets. A typical dosage[10] CloseTrusted SourceDailyMedThe database containing labeling for FDA-approved products and additional products regulated but not approved by the FDA.Go to source is 10 mg taken 30 minutes before sleeping, with a maximum dosage of 20 mg.

Typical dosages are provided for informational purposes only. Please consult your healthcare provider and follow their instructions.

Cost

Ambien sold under its brand name is more expensive ($756.30 to $779.99 for 30 tablets of 10 mg) than the generic version ($27.38 to $122.74 for 30 tablets of 10 mg); coupons are available for both options. The cost of a 30-tablet supply of 20 mg Belsomra is from $531.02 to $565.32, depending on the pharmacy; coupons are also available. Some insurance plans cover these medications as well.

Is Belsomra Similar to Ambien?

Along with the same use, there are other similarities, such as:

  • Federally Controlled Status: Both Belsomra and Ambien are federally controlled in the United States and classified under Schedule IV[11] CloseTrusted SourceUnited States Drug Enforcement AdministrationThe federal organization responsible for enforcing U.S. laws related to controlled substances.Go to source substances. This indicates that they have some potential for misuse and dependence.
  • Onset of Action: Both medications take approximately 30 minutes to work. Note that the onset of action may differ depending on individual factors; never exceed the prescribed dose.
  • Approved Age: For adults over 18 years of age.
  • Withdrawal Symptoms: Patients may experience withdrawal symptoms if they suddenly stop taking any of these medicines. It is advised to consult your healthcare provider and seek guidance before starting the tapering-off process.
  • Drug Interactions: Certain medications and substances can interact with Belsomra and Ambien, such as alcohol, opioids, seizure medications, antibiotics, antifungals, benzodiazepines, SSRIs, and tricyclic antidepressants.
Discuss your health history with a medical provider to learn what treatment for insomnia can be right for you.
Book an appointment

Side Effects

Many of the common side effects of the two medications are the same, including:

  • Drowsiness
  • Dizziness
  • Headache
  • Diarrhea
  • Dry mouth
  • Blurred vision
  • Mood changes (anxiety, irritability, confusion)
  • Abnormal dreams
  • Upper respiratory infections

Note that there are also differing adverse reactions; read the label of your medication carefully and discuss any concerns with your medical provider.

Both Ambien and Belsomra may cause complex sleep behaviors, for example, sleep-walking, sleep-driving, or other activities that one performs while not being fully awake. If you experience such effects, the symptoms of depression, or suicidal thoughts, contact your healthcare provider to adjust your treatment.

 

Belsomra[10] CloseTrusted SourceDailyMedThe database containing labeling for FDA-approved products and additional products regulated but not approved by the FDA.Go to source

Ambien[12] CloseTrusted SourceDailyMedThe database containing labeling for FDA-approved products and additional products regulated but not approved by the FDA.Go to source

Drowsiness

✅ (7%)

✅ (8%)

Dizziness

✅ (3%)

✅ (5%)

Headache

✅ (7%)

✅ (7%)

Diarrhea

✅ (2%)

✅ (3%)

Dry mouth

✅ (2%)

✅ (3%)

Abnormal dreams

✅ (2%)

✅ (1%)

Cough

✅ (2%)

✅ (less than 1%)

Upper respiratory tract infection

✅ (2%)

✅ (% not reported)

Palpitation

✅ (% not reported)

✅ (2%)

Nausea

✅ (% not reported)

✅ (% not reported)

Allergy

❌

✅ (4%)

Back pain

❌

✅ (3%)

Lethargy

❌

✅ (3%)

Altered sensation or “drugged feeling”

❌

✅ (3%)

Belsomra vs. Ambien: Effectiveness

According to the American Association of Family Physicians[13] CloseTrusted SourceThe American Academy of Family PhysiciansAn organization supporting the community of family physicians focused on advancing patient and community health.Go to source, zolpidem is prescribed as the second-line choice for insomnia, and the effectiveness of suvorexant is relatively similar. However, one study[14] CloseTrusted SourcePubMedA free resource of the National Institute of Health containing over 35M biomedical literature citations, life science journals, & online books.Go to source showed that there are also specific differences. While both medications increased the duration of sleep, zolpidem helped individuals fall asleep faster and suvorexant decreased the probability of waking up during the night.

So, the effectiveness of any chosen sleep medication depends on the type of insomnia you are dealing with, your symptoms, and health history, as well as individual response.

What Is Safer, Ambien or Belsomra?

As mentioned above, both medications are Schedule IV controlled substances, which means they carry some risk of dependency, tolerance, and misuse. There is limited evidence[15] CloseTrusted SourcePubMed Central (PMC)PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM).Go to source that suvorexant is more or less safe than other sleep medications like zolpidem, so safety is determined based on individual health status and the medication’s precautions and potential side effects. Also, in a suvorexant study[16] CloseTrusted SourcePubMedA free resource of the National Institute of Health containing over 35M biomedical literature citations, life science journals, & online books.Go to source, withdrawal and rebound insomnia were not observed, which can be an advantage.

If you want to learn more about insomnia treatment, our licensed medical providers at MEDvidi are here to assess your symptoms, define whether you may need medication, and prescribe it online if deemed appropriate.

Warnings and Precautions

Like every medication, Ambien and Belsomra come with a set of warnings and precautions to keep in mind when starting and during use. Some of these include: 

  • Not suitable for children under 18 years of age. 
  • Before taking these medications, tell your healthcare provider about all your medical conditions, medical history, and the medications you already take.
  • Be careful, as there is a high chance of injuries because of adverse effects like drowsiness and sleep-walking.
  • The medication should not be taken in the middle of the night. Also, it is important to get 7 to 8 hours of sleep to avoid diminished alertness.
  • Certain individuals should be prescribed these medications carefully:
    • People with breathing problems.
    • Individuals dealing with depression or suicidal thoughts.
    • Pregnant[17] CloseTrusted SourcePrescription Drug InformationAn independent medicine information website supplying unbiased, precise data on 24,000+ prescription drugs and over-the-counter medications.Go to source or breastfeeding females.
"Both Belsomra and Ambien are intended for short-term use. While effective for managing insomnia, prolonged use can lead to physical dependence, making it harder to sleep without them. To reduce the risk of rebound insomnia, we generally recommend limiting use to a few months at a time and tapering off gradually."
Dr. Henry Bradford, MD
Dr. Henry Bradford, MD
Medical provider at MEDvidi

Can You Take Belsomra and Ambien Together?

Ambien and Belsomra should not be taken together. Both medications work towards the same purpose by inducing sleep but in different ways. Combining the two medications can drastically increase sedation in turn causing dangerous adverse effects such as complex sleep behaviors, respiratory depression, severe next-day impairment, and others.

Switching Between Ambien and Belsomra

If you experience side effects and they are getting worse, or if the chosen treatment is not proving to be effective in improving your insomnia symptoms, you can discuss the transition to another medicine with your healthcare provider. 

When switching from Ambien to Belsomra or vice versa, it’s important to start taking the new medication only after the previous one is no longer in the system to avoid overlapping effects. This period may differ depending on the medication’s half-life and the dosage you’ve been taking. Some other health factors may also make it necessary to choose another treatment rather than Belsomra or Ambien. So, it’s important to discuss the details with your medical provider and follow their instructions.

Alternatives

Insomnia can be treated in many ways depending upon the severity of symptoms. Although Ambien and Belsomra are some of the common treatment options, there are alternatives for those who cannot take them for some reason. Some options include:
  • Other brand versions of zolpidem (Ambien’s active ingredient): Edluar[18] CloseTrusted SourceU.S. Food and Drug AdministrationThe organization safeguarding public health through the safety and security of drugs, food, biologics, medical devices, cosmetics, and other products.Go to source and Zolpimist[19] CloseTrusted SourceU.S. Food and Drug AdministrationThe organization safeguarding public health through the safety and security of drugs, food, biologics, medical devices, cosmetics, and other products.Go to source.
  • Other prescription medications for insomnia, such as:
    • Z drugs (hypnotics): Zaleplon (Sonata), Eszopiclone (Lunesta), etc.
    • Melatonin receptor agonist: Ramelton (Rozerem)
    • Benzodiazepines: Triazolam (Halcion), Temazepam (Restoril), etc.
    • Antihistamines: Hydroxyzine.
    • Antidepressants: Amitriptyline, Trazodone.
  • Over-the-counter (OTC) sleep aids, including antihistamines, magnesium, and melatonin supplements that help induce sleep.
Always consult with your healthcare provider before taking OTC supplements for sleep.

Non-Medication Alternatives

Cognitive-behavioral therapy (CBT[20] CloseTrusted SourcePubMed Central (PMC)PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM).Go to source) and CBT for insomnia (CBT-I[21] CloseTrusted SourcePubMed Central (PMC)PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM).Go to source) are the most common non-medication approaches to managing sleep issues. These kinds of therapies aid in identifying and altering negative behaviors on a deeper level to help improve sleep quality. 

Your healthcare provider may also suggest other measures to accompany talk therapy to add to its effectiveness, such as:

  • Regular exercising.
  • Reduced use of caffeine, alcohol, and other stimulants. 
  • Reduced screen time before bed.
  • Having a comfortable sleeping environment and a consistent sleeping routine. 

It is important to note that only a qualified healthcare professional can decide on the most suitable alternative for you based on your health, cause of insomnia, medical history, possibility of side effects, and risk factors.

How to Get Help for Insomnia

If you experience symptoms of chronic insomnia and its consequences, such as feeling tired throughout the day or memory difficulties, it’s important to seek help.

The first-line treatment for insomnia is cognitive-behavioral therapy[22] CloseTrusted SourcePubMed Central (PMC)PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM).Go to source. If there is no access to a therapist, or you don’t see a significant improvement, your healthcare provider may recommend a medication like Ambien, Belsomra, or another option. Medications can be chosen and prescribed only by a licensed healthcare provider, such as a PCP, a psychiatrist, a nurse practitioner, or a physician assistant after a detailed assessment.

At MEDvidi, you can have an online consultation for insomnia treatment. Our medical professionals can evaluate your symptoms, make a diagnosis, and prescribe medication online if deemed appropriate in your case.

Conclusion

There is no one simple answer to whether Belsomra or Ambien is better, since the decision is based on many clinical and individual factors. Depending on your symptoms, the duration and severity of insomnia, and the details of your health history, a healthcare provider may decide whether Belsomra can be more suitable for you compared to Ambien or if you might benefit from another treatment option. Book an appointment today to discuss different options, their pros and cons, and get a treatment plan tailored to your needs.

FAQs

Even though Belsomra and Ambien are both used in the management of sleep disorders, they are not the same. They differ in the active ingredient they contain, drug class, and the mechanism of action through which they induce sleep regulation.

Since these are different medications with slightly different mechanisms of improving sleep, there is no straight answer to defining which one is “stronger.” Belsomra enhances sleep maintenance throughout the night while Ambien, on the other hand, helps to deal with trouble falling asleep.

There is no direct link[23] CloseTrusted SourceHarvard Health PublishingA publisher committed to providing trustworthy, scientifically sound health information, including articles, blogs, and newsletters.Go to source between Ambien and weight loss or gain, and weight changes are not listed as side effects of Belsomra either. However, as individual responses vary, if you experience any weight changes don’t hesitate to discuss that with your healthcare professional.

Ambien and Belsomra are both categorized in FDA pregnancy category C, which indicates that any of these can be prescribed only when a healthcare practitioner deems it absolutely necessary such that the benefit outweighs the risk to the fetus. It is mostly advised to take safer alternatives during pregnancy.

No, it is strongly advised to not use Belsomra or Ambien with alcohol as it can cause serious adverse effects such as trouble with body movement, unusual sleep behaviors, excessive drowsiness, and addiction.

Lunesta (eszopiclone) is more similar to Ambien than Belsomra because it also belongs to the class of non-benzodiazepines under sedative-hypnotics. Lunesta is used for short-term treatment of insomnia by promoting the activity of GABA receptors in the brain hence regulating sleepiness.

Sources

hide
23 sources
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  2. Morin CM, Jarrin DC. Epidemiology of Insomnia: Prevalence, Course, Risk Factors, and Public Health Burden. Sleep Med Clin. 2022 Jun;17(2):173-191. doi: 10.1016/j.jsmc.2022.03.003. Epub 2022 Apr 23. PMID: 35659072.
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  3. HIGHLIGHTS of PRESCRIBING INFORMATION. BELSOMRA® (suvorexant) tablets
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  4. Rocha RB, Bomtempo FF, Nager GB, Cenci GI, Telles JPM. Dual orexin receptor antagonists for the treatment of insomnia: systematic review and network meta-analysis. Arq Neuropsiquiatr. 2023 May;81(5):475-483. doi: 10.1055/s-0043-1768667. Epub 2023 May 31. PMID: 37257468; PMCID: PMC10232020.
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  8. Edinoff AN, Wu N, Ghaffar YT, Prejean R, Gremillion R, Cogburn M, Chami AA, Kaye AM, Kaye AD. Zolpidem: Efficacy and Side Effects for Insomnia. Health Psychol Res. 2021 Jun 18;9(1):24927. doi: 10.52965/001c.24927. PMID: 34746488; PMCID: PMC8567759.
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  9. HIGHLIGHTS of PRESCRIBING INFORMATION. AMBIEN CR® (zolpidem tartrate extended-release) tablets
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  15. Kripke DF. Is suvorexant a better choice than alternative hypnotics? F1000Res. 2015 Aug 3;4:456. doi: 10.12688/f1000research.6845.1. PMID: 26594338; PMCID: PMC4648222.
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  16. Citrome L. Suvorexant for insomnia: a systematic review of the efficacy and safety profile for this newly approved hypnotic - what is the number needed to treat, number needed to harm and likelihood to be helped or harmed? Int J Clin Pract. 2014 Dec;68(12):1429-41. doi: 10.1111/ijcp.12568. Epub 2014 Sep 18. PMID: 25231363.
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Wafaa Amjad Dar
Written by:
Wafaa Amjad Dar
 Medical Writer
Dr. Henry Bradford
Medical Reviewer:
Dr. Henry Bradford
 MD
Share

Content

  1. What Is Belsomra?
  2. What Is Ambien?
  3. Ambien vs Belsomra: Differences
  4. Is Belsomra Similar to Ambien?
  5. Side Effects
  6. Belsomra vs. Ambien: Effectiveness
  7. What Is Safer, Ambien or Belsomra?
  8. Warnings and Precautions
  9. Can You Take Belsomra and Ambien Together?
  10. Switching Between Ambien and Belsomra
  11. Alternatives
  12. How to Get Help for Insomnia
  13. Conclusion
  14. FAQs

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