However, even with a much higher LOQ of 50 ng/mL for ZCA in this work, the positivity from ZCA results is significantly higher (e.g., 64.8%) than reported earlier (50.3%). Estimates of patient positivity are dependent upon the value of the limit of quantification (LOQ) as demonstrated by the zolpidem results herein (LOQ = 50 ng/mL vs. Further, while the Food and Drug Administration has pointed out that female dosing should be half that given to males, results of this population testing indicate that the majority of patients (83% male and 73% female) receive 10 mg/day or 12.5 mg/day for Ambien CR® with females demonstrating statistically significantly higher levels of ZCA albeit zolpidem levels are not statistically significantly different between men and women. These data suggest that monitoring ZCA may result in even higher levels of positivity. However, the data observed herein for ZCA are not consistent with the earlier report. Results from patient testing over a year’s time are in agreement with the reported zolpidem results. Journal of Analytical Toxicology, 38, 513–518 reported that zolpidem in urine is not very prevalent being present <23% of the time in patient urine while the major metabolite, zolpidem 4-phenyl carboxylic acid (ZCA), is much more prevalent in urine with positive rates as high as 50% of the patient samples reviewed. (2014) Determing zolpidem compliance: urinary metabolite detection and prevalence in chronic pain patients. Schwope, D.M., DePriest, A., Black, D.L., Caplan, Y.H., Cone, E.J., Heltsley, R. Zolpidem (Ambien®) is one of the “Z” drugs often used to improve sleep in older patients and those suffering from insomnia.
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