Quantity limit guidelines have been established to ensure safe and effective utilization of non-benzodiazepine, non-barbiturate sedative-hypnotics for HMSA's formulary for its private business plans.
| Drug | Maximum recommended daily dose* | Dosage Form | Quantity limit per day |
|---|---|---|---|
|
Zolpidem (Ambien)
|
10 mg
|
5 mg | 2 |
| 10 mg | 1 | ||
|
Zolpidem extended release (Ambien CR)
|
12.5 mg
|
6.25 mg | 2 |
| 12.5 mg | 1 | ||
|
Zalephon (Sonata)
|
20 mg
|
5 mg | 4 |
| 10 mg | 2 | ||
|
Exzopiclone (Lunesta)
|
3 mg
|
1 mg | 3 |
| 2 mg | 1.5 | ||
| 3 mg | 1 |
*Reference: Ambien PI (5/7/08), Ambien CR PI (12/20/07), Lunesta PI (1/29/08), Sonata PI (12/11/07)
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |