Ramelteon interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of ramelteon. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving ramelteon should be advised to avoid the consumption of alcohol. For faster sleep onset, ramelteon should not be administered with or immediately after a high-fat/heavy meal.

  1 source

  1. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):

Conditions

Conditions in which Ramelteon needs care, as documented in this source.

• Depressive Disorder

  Major

  A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

  14 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  4. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  5. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  6. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  8. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):

  Show all 14 sourcesShow fewer sources

  9. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):
  10. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  11. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  12. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):
  13. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  14. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Kidney Failure, Chronic

  Major

  Some anxiolytic, sedative and hypnotic drugs have not been studied in patients with severe renal impairment and should not be used on these patients.

  5 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  3. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  4. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  5. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Sleep Apnea Syndromes

  Major

  The use of ramelteon could exacerbate symptoms of sleep apnea, and has not been studied in patients with severe sleep apnea. Ramelteon is not recommended in patients with severe sleep apnea.

  1 source

  1. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):

• Glaucoma

  Moderate

  Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

  2 sources

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  2. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):

• Liver Diseases

  Moderate

  In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

  13 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  3. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  4. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  5. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  6. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  7. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):
  8. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  10. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  11. "Product Information. Intermezzo (zolpidem)." Purdue Pharma LP (2011):
  12. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  13. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

Therapeutic duplication

Drug classes that overlap with Ramelteon, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• hypnotics

  The recommended maximum number of medicines in the 'hypnotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'hypnotics' category.

  Example product in the source data (US market): Xywav