Drug Interactions between Grastek and melatonin
This report displays the potential drug interactions for the following 2 drugs:
- Grastek (timothy grass pollen allergen extract)
- melatonin
Interactions between your drugs
No interactions were found between Grastek and melatonin. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Grastek
A total of 139 drugs are known to interact with Grastek.
- Grastek is in the drug class allergenics.
- Grastek is used to treat Allergic Rhinitis.
melatonin
A total of 315 drugs are known to interact with melatonin.
- Melatonin is in the following drug classes: minerals and electrolytes, miscellaneous anxiolytics, sedatives and hypnotics, nutraceutical products.
- Melatonin is used to treat the following conditions:
Drug and food interactions
melatonin food
Applies to: melatonin
MONITOR: Oral caffeine may significantly increase the bioavailability of melatonin. The proposed mechanism is inhibition of CYP450 1A2 first-pass metabolism. After administration of melatonin 6 mg and caffeine 200 mg orally (approximately equivalent to 1 large cup of coffee) to 12 healthy subjects, the mean peak plasma concentration (Cmax) of melatonin increased by 137% and the area under the concentration-time curve (AUC) increased by 120%. The metabolic inhibition was greater in nonsmokers (n=6) than in smokers (n=6). The greatest effect was seen in subjects with the *1F/*1F genotype (n=7), whose melatonin Cmax increased by 202%. The half-life did not change significantly. The clinical significance of this interaction is unknown.
According to some authorities, alcohol may reduce the effect of melatonin on sleep. The mechanism of this interaction is not fully understood.
In addition, CYP450 1A2 inducers like cigarette smoking may reduce exogenous melatonin plasma levels. In a small clinical trial (n=8), habitual smokers had their melatonin plasma levels measured two times, each after a single oral dose of 25 mg of melatonin. They had smoked prior to the first measurement but had not smoked for 7 days prior to the second. Cigarette smoking significantly reduced melatonin plasma exposure (AUC) as compared to melatonin levels after 7 days of smoking abstinence (7.34 +/- 1.85 versus 21.07 +/- 7.28 nmol/L*h, respectively).
MANAGEMENT: Caution and monitoring are recommended if melatonin is used with inhibitors of CYP450 1A2 like caffeine or inducers of CYP450 1A2 like cigarette smoking. Consumption of alcohol should be avoided when taking melatonin.
References
- Hartter S, Nordmark A, Rose DM, Bertilsson L, Tybring G, Laine K (2003) "Effects of caffeine intake on the pharmacokinetics of melatonin, a probe drug for CYP1A2 activity." Br J Clin Pharmacol, 56, p. 679-682
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Ursing C, Bahr CV, Brismar K, Rojdmark S (2005) "Influence of cigarette smoking on melatonin levels in man" Eur J Clin Pharmacol, 61, p. 197-201
timothy grass pollen allergen extract food
Applies to: Grastek (timothy grass pollen allergen extract)
ADJUST DOSING INTERVAL: Since sublingual preparations of allergenic extracts are meant to be absorbed directly from tissues under the tongue into the blood stream, consuming food or beverage during or immediately after administration may reduce the systemic bioavailability of the medication.
MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. A causal relationship with all allergenic extracts has not been established.
MANAGEMENT: Food or beverage should not be taken with, or for at least 5 minutes after, the administration of sublingual allergenic extracts. Patients should also avoid swallowing for about 1 minute following placement of the allergen extract under the tongue. Caution is advised if allergenic extracts for immunotherapy are used concomitantly with alcohol. Some manufacturers of peanut allergen extract recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract and if alcohol use cannot be avoided, that withholding or decreasing peanut allergen dosage should be considered. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.
References
- (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
- (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
- (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
- Cerner Multum, Inc. (2015) "Canadian Product Information."
- (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
- (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
- Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
- (2023) "Product Information. Odactra (house dust mite allergen extract)." ALK-Abello Inc
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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