Ramelteon Alcohol, Food & Lifestyle Interactions

There are 3 food and lifestyle interactions with ramelteon which include:

MONITOR: Coadministration with inhibitors of CYP450 1A2 may increase the plasma concentrations and pharmacologic effects of ramelteon, which is primarily metabolized by the isoenzyme. In healthy volunteers, pretreatment with the potent CYP450 1A2 inhibitor fluvoxamine (100 mg orally twice daily for 4 days) increased the peak plasma concentration (Cmax) and systemic exposure (AUC) of ramelteon (16 mg single oral dose on day 4) by an average of 70- and 190-fold, respectively, compared to administration of ramelteon alone. Use with other, less potent CYP450 1A2 inhibitors has not been adequately studied.

MANAGEMENT: Caution is advised if ramelteon is prescribed with CYP450 1A2 inhibitors. A reduction in the ramelteon dosage may be necessary in patients who experience excessive sedation.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

ADJUST DOSING INTERVAL: Administration of ramelteon with or immediately after a high-fat/heavy meal may delay the onset of hypnotic effects. In study subjects, administration of a 16 mg dose of ramelteon with a high-fat meal decreased the peak plasma drug concentration (Cmax) by 22% and delayed the median time to reach peak plasma drug concentration (Tmax) by approximately 45 minutes compared to administration in a fasted state.

MANAGEMENT: For faster sleep onset, ramelteon should not be administered with or immediately after a high-fat/heavy meal.

You should also know about...

ramelteon drug Interactions

There are 139 drug interactions with ramelteon

See also...

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2009 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.