ramelteon

Generic Name: ramelteon (ram EL tee on)
Brand Names: Rozerem

What is ramelteon?

Ramelteon is a sedative, also called a hypnotic. It works by affecting certain substances in your body that help regulate your "sleep-wake cycle."

Ramelteon is used to treat insomnia that is associated with having trouble falling asleep.

Unlike some other sleep medications, ramelteon is not known to be habit-forming.

Ramelteon may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about ramelteon?

Do not use this medication if you are allergic to ramelteon, or if you have severe liver disease.

You should not take ramelteon if you are also taking the antidepressant fluvoxamine (Luvox).

Before taking ramelteon, tell your doctor if you have liver disease, sleep apnea, a breathing disorder such as chronic obstructive pulmonary disease, or a history of depression, mental illness, or suicidal thoughts.

Take ramelteon 30 minutes before your normal bedtime. After you take ramelteon, avoid doing anything other than getting ready for bed.

Avoid taking ramelteon together with or just after eating a high-fat meal. This will make it harder for your body to absorb the medication.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking ramelteon and talk with your doctor about another treatment for your sleep disorder.

What should I discuss with my healthcare provider before taking ramelteon?

Do not use this medication if you are allergic to ramelteon, or if you have severe liver disease.

You should not take ramelteon if you are also taking the antidepressant fluvoxamine (Luvox).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use ramelteon:

• liver disease;

• sleep apnea (breathing stops while you are asleep);

• a breathing disorder such as chronic obstructive pulmonary disease (COPD); or

• a history of depression, mental illness, or suicidal thoughts.

FDA pregnancy category C. It is not known whether ramelteon is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether ramelteon passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Ramelteon may affect the levels of male or female hormones (testosterone or prolactin). This may affect menstrual periods in women, sexual desire in men, or fertility (ability to have children) in either a man or a woman.

How should I take ramelteon?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass of water.

Take ramelteon 30 minutes before your normal bedtime. After you take ramelteon, avoid doing anything other than getting ready for bed.

Avoid taking ramelteon together with or just after eating a high-fat meal. This will make it harder for your body to absorb the medication.

Talk with your doctor if your insomnia does not improve after 7 days of using ramelteon. You may need to be checked for other medical illnesses that may cause insomnia.

Store ramelteon at room temperature away from moisture and heat.

What happens if I miss a dose?

Since ramelteon is usually taken as needed, you may not be on a dosing schedule. Ramelteon should be taken only within 30 minutes of your normal bedtime. Do not take extra medicine to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a ramelteon overdose are not known.

What should I avoid while taking ramelteon?

Ramelteon can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol while you are taking ramelteon. Alcohol may add to sleepiness caused by ramelteon.

Ramelteon side effects

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking ramelteon and talk with your doctor about another treatment for your sleep disorder. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking ramelteon and call your doctor at once if you have a serious side effect such as:

• unusual thoughts or behavior, hallucinations, worsening depression, thoughts about hurting yourself;

• a missed menstrual period;

• nipple discharge; or

• loss of interest in sex.

Less serious side effects may include:

• drowsiness;

• dizziness;

• headache; or

• nausea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ramelteon Dosing Information

Usual Adult Dose for Insomnia:

8 mg orally once a day, 30 minutes prior to bedtime, as needed for insomnia.

Usual Geriatric Dose for Insomnia:

8 mg orally once a day, 30 minutes prior to bedtime, as needed for insomnia.

What other drugs will affect ramelteon?

Before taking ramelteon, tell your doctor if you are taking any of the following drugs:

• methoxsalen (Oxsoralen);

• primaquine o thabendazole (Mintezol);

• rifampin (Rifadin, Rifater, Rifamate, Rimactane);

• an antibiotic such as ciprofloxacin (Cipro), norfloxacin (Noroxin), or ofloxacin (Floxin);

• heart rhythm medication such as amiodarone (Cordarone, Pacerone) or mexiletine (Mexitil); or

• an antifungal medication such as fluconazole (Diflucan) or ketoconazole (Nizoral).

This list is not complete and there may be other drugs that can interact with ramelteon. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about ramelteon.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information 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.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.01. Revision Date: 10/09/2009 3:08:13 PM.