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Drug Interactions between Dvorah and ramelteon

This report displays the potential drug interactions for the following 2 drugs:

  • Dvorah (acetaminophen/caffeine/dihydrocodeine)
  • ramelteon

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Interactions between your drugs

Major

dihydrocodeine ramelteon

Applies to: Dvorah (acetaminophen / caffeine / dihydrocodeine) and ramelteon

Using narcotic pain or cough medications together with other medications that also cause central nervous system depression can lead to serious side effects including respiratory distress, coma, and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, because these medications may cause dizziness, drowsiness, difficulty concentrating, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

caffeine ramelteon

Applies to: Dvorah (acetaminophen / caffeine / dihydrocodeine) and ramelteon

Caffeine may increase the blood levels of ramelteon in some patients. This can increase the risk of side effects including daytime drowsiness, motor impairment, amnesia, anxiety, abnormal thinking, hallucinations, behavioral changes, and breathing difficulties (especially if you have a respiratory disorder such as asthma or obstructive sleep apnea). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Avoid driving or operating hazardous machinery until you know how these medications affect you, and do not exceed the dosage or frequency of use of ramelteon prescribed by your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

ramelteon food

Applies to: ramelteon

Taking ramelteon with a high-fat or heavy meal may delay the onset of sleep. For faster sleep onset, ramelteon should not be administered with or immediately after a high-fat or heavy meal. This will make it easier for your body to absorb the medication. Do not drink alcohol while you are taking ramelteon. It can increase some of the side effects including dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

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Minor

caffeine food

Applies to: Dvorah (acetaminophen / caffeine / dihydrocodeine)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

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.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.