Can You Take Melatonin with Vitamin B12?

Both smoking and excessive caffeine consumption can alter the blood levels of melatonin, which may affect the dosing. Tobacco smoking reduces, while caffeine increases melatonin blood levels. If you start smoking or undergo smoking cessation, your doctor may need to adjust the dose of melatonin. In addition, alcohol may reduce the effect of melatonin on sleep. It is best to avoid alcohol consumption during melatonin therapy. Talk to a healthcare professional if you have any questions or concerns. 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.

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.

Hypokalemia (resulting in death) has occurred during vitamin B12 therapy as a result of increased red blood cell requirements during hematopoiesis. Clinical monitoring and correction of potassium levels prior to and during vitamin B12 therapy is necessary.

The use of cyanocobalamin is contraindicated in patients with Leber's disease (hereditary optic nerve atrophy). Cyanocobalamin has induced severe and rapid optic nerve atrophy in patient's with early Leber's disease.

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.

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.

Absorption of vitamin B12 is decreased in malabsorption syndromes and in pernicious anemia without coadministration of intrinsic factor (IF). Cyanocobalamin is rapidly absorbed following IM or subcutaneous injections. Hydroxocobalamin (cyanocobalamin analog) functions the same a cyanocobalamin, but has induced antibody formation to the hydroxocobalamin-transcobalamin II complex. The use of cyanocobalamin may be preferred in patients with these conditions.

Cyanocobalamin products contain aluminum that may be toxic and may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and other solutions which also contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum greater than 4-5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Caution and monitoring are recommended.

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.