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Drug Interactions between ramelteon and viloxazine

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

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Interactions between your drugs

Major

ramelteon viloxazine

Applies to: ramelteon and viloxazine

CONTRAINDICATED: Coadministration of viloxazine, a potent inhibitor of CYP450 1A2, may significantly increase the risk of adverse reactions to sensitive CYP450 1A2 substrates or CYP450 1A2 substrates with a narrow therapeutic range. According to the prescribing information, viloxazine increased the systemic exposure (AUC) of caffeine, a probe CYP450 1A2 substrate, by nearly 6-fold without affecting its peak plasma concentration (Cmax).

MANAGEMENT: Concomitant use of viloxazine with sensitive CYP450 1A2 substrates or CYP450 1A2 substrates with a narrow therapeutic range such as alosetron, duloxetine, ramelteon, tasimelteon, tizanidine, or theophylline is contraindicated.

References (1)
  1. (2021) "Product Information. Qelbree (viloxazine)." Supernus Pharmaceuticals Inc

Drug and food interactions

Moderate

ramelteon food

Applies to: ramelteon

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

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: Patients receiving ramelteon should be advised to avoid the consumption of alcohol. For faster sleep onset, ramelteon should not be administered with or immediately after a high-fat/heavy meal.

References (1)
  1. (2005) "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America

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.

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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.

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