Drug Interaction Report

Nalidixic acid 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.

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.

Nalidixic acid and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of nalidixic acid into the bloodstream and reduce its effectiveness. If possible, it may be best to avoid taking multivitamin with minerals while your are being treated with nalidixic acid. Otherwise, you should take nalidixic acid either 2 hours before or 2 hours after the multivitamin with minerals dose. Talk to a healthcare professional if you are not sure whether a product contains something that could potentially interact with your medication or if you have questions on how to take this or other medications you are prescribed. 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.

Using caffeine together with nalidixic acid may increase the effects of caffeine. Contact your doctor if you experience headache, tremor, restlessness, nervousness, insomnia, and increased blood pressure or heart rate. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. 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.