Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 1A2 may increase the plasma concentrations and pharmacologic effects of ramelteon, which is primarily metabolized by the isoenzyme. In healthy volunteers, administration of a single 16 mg dose of ramelteon following pretreatment with the potent CYP450 1A2 inhibitor fluvoxamine (100 mg orally twice daily for 3 days) resulted in a 70-fold increase in ramelteon peak plasma concentration (Cmax) and a 190-fold increase in systemic exposure (AUC) compared to administration of ramelteon alone. However, fluvoxamine is known to also inhibit CYP450 2C9 and 3A4, both of which contribute significantly to the metabolism of ramelteon. Concomitant administration of ramelteon with less potent CYP450 1A2 inhibitors has not been evaluated.

MANAGEMENT: Caution is advised when ramelteon is used with CYP450 1A2 inhibitors. A reduction in the ramelteon dosage may be necessary in patients who experience excessive sedation or other adverse effects.

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.