Drug Interaction Report

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 1A2 may significantly increase the plasma concentrations of melatonin. Data from available studies suggest that melatonin is primarily metabolized by CYP450 1A2, with possible contribution from CYP450 2C19 and 2C9. Coadministration of fluvoxamine, a potent CYP450 1A2 inhibitor that also inhibits CYP450 2C19 and 2C9, increased melatonin systemic exposure (AUC) by 17-fold and maximum plasma concentration (Cmax) by 12-fold.

MANAGEMENT: Concomitant use of melatonin with potent CYP450 1A2 inhibitors should be avoided.

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.

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The oral bioavailability of quinolone and tetracycline antibiotics may be reduced by concurrent administration of preparations containing polyvalent cations such as aluminum, calcium, iron, magnesium, and zinc. Therapeutic failure may result. The proposed mechanism is chelation of quinolone and tetracycline antibiotics by di- and trivalent cations, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. Reduced gastrointestinal absorption of the cations should also be considered.

MANAGEMENT: Concomitant administration of oral quinolone and tetracycline antibiotics with preparations containing aluminum, calcium, iron, magnesium, and/or zinc salts should generally be avoided. Otherwise, the times of administration should be staggered by as much as possible to minimize the potential for interaction. Quinolones should typically be dosed either 2 to 4 hours before or 4 to 6 hours after polyvalent cation preparations, depending on the quinolone and formulation. Likewise, tetracyclines and polyvalent cation preparations should typically be administered 2 to 4 hours apart. The prescribing information for the antibiotic should be consulted for more specific dosing recommendations.

Using caffeine together with enoxacin 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.