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      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
      Drugs & Diseases

      Melatonin (Herb/Suppl)

      Brand and Other Names:N-acetyl-5-methoxytryptamine, pineal hormone melatonin
      • Print

      Suggested Dosing

      Benzodiazepine Withdrawal in Elderly with Insomnia

      2 mg controlled-release PO qHS for up to 6 months; taper dose over 6 weeks

      Cancer, Adjunctive Therapy

      10-50 mg PO daily

      Cluster Headache, Prevention

      10 mg PO qHS

      Migraine Headache

      3 mg PO HS

      Insomnia

      3-5 mg PO qHS

      Difficulty falling asleep

      • 5 mg PO 3-4 hour before sleep period x 4 weeks

      Difficulty maintaining sleep

      • Use controlled release formulation

      Thrombocytopenia, Chemo-related

      20 mg PO qHS

      Jet Lag

      0.5-5 mg PO HS

      Eastbound

      • Preflight, early evening dose followed by HS dosing x 4days

      Westbound

      • Treat HS x 4days when in new time zone

      Chronic Fatique Syndrome

      5 mg PO HS

      Nicotine Withdrawal

      0.3 mg PO 3.5 hours after stopping smoking

      Winter Depression

      0.125 mg PO twice daily

      Premedication for Surgery

      0.5 mg/kg SL

      Tardive Dyskinesia

      10 mg controlled-release PO qDay

      Sleep Disorders (Orphan)

      Orphan designation for treatment of circadian rhythm sleep disorders in blind people without light perception

      Orphan sponsors

      • Neurim Pharmaceuticals, Ltd; 8 Hanechoshet St; Tel-Aviv, Israel
      • Sack, Robert, M.D.; Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road; Portland, OR 97201

      Encephalopathy (Orphan)

      Orphan designation for treatment of neonatal hypoxic ischemic encephalopathy

      Orphan sponsor

      • Scharper S.p.A.; Viale Ortles 12; Milan 20139, Italy

      Smith-Magenis Syndrome (Orphan)

      Orphan designation for treatment of Smith-Magenis syndrome in combination with a beta-blocker

      Orphan sponsor

      • Therapicon SrL; 21 Via Malachia Marchesi de Taddei; Milano, Italy

      Acetaminophen Overdose (Orphan)

      Orphan designation for treatment of acute acetaminophen overdose

      Orphan sponsor

      • Therapicon SrL; 21 Via Malachia Marchesi de Taddei; Milano, Italy

      Short Bowel Syndrome (Orphan)

      Orphan designation for treatment of short bowel syndrome

      Orphan sponsor

      • Therapicon SrL; 21 Via Malachia Marchesi de Taddei; Milano, Italy

      Necrotizing Enterocolitis (Orphan)

      Orphan designation for treatment of necrotizing enterocolitis

      Orphan sponsor

      • Therapicon SrL; 21 Via Malachia Marchesi de Taddei; Milano, Italy

      Acute Radiation Syndrome (Orphan)

      Orphan designation for treatment of acute radiation syndrome

      Orphan sponsor

      • WORPHMED Srl; Via Malachia Marchesi de Taddei, 21; Milan, Italy

      Hepatocellular Carcinoma (Orphan)

      Orphan designation for treatment of hepatocellular carcinoma

      Orphan sponsor

      • Worphmed Srl; Via Malachia Marchesi de Taddei, 21; Milan, Italy

      Heat Stroke (Orphan)

      Orphan designation for treatment of heat stroke

      Orphan sponsor

      • Worphmed Srl; Via Malachia Marchesi de Taddei, 21; Milan, Italy

      Pancreatic Cancer (Orphan)

      Orphan designation for treatment of pancreatic cancer

      Sponsor

      • WORPHMED Srl; Via Malachia Marchesi de Taddei, 21; Milan, Italy
      Next:

      Suggested Uses

      Alzheimer's disease, benzodiazepine or nicotine withdrawal, cancer (adjunctive treatment), headache (prevention), insomnia, jet lag, shift-work disorder, sleep disorders, thrombocytopenia (chemo-induced), winter depression, tardive dyskinesia

      Efficacy

      Circadian rhythm sleep disorders: FDA orphan drug status

      Insomnia: Helpful for sleep-wake cycle disorders

      Research is continuing

      Previous
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      Interactions

      Interaction Checker

      and Melatonin

      No Results

         activity indicator 
        No Interactions Found
        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

              Minor

                All Interactions Sort By:
                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (4)

                  • abametapir

                    abametapir will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.

                  • calcium/magnesium/potassium/sodium oxybates

                    melatonin, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • givosiran

                    givosiran will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.

                  • sodium oxybate

                    melatonin, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  Monitor Closely (206)

                  • abciximab

                    melatonin increases effects of abciximab by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • albuterol

                    melatonin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • alfentanil

                    alfentanil and melatonin both increase sedation. Use Caution/Monitor.

                  • alprazolam

                    alprazolam and melatonin both increase sedation. Use Caution/Monitor.

                  • alteplase

                    melatonin increases effects of alteplase by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • amitriptyline

                    amitriptyline and melatonin both increase sedation. Use Caution/Monitor.

                  • amobarbital

                    amobarbital and melatonin both increase sedation. Use Caution/Monitor.

                  • amoxapine

                    amoxapine and melatonin both increase sedation. Use Caution/Monitor.

                  • anagrelide

                    melatonin increases effects of anagrelide by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • antithrombin III

                    melatonin increases effects of antithrombin III by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • apixaban

                    melatonin increases effects of apixaban by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • apomorphine

                    apomorphine and melatonin both increase sedation. Use Caution/Monitor.

                  • arformoterol

                    melatonin increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • argatroban

                    melatonin increases effects of argatroban by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • aripiprazole

                    aripiprazole and melatonin both increase sedation. Use Caution/Monitor.

                  • armodafinil

                    melatonin increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • aspirin

                    melatonin increases effects of aspirin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • azelastine

                    azelastine and melatonin both increase sedation. Use Caution/Monitor.

                  • baclofen

                    baclofen and melatonin both increase sedation. Use Caution/Monitor.

                  • belladonna and opium

                    belladonna and opium and melatonin both increase sedation. Use Caution/Monitor.

                  • benperidol

                    benperidol and melatonin both increase sedation. Use Caution/Monitor.

                  • benzphetamine

                    melatonin increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • bivalirudin

                    melatonin increases effects of bivalirudin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • brompheniramine

                    brompheniramine and melatonin both increase sedation. Use Caution/Monitor.

                  • buprenorphine

                    buprenorphine and melatonin both increase sedation. Use Caution/Monitor.

                  • buprenorphine buccal

                    buprenorphine buccal and melatonin both increase sedation. Use Caution/Monitor.

                  • butabarbital

                    butabarbital and melatonin both increase sedation. Use Caution/Monitor.

                  • butalbital

                    butalbital and melatonin both increase sedation. Use Caution/Monitor.

                  • butorphanol

                    butorphanol and melatonin both increase sedation. Use Caution/Monitor.

                  • caffeine

                    melatonin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • carbinoxamine

                    carbinoxamine and melatonin both increase sedation. Use Caution/Monitor.

                  • carisoprodol

                    carisoprodol and melatonin both increase sedation. Use Caution/Monitor.

                  • chloral hydrate

                    chloral hydrate and melatonin both increase sedation. Use Caution/Monitor.

                  • chlordiazepoxide

                    chlordiazepoxide and melatonin both increase sedation. Use Caution/Monitor.

                  • chlorpheniramine

                    chlorpheniramine and melatonin both increase sedation. Use Caution/Monitor.

                  • chlorpromazine

                    chlorpromazine and melatonin both increase sedation. Use Caution/Monitor.

                  • chlorzoxazone

                    chlorzoxazone and melatonin both increase sedation. Use Caution/Monitor.

                  • cilostazol

                    melatonin increases effects of cilostazol by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • cinnarizine

                    cinnarizine and melatonin both increase sedation. Use Caution/Monitor.

                  • clemastine

                    clemastine and melatonin both increase sedation. Use Caution/Monitor.

                  • clomipramine

                    clomipramine and melatonin both increase sedation. Use Caution/Monitor.

                  • clonazepam

                    clonazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • clopidogrel

                    melatonin increases effects of clopidogrel by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • clorazepate

                    clorazepate and melatonin both increase sedation. Use Caution/Monitor.

                  • clozapine

                    clozapine and melatonin both increase sedation. Use Caution/Monitor.

                  • codeine

                    codeine and melatonin both increase sedation. Use Caution/Monitor.

                  • cyclizine

                    cyclizine and melatonin both increase sedation. Use Caution/Monitor.

                  • cyclobenzaprine

                    cyclobenzaprine and melatonin both increase sedation. Use Caution/Monitor.

                  • cyproheptadine

                    cyproheptadine and melatonin both increase sedation. Use Caution/Monitor.

                  • dabigatran

                    melatonin increases effects of dabigatran by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • dalteparin

                    melatonin increases effects of dalteparin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • dantrolene

                    dantrolene and melatonin both increase sedation. Use Caution/Monitor.

                  • desipramine

                    desipramine and melatonin both increase sedation. Use Caution/Monitor.

                  • desirudin

                    melatonin increases effects of desirudin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • dexchlorpheniramine

                    dexchlorpheniramine and melatonin both increase sedation. Use Caution/Monitor.

                  • dexfenfluramine

                    melatonin increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dexmedetomidine

                    dexmedetomidine and melatonin both increase sedation. Use Caution/Monitor.

                  • dexmethylphenidate

                    melatonin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dextroamphetamine

                    melatonin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dextromoramide

                    dextromoramide and melatonin both increase sedation. Use Caution/Monitor.

                  • diamorphine

                    diamorphine and melatonin both increase sedation. Use Caution/Monitor.

                  • diazepam

                    diazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • diclofenac

                    melatonin increases effects of diclofenac by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • diethylpropion

                    melatonin increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • difenoxin hcl

                    difenoxin hcl and melatonin both increase sedation. Use Caution/Monitor.

                  • diflunisal

                    melatonin increases effects of diflunisal by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • dimenhydrinate

                    dimenhydrinate and melatonin both increase sedation. Use Caution/Monitor.

                  • diphenhydramine

                    diphenhydramine and melatonin both increase sedation. Use Caution/Monitor.

                  • diphenoxylate hcl

                    diphenoxylate hcl and melatonin both increase sedation. Use Caution/Monitor.

                  • dipipanone

                    dipipanone and melatonin both increase sedation. Use Caution/Monitor.

                  • dipyridamole

                    melatonin increases effects of dipyridamole by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • dobutamine

                    melatonin increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dopamine

                    melatonin increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dopexamine

                    melatonin increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • doxepin

                    doxepin and melatonin both increase sedation. Use Caution/Monitor.

                  • doxylamine

                    doxylamine and melatonin both increase sedation. Use Caution/Monitor.

                  • droperidol

                    droperidol and melatonin both increase sedation. Use Caution/Monitor.

                  • enoxaparin

                    melatonin increases effects of enoxaparin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • ephedrine

                    melatonin increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • epinephrine

                    melatonin increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • epinephrine racemic

                    melatonin increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • eptifibatide

                    melatonin increases effects of eptifibatide by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • estazolam

                    estazolam and melatonin both increase sedation. Use Caution/Monitor.

                  • ethanol

                    ethanol and melatonin both increase sedation. Use Caution/Monitor.

                  • etodolac

                    melatonin increases effects of etodolac by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • fenfluramine

                    melatonin increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • fenoprofen

                    melatonin increases effects of fenoprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • fexinidazole

                    fexinidazole will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

                  • fluphenazine

                    fluphenazine and melatonin both increase sedation. Use Caution/Monitor.

                  • flurazepam

                    flurazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • flurbiprofen

                    melatonin increases effects of flurbiprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • fondaparinux

                    melatonin increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • formoterol

                    melatonin increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • haloperidol

                    haloperidol and melatonin both increase sedation. Use Caution/Monitor.

                  • heparin

                    melatonin increases effects of heparin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • hydromorphone

                    hydromorphone and melatonin both increase sedation. Use Caution/Monitor.

                  • hydroxyzine

                    hydroxyzine and melatonin both increase sedation. Use Caution/Monitor.

                  • ibuprofen

                    melatonin increases effects of ibuprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • ibuprofen IV

                    melatonin increases effects of ibuprofen IV by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • iloperidone

                    iloperidone and melatonin both increase sedation. Use Caution/Monitor.

                  • imipramine

                    imipramine and melatonin both increase sedation. Use Caution/Monitor.

                  • indomethacin

                    melatonin increases effects of indomethacin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • isoproterenol

                    melatonin increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • ketamine

                    ketamine and melatonin both increase sedation. Use Caution/Monitor.

                  • ketoprofen

                    melatonin increases effects of ketoprofen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • ketorolac

                    melatonin increases effects of ketorolac by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • ketotifen, ophthalmic

                    ketotifen, ophthalmic and melatonin both increase sedation. Use Caution/Monitor.

                  • levalbuterol

                    melatonin increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • levorphanol

                    levorphanol and melatonin both increase sedation. Use Caution/Monitor.

                  • lisdexamfetamine

                    melatonin increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • lofepramine

                    lofepramine and melatonin both increase sedation. Use Caution/Monitor.

                  • lofexidine

                    lofexidine and melatonin both increase sedation. Use Caution/Monitor.

                  • loprazolam

                    loprazolam and melatonin both increase sedation. Use Caution/Monitor.

                  • lorazepam

                    lorazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • lormetazepam

                    lormetazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • loxapine

                    loxapine and melatonin both increase sedation. Use Caution/Monitor.

                  • loxapine inhaled

                    loxapine inhaled and melatonin both increase sedation. Use Caution/Monitor.

                  • maprotiline

                    maprotiline and melatonin both increase sedation. Use Caution/Monitor.

                  • marijuana

                    marijuana and melatonin both increase sedation. Use Caution/Monitor.

                  • meclofenamate

                    melatonin increases effects of meclofenamate by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • mefenamic acid

                    melatonin increases effects of mefenamic acid by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • meperidine

                    meperidine and melatonin both increase sedation. Use Caution/Monitor.

                  • meprobamate

                    melatonin and meprobamate both increase sedation. Use Caution/Monitor.

                  • metaproterenol

                    melatonin increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • metaxalone

                    metaxalone and melatonin both increase sedation. Use Caution/Monitor.

                  • methadone

                    methadone and melatonin both increase sedation. Use Caution/Monitor.

                  • methamphetamine

                    melatonin increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • methocarbamol

                    methocarbamol and melatonin both increase sedation. Use Caution/Monitor.

                  • methylenedioxymethamphetamine

                    melatonin increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • midazolam

                    midazolam and melatonin both increase sedation. Use Caution/Monitor.

                  • midodrine

                    melatonin increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • mirtazapine

                    melatonin and mirtazapine both increase sedation. Use Caution/Monitor.

                  • modafinil

                    melatonin increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • morphine

                    morphine and melatonin both increase sedation. Use Caution/Monitor.

                  • motherwort

                    melatonin and motherwort both increase sedation. Use Caution/Monitor.

                  • moxonidine

                    melatonin and moxonidine both increase sedation. Use Caution/Monitor.

                  • nabilone

                    melatonin and nabilone both increase sedation. Use Caution/Monitor.

                  • nabumetone

                    melatonin increases effects of nabumetone by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • nalbuphine

                    nalbuphine and melatonin both increase sedation. Use Caution/Monitor.

                  • naproxen

                    melatonin increases effects of naproxen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • nifedipine

                    melatonin decreases effects of nifedipine by pharmacodynamic antagonism. Use Caution/Monitor.

                  • norepinephrine

                    melatonin increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • nortriptyline

                    nortriptyline and melatonin both increase sedation. Use Caution/Monitor.

                  • olanzapine

                    olanzapine and melatonin both increase sedation. Use Caution/Monitor.

                  • opium tincture

                    opium tincture and melatonin both increase sedation. Use Caution/Monitor.

                  • orphenadrine

                    orphenadrine and melatonin both increase sedation. Use Caution/Monitor.

                  • oxaprozin

                    melatonin increases effects of oxaprozin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • oxazepam

                    oxazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • oxycodone

                    oxycodone and melatonin both increase sedation. Use Caution/Monitor.

                  • oxymorphone

                    oxymorphone and melatonin both increase sedation. Use Caution/Monitor.

                  • paliperidone

                    paliperidone and melatonin both increase sedation. Use Caution/Monitor.

                  • papaveretum

                    papaveretum and melatonin both increase sedation. Use Caution/Monitor.

                  • pentazocine

                    pentazocine and melatonin both increase sedation. Use Caution/Monitor.

                  • pentobarbital

                    pentobarbital and melatonin both increase sedation. Use Caution/Monitor.

                  • perphenazine

                    perphenazine and melatonin both increase sedation. Use Caution/Monitor.

                  • phendimetrazine

                    melatonin increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • phenobarbital

                    phenobarbital and melatonin both increase sedation. Use Caution/Monitor.

                  • phentermine

                    melatonin increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • phenylephrine

                    melatonin increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • phenylephrine PO

                    melatonin increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                  • pholcodine

                    melatonin and pholcodine both increase sedation. Use Caution/Monitor.

                  • pimozide

                    pimozide and melatonin both increase sedation. Use Caution/Monitor.

                  • pirbuterol

                    melatonin increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • piroxicam

                    melatonin increases effects of piroxicam by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • prasugrel

                    melatonin increases effects of prasugrel by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • primidone

                    primidone and melatonin both increase sedation. Use Caution/Monitor.

                  • prochlorperazine

                    prochlorperazine and melatonin both increase sedation. Use Caution/Monitor.

                  • promethazine

                    promethazine and melatonin both increase sedation. Use Caution/Monitor.

                  • propylhexedrine

                    melatonin increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • protein C concentrate

                    melatonin increases effects of protein C concentrate by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • protriptyline

                    protriptyline and melatonin both increase sedation. Use Caution/Monitor.

                  • quazepam

                    quazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • quetiapine

                    quetiapine and melatonin both increase sedation. Use Caution/Monitor.

                  • ramelteon

                    melatonin and ramelteon both increase sedation. Use Caution/Monitor.

                  • reteplase

                    melatonin increases effects of reteplase by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • risperidone

                    risperidone and melatonin both increase sedation. Use Caution/Monitor.

                  • rivaroxaban

                    melatonin increases effects of rivaroxaban by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • rucaparib

                    rucaparib will increase the level or effect of melatonin by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

                  • salmeterol

                    melatonin increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • scullcap

                    melatonin and scullcap both increase sedation. Use Caution/Monitor.

                  • secobarbital

                    secobarbital and melatonin both increase sedation. Use Caution/Monitor.

                  • shepherd's purse

                    melatonin and shepherd's purse both increase sedation. Use Caution/Monitor.

                  • stiripentol

                    stiripentol, melatonin. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.

                  • sufentanil

                    sufentanil and melatonin both increase sedation. Use Caution/Monitor.

                  • sulindac

                    melatonin increases effects of sulindac by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • tapentadol

                    tapentadol and melatonin both increase sedation. Use Caution/Monitor.

                  • temazepam

                    temazepam and melatonin both increase sedation. Use Caution/Monitor.

                  • tenecteplase

                    melatonin increases effects of tenecteplase by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • terbutaline

                    melatonin increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • thioridazine

                    thioridazine and melatonin both increase sedation. Use Caution/Monitor.

                  • thiothixene

                    thiothixene and melatonin both increase sedation. Use Caution/Monitor.

                  • ticlopidine

                    melatonin increases effects of ticlopidine by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • tirofiban

                    melatonin increases effects of tirofiban by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • tolmetin

                    melatonin increases effects of tolmetin by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.

                  • topiramate

                    melatonin and topiramate both increase sedation. Modify Therapy/Monitor Closely.

                  • tramadol

                    tramadol and melatonin both increase sedation. Use Caution/Monitor.

                  • trazodone

                    trazodone and melatonin both increase sedation. Use Caution/Monitor.

                  • triazolam

                    triazolam and melatonin both increase sedation. Use Caution/Monitor.

                  • triclofos

                    triclofos and melatonin both increase sedation. Use Caution/Monitor.

                  • trifluoperazine

                    trifluoperazine and melatonin both increase sedation. Use Caution/Monitor.

                  • trimipramine

                    trimipramine and melatonin both increase sedation. Use Caution/Monitor.

                  • triprolidine

                    triprolidine and melatonin both increase sedation. Use Caution/Monitor.

                  • xylometazoline

                    melatonin increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • yohimbine

                    melatonin increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • ziconotide

                    melatonin and ziconotide both increase sedation. Use Caution/Monitor.

                  • ziprasidone

                    ziprasidone and melatonin both increase sedation. Use Caution/Monitor.

                  Minor (18)

                  • acebutolol

                    melatonin decreases toxicity of acebutolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • atenolol

                    melatonin decreases toxicity of atenolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • betaxolol

                    melatonin decreases toxicity of betaxolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • bisoprolol

                    melatonin decreases toxicity of bisoprolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • carvedilol

                    melatonin decreases toxicity of carvedilol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • celiprolol

                    melatonin decreases toxicity of celiprolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • esmolol

                    melatonin decreases toxicity of esmolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • eucalyptus

                    eucalyptus and melatonin both increase sedation. Minor/Significance Unknown.

                  • labetalol

                    melatonin decreases toxicity of labetalol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • metoprolol

                    melatonin decreases toxicity of metoprolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • nadolol

                    melatonin decreases toxicity of nadolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • nebivolol

                    melatonin decreases toxicity of nebivolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • penbutolol

                    melatonin decreases toxicity of penbutolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • pindolol

                    melatonin decreases toxicity of pindolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • propranolol

                    melatonin decreases toxicity of propranolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • sage

                    melatonin and sage both increase sedation. Minor/Significance Unknown.

                  • sotalol

                    melatonin decreases toxicity of sotalol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  • timolol

                    melatonin decreases toxicity of timolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

                  Previous
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                  Adverse Effects

                  Frequency Not Defined

                  Abdominal cramps

                  Alertness decreased

                  Circadian rhythm disruption

                  Daytime fatigue

                  Depression (transient)

                  Dizziness

                  Drowsiness

                  Dysphoria in depressed patients

                  Headache

                  Irritability

                  Previous
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                  Warnings

                  Contraindications

                  Concurrent immunosuppressive treatment

                  Cautions

                  Age <20 years old, depression, hypertension, impaired liver function, seizure disorder

                  Previous
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                  Pregnancy & Lactation

                  Pregnancy: avoid use

                  Lactation: avoid use

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

                  Previous
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                  Pharmacology

                  Mechanism of Action

                  Hormone produced by pineal gland; regulates sleep cycle

                  Pharmacokinetics

                  Not studied

                  Previous
                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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