Melatonin (Herb/Suppl)

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

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Interactions

Interaction Checker

and Melatonin

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              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 (207)

              • 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.

              • warfarin

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

              • 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.

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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

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              Warnings

              Contraindications

              Concurrent immunosuppressive treatment

              Cautions

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

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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.

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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.