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    For You 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

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      No Interactions Found
      Interactions Found

      Contraindicated

        Serious - Use Alternative

          Significant - Monitor Closely

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               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 (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.

                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

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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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