Ramelteon, marketed under the brand name Rozerem, is a sleep agent medicine.
It binds exclusively to the suprachiasmatic nucleus of the MT1 and MT2 receptors, unlike drugs such as zolpidem, which bind to GABAA receptors.
Ramelteon Uses
Helps patients fall asleep more rapidly who have sleep-onset insomnia (difficulty falling asleep).
Belongs to a class of medicines called agonists of the melatonin receptor.
Functions similarly to melatonin, a natural substance in the brain required for sleep.
Ramelteon Side Effects:
Common Side Effects:
Swelling of the tongue or throat
Difficulty swallowing or breathing
Feeling that the throat is closing
Nausea
Vomiting
Irregular or missed menstrual periods
Serious Side Effects:
Milky discharge from the nipples
Decreased sexual desire
Fertility problems
Drowsiness or tiredness
Dizziness
Precautions Required To Be Taken For Ramelteon
Notify your doctor if you are allergic to Ramelteon or any other drugs.
Inform your doctor if you are taking fluvoxamine (Luvox).
Tell your doctor about any history of suicidal thoughts or attempts, chronic obstructive pulmonary disease ( COPD), or other lung diseases, and sleep apnea.
Inform your doctor if you are pregnant, planning to become pregnant or breastfeeding.
Do not drink alcohol during treatment as it can worsen side effects.
Be cautious of endocrine effects, including reduced testosterone and increased prolactin levels.
Use caution in patients with respiratory disability, including sleep apnea or COPD, not recommended for patients with severe sleep apnea.
Use caution in patients with hepatic impairment, not recommended for severe hepatic impairment.
Be aware of potential drug interactions.
How to Take Ramelteon
Comes as a tablet to take by mouth.
Take once a day, 30 minutes before bedtime.
Do not take with you a meal or soon after.
Follow prescription instructions carefully.
Swallow whole tablets; do not divide, chew, or crush them.
Finish bedtime preparations and go to bed after taking Ramelteon.
Do not use it if you cannot stay asleep for 7 to 8 hours after taking it.
Insomnia should improve within 7 to 10 days; consult your doctor if it does not.
Read the Medication Guide provided by your doctor or pharmacist.
How Does Ramelteon Work?
High affinity for melatonin MT1 and MT2 receptors, low selectivity for the MT3 receptor.
Melatonin levels rise with nocturnal sleep, associated with sleepiness and increased sleep tendency.
MT1 receptors control sleepiness and promote sleep onset.
MT2 receptors mediate melatonin’s phase-shifting effects on circadian rhythm.
No significant affinity for other neuropeptides, cytokines, serotonin, dopamine, norepinephrine, acetylcholine or opiates.
Ramelteon Dosage Information
Adult Dose: 8 mg taken within 30 minutes of bedtime.
Do not take with or directly after a high-fat meal.
Do not exceed 8 mg daily.
Dosing in Patients with Hepatic Deficiency:
Not recommended for patients with serious liver disease.
Use with caution in patients with mild liver disease.
Management of Other Drugs:
Do not use fluvoxamine.
Use with caution in patients taking other CYP1A2 inhibiting medications.
Storage:
Store away from heat, air, and light.
Keep out of reach of children.
Ramelteon vs Melatonin:
Ramelteon
Melatonin
Formula: C16H21NO2
Formula: C13H16N2O2
Is a sleep agent medication
Associated with control of the sleep-wake cycle.
Ramelteon is used to help patients fall asleep more rapidly who have sleep-onset insomnia
