Ramelteon has 10 known drug interactions based on U.S. FDA drug labeling data. Of these, 2 are contraindicated combinations that should be avoided entirely. 1 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Alcohol, Fluvoxamine, Rifampin. Patients taking Ramelteon should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 10
- Contraindicated
- 2
- Major
- 1
- Moderate
- 5
Contraindicated (2)
- Ramelteon + Alcohol— Causes additive psychomotor impairment. Should not be used in combination with ramelteon.
- Ramelteon + Fluvoxamine— Strong CYP1A2 inhibitor that increases ramelteon AUC approximately 190-fold and Cmax approximately 70-fold; should not b…
Major (1)
- Ramelteon + Rifampin— Strong CYP enzyme inducer causing approximately 80% decrease in ramelteon exposure and metabolite M-II. Efficacy may be …
Moderate (5)
- Ramelteon + Deferasirox— Deferasirox inhibits CYP1A2 resulting in increased ramelteon concentration. Monitor for exposure related toxicity.
- Ramelteon + Donepezil— Increases ramelteon AUC by approximately 100% and Cmax by 87%; patients should be closely monitored.
- Ramelteon + Doxepin— Increases ramelteon AUC by approximately 66% and Cmax by 69%; patients should be closely monitored.
- Ramelteon + Fluconazole— ( 7.1 ) Fluconazole (strong CYP2C9 inhibitor): Increases systemic exposure of ramelteon; administer with caution. Flucon…
- Ramelteon + Ketoconazole— ( 7.1 ) Ketoconazole (strong CYP3A4 inhibitor): Increases AUC for ramelteon; administer with caution. Ketoconazole (stro…