Drug interactions
Butabarbital + Ramelteon
Severity: Moderate
Butabarbital and Ramelteon: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Butabarbital is a barbiturate that induces hepatic enzymes including CYP1A2, and may lower ramelteon exposure and efficacy. Both drugs are also sedating, so additive CNS depression can occur.
What this interaction means in plain words
Butabarbital and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Enzyme induction by the barbiturate increases ramelteon metabolism, along with additive CNS depression.
What to do
Monitor for reduced hypnotic effect and for excessive sedation. Consider an alternative hypnotic if ramelteon is ineffective.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Frequently asked questions
Can I take Butabarbital with Ramelteon?
MediHelp rates the interaction as moderate. Butabarbital and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Butabarbital is a barbiturate that induces hepatic enzymes including CYP1A2, and may lower ramelteon exposure and efficacy. Both drugs are also sedating, so additive CNS depression can occur.
How serious is the interaction between Butabarbital and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced hypnotic effect and for excessive sedation. Consider an alternative hypnotic if ramelteon is ineffective.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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