Drug interactions
Carbamazepine + Ramelteon
Severity: Moderate
Carbamazepine 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
Carbamazepine is a strong inducer of CYP3A4 and also induces CYP1A2, which can substantially reduce ramelteon exposure. The hypnotic effect may be weakened or lost.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Ramelteon belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP1A2 and CYP3A4, accelerating ramelteon metabolism.
What to do
Monitor sleep response and consider an alternative hypnotic if ramelteon becomes ineffective. Reassess if carbamazepine is stopped.
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
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Ramelteon?
MediHelp rates the interaction as moderate. Carbamazepine 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. Carbamazepine is a strong inducer of CYP3A4 and also induces CYP1A2, which can substantially reduce ramelteon exposure. The hypnotic effect may be weakened or lost.
How serious is the interaction between Carbamazepine 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 sleep response and consider an alternative hypnotic if ramelteon becomes ineffective. Reassess if carbamazepine is stopped.
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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