Drug interactions
Cigarette smoking + Ramelteon
Severity: Minor
Cigarette smoking and Ramelteon: minor 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
Components of tobacco smoke induce CYP1A2, the main enzyme metabolizing ramelteon. Smokers may have lower ramelteon exposure and a weaker hypnotic effect.
What this interaction means in plain words
Cigarette smoking and Ramelteon have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Induction of CYP1A2 by polycyclic aromatic hydrocarbons in tobacco smoke.
What to do
Assess response in smokers and consider an alternative if efficacy is inadequate. Reassess ramelteon response if smoking status changes.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Cigarette smoking with Ramelteon?
MediHelp rates the interaction as minor. Cigarette smoking and Ramelteon have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Components of tobacco smoke induce CYP1A2, the main enzyme metabolizing ramelteon. Smokers may have lower ramelteon exposure and a weaker hypnotic effect.
How serious is the interaction between Cigarette smoking and Ramelteon?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess response in smokers and consider an alternative if efficacy is inadequate. Reassess ramelteon response if smoking status changes.
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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