Drug interactions
Cimetidine + Ramelteon
Severity: Moderate
Cimetidine 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
Cimetidine may raise ramelteon concentrations, resulting in increased sedation, dizziness or next-day somnolence. The effect is expected from enzyme inhibition and is generally modest.
What this interaction means in plain words
Cimetidine 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.
Cimetidine belongs to Gastrointestinal Tract; Ramelteon belongs to Central Nervous System.
Why it happens
Cimetidine inhibits CYP1A2 and CYP3A4, which metabolize ramelteon.
What to do
Monitor for excessive sedation and counsel on next-day impairment. Consider famotidine if an acid suppressant is needed.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
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 Cimetidine with Ramelteon?
MediHelp rates the interaction as moderate. Cimetidine 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. Cimetidine may raise ramelteon concentrations, resulting in increased sedation, dizziness or next-day somnolence. The effect is expected from enzyme inhibition and is generally modest.
How serious is the interaction between Cimetidine 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 excessive sedation and counsel on next-day impairment. Consider famotidine if an acid suppressant is needed.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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