Drug interactions
Difenoxin + Ramelteon
Severity: Moderate
Difenoxin 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
Difenoxin, an opioid antidiarrheal metabolite of diphenoxylate, can cause drowsiness and dizziness. Combined with ramelteon, additive sedation and impaired psychomotor performance may occur.
What this interaction means in plain words
Difenoxin 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.
Difenoxin belongs to Gastrointestinal Tract; Ramelteon belongs to Central Nervous System.
Why it happens
Additive CNS depressant effects of an opioid-type agent and a hypnotic.
What to do
Warn patients about additive drowsiness and avoid driving until the response is known. Monitor for excessive sedation, especially in older adults.
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 Difenoxin
Frequently asked questions
Can I take Difenoxin with Ramelteon?
MediHelp rates the interaction as moderate. Difenoxin 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. Difenoxin, an opioid antidiarrheal metabolite of diphenoxylate, can cause drowsiness and dizziness. Combined with ramelteon, additive sedation and impaired psychomotor performance may occur.
How serious is the interaction between Difenoxin 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: Warn patients about additive drowsiness and avoid driving until the response is known. Monitor for excessive sedation, especially in older adults.
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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