Drug interactions
Donepezil + Ramelteon
Severity: Moderate
Donepezil 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
Donepezil has been reported to raise ramelteon exposure, roughly doubling its AUC in a pharmacokinetic study. Higher ramelteon levels could increase drowsiness, dizziness and other adverse effects.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Ramelteon belongs to Central Nervous System.
Why it happens
The mechanism is not established, although altered ramelteon metabolism is suspected.
What to do
Start ramelteon at the usual dose and watch for excess sedation or dizziness. Reduce or stop ramelteon if adverse effects occur.
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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Ramelteon?
MediHelp rates the interaction as moderate. Donepezil 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. Donepezil has been reported to raise ramelteon exposure, roughly doubling its AUC in a pharmacokinetic study. Higher ramelteon levels could increase drowsiness, dizziness and other adverse effects.
How serious is the interaction between Donepezil 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: Start ramelteon at the usual dose and watch for excess sedation or dizziness. Reduce or stop ramelteon if adverse effects occur.
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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