Drug interactions
Doxepin + Ramelteon
Severity: Moderate
Doxepin 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
Doxepin is a sedating tricyclic antidepressant and its effects add to those of ramelteon, increasing drowsiness. Doxepin has also been reported to raise ramelteon exposure, which may further intensify sedation.
What this interaction means in plain words
Doxepin 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.
Doxepin belongs to Dermatology; Ramelteon belongs to Central Nervous System.
Why it happens
Additive CNS sedation plus a pharmacokinetic increase in ramelteon exposure, possibly via inhibition of its metabolism (mechanism not firmly established).
What to do
Monitor for excessive sedation and next-day impairment; consider reducing ramelteon dose or avoiding combined hypnotic use. Counsel on driving and falls.
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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Ramelteon?
MediHelp rates the interaction as moderate. Doxepin 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. Doxepin is a sedating tricyclic antidepressant and its effects add to those of ramelteon, increasing drowsiness. Doxepin has also been reported to raise ramelteon exposure, which may further intensify sedation.
How serious is the interaction between Doxepin 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 next-day impairment; consider reducing ramelteon dose or avoiding combined hypnotic use. Counsel on driving and falls.
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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