Drug interactions
Elranatamab + Ramelteon
Severity: Moderate
Elranatamab 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
Elranatamab induces cytokine release syndrome, and the inflammatory cytokines can transiently suppress CYP enzymes. Ramelteon, a CYP1A2 substrate, may reach higher concentrations and cause more sedation or dizziness.
What this interaction means in plain words
Elranatamab 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.
Elranatamab belongs to Oncology; Ramelteon belongs to Central Nervous System.
Why it happens
Cytokine-mediated downregulation of CYP1A2 activity reduces ramelteon clearance.
What to do
Monitor for increased ramelteon effects (somnolence, dizziness) during step-up dosing and for about two weeks after, and during CRS episodes. Consider holding ramelteon if sedation becomes excessive.
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 Elranatamab
- Elranatamab + Ergotamine Major
- Elranatamab + Pimozide Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Ramelteon?
MediHelp rates the interaction as moderate. Elranatamab 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. Elranatamab induces cytokine release syndrome, and the inflammatory cytokines can transiently suppress CYP enzymes. Ramelteon, a CYP1A2 substrate, may reach higher concentrations and cause more sedation or dizziness.
How serious is the interaction between Elranatamab 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 increased ramelteon effects (somnolence, dizziness) during step-up dosing and for about two weeks after, and during CRS episodes. Consider holding ramelteon if sedation becomes excessive.
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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