Drug interactions
Fluconazole + Ramelteon
Severity: Moderate
Fluconazole 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
Fluconazole can substantially raise ramelteon concentrations because ramelteon is metabolized by CYP1A2, CYP2C9 and CYP3A4. This may cause excess drowsiness, dizziness and next-day impairment.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Ramelteon belongs to Central Nervous System.
Why it happens
Fluconazole inhibits CYP2C9 and CYP3A4 metabolism of ramelteon.
What to do
Use with caution and monitor for excessive sedation; labeling advises caution with strong CYP2C9 inhibitors such as fluconazole. Consider an alternative hypnotic if sedation is troublesome.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
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 Fluconazole with Ramelteon?
MediHelp rates the interaction as moderate. Fluconazole 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. Fluconazole can substantially raise ramelteon concentrations because ramelteon is metabolized by CYP1A2, CYP2C9 and CYP3A4. This may cause excess drowsiness, dizziness and next-day impairment.
How serious is the interaction between Fluconazole 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: Use with caution and monitor for excessive sedation; labeling advises caution with strong CYP2C9 inhibitors such as fluconazole. Consider an alternative hypnotic if sedation is troublesome.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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