Drug interactions
Hydroxyzine + Ramelteon
Severity: Moderate
Hydroxyzine 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
Hydroxyzine is a sedating antihistamine that can add to ramelteon's sedative effects. This may cause daytime impairment, confusion and falls, particularly in older patients.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Ramelteon belongs to Central Nervous System.
Why it happens
Additive sedation from melatonin receptor agonism and central H1 antagonism.
What to do
Use the lowest effective dose of each and warn about impaired alertness. Avoid the combination in older adults when alternatives exist.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Ramelteon?
MediHelp rates the interaction as moderate. Hydroxyzine 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. Hydroxyzine is a sedating antihistamine that can add to ramelteon's sedative effects. This may cause daytime impairment, confusion and falls, particularly in older patients.
How serious is the interaction between Hydroxyzine 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 the lowest effective dose of each and warn about impaired alertness. Avoid the combination in older adults when alternatives exist.
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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