Drug interactions
Itraconazole + Ramelteon
Severity: Moderate
Itraconazole 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
Itraconazole may increase ramelteon exposure, leading to more daytime sedation, dizziness and impaired psychomotor performance. The effect is mostly via CYP3A4, a secondary pathway for ramelteon.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Ramelteon belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4-mediated ramelteon metabolism.
What to do
Monitor for excessive sedation and consider using a lower ramelteon dose or an alternative hypnotic.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole 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 Itraconazole with Ramelteon?
MediHelp rates the interaction as moderate. Itraconazole 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. Itraconazole may increase ramelteon exposure, leading to more daytime sedation, dizziness and impaired psychomotor performance. The effect is mostly via CYP3A4, a secondary pathway for ramelteon.
How serious is the interaction between Itraconazole 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 consider using a lower ramelteon dose or an alternative hypnotic.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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