Drug interactions
Mexiletine + Ramelteon
Severity: Moderate
Mexiletine 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
Ramelteon is metabolized mainly by CYP1A2, and mexiletine inhibits this enzyme. Ramelteon exposure may rise, causing more daytime somnolence, dizziness, and fatigue.
What this interaction means in plain words
Mexiletine 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.
Mexiletine belongs to Cardiovascular; Ramelteon belongs to Central Nervous System.
Why it happens
Mexiletine inhibits CYP1A2 metabolism of ramelteon.
What to do
Monitor for excessive sedation and dizziness. Consider 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 Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
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 Mexiletine with Ramelteon?
MediHelp rates the interaction as moderate. Mexiletine 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. Ramelteon is metabolized mainly by CYP1A2, and mexiletine inhibits this enzyme. Ramelteon exposure may rise, causing more daytime somnolence, dizziness, and fatigue.
How serious is the interaction between Mexiletine 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 dizziness. Consider a lower ramelteon dose or an alternative hypnotic.
What other medicines interact with Mexiletine?
MediHelp also lists interactions of Mexiletine with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Mexiletine page.
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