Drug interactions
Phenobarbital + Ramelteon
Severity: Moderate
Phenobarbital 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
Phenobarbital induces hepatic enzymes including CYP1A2 and may lower ramelteon concentrations, reducing its effect. Both are sedating, so additive drowsiness can occur.
What this interaction means in plain words
Phenobarbital 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.
Why it happens
Enzyme induction by phenobarbital increases ramelteon clearance, plus additive CNS depression.
What to do
Monitor sleep response and daytime sedation; consider an alternative hypnotic if ramelteon becomes ineffective.
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
Frequently asked questions
Can I take Phenobarbital with Ramelteon?
MediHelp rates the interaction as moderate. Phenobarbital 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. Phenobarbital induces hepatic enzymes including CYP1A2 and may lower ramelteon concentrations, reducing its effect. Both are sedating, so additive drowsiness can occur.
How serious is the interaction between Phenobarbital 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 sleep response and daytime sedation; consider an alternative hypnotic if ramelteon becomes ineffective.
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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