Drug interactions
Pipemidic acid + Ramelteon
Severity: Moderate
Pipemidic acid 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
Pipemidic acid is a quinolone that inhibits CYP1A2 and may raise ramelteon concentrations. Fluvoxamine, a strong CYP1A2 inhibitor, markedly increases ramelteon exposure, so increased sedation is possible.
What this interaction means in plain words
Pipemidic acid 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
Inhibition of CYP1A2, the main enzyme metabolizing ramelteon.
What to do
Monitor for excessive sedation and dizziness, and consider a lower ramelteon dose or an alternative antibiotic.
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 Pipemidic acid with Ramelteon?
MediHelp rates the interaction as moderate. Pipemidic acid 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. Pipemidic acid is a quinolone that inhibits CYP1A2 and may raise ramelteon concentrations. Fluvoxamine, a strong CYP1A2 inhibitor, markedly increases ramelteon exposure, so increased sedation is possible.
How serious is the interaction between Pipemidic acid 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, and consider a lower ramelteon dose or an alternative antibiotic.
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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