Drug interactions
Protriptyline + Ramelteon
Severity: Moderate
Protriptyline 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
Both drugs can cause drowsiness, and taking them together may increase daytime sedation and impair psychomotor performance. Protriptyline is less sedating than other tricyclics, so the effect is usually modest.
What this interaction means in plain words
Protriptyline 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
Additive CNS depressant effects; ramelteon is a melatonin receptor agonist and protriptyline has tricyclic antihistaminic and anticholinergic activity.
What to do
Assess daytime drowsiness and psychomotor function, especially at initiation. Advise patients to avoid driving until the response is known.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Protriptyline and Ramelteon, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Protriptyline with Ramelteon?
MediHelp rates the interaction as moderate. Protriptyline 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. Both drugs can cause drowsiness, and taking them together may increase daytime sedation and impair psychomotor performance. Protriptyline is less sedating than other tricyclics, so the effect is usually modest.
How serious is the interaction between Protriptyline 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: Assess daytime drowsiness and psychomotor function, especially at initiation. Advise patients to avoid driving until the response is known.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
