Drug interactions
Ramelteon + Rifampin
Severity: Moderate
Ramelteon and Rifampin: 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
Rifampin markedly lowers ramelteon exposure, which can lead to loss of hypnotic effect. Ramelteon is metabolized mainly by CYP1A2 with contributions from CYP3A4 and CYP2C, all of which rifampin induces.
What this interaction means in plain words
Ramelteon and Rifampin 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
Rifampin induces CYP1A2, CYP3A4 and CYP2C enzymes, accelerating ramelteon clearance.
What to do
Monitor for reduced efficacy of ramelteon during rifampin therapy. Consider an alternative sleep agent if insomnia control is lost.
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 Ramelteon with Rifampin?
MediHelp rates the interaction as moderate. Ramelteon and Rifampin 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. Rifampin markedly lowers ramelteon exposure, which can lead to loss of hypnotic effect. Ramelteon is metabolized mainly by CYP1A2 with contributions from CYP3A4 and CYP2C, all of which rifampin induces.
How serious is the interaction between Ramelteon and Rifampin?
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 reduced efficacy of ramelteon during rifampin therapy. Consider an alternative sleep agent if insomnia control is lost.
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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