AdultPediatricDosage Forms & Strengths tablet 8mg Insomnia 8 mg PO qHSSafety and efficacy not establishedInteraction CheckerEnter a drug name and ramelteonNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (3)calcium/magnesium/potassium/sodium oxybatesramelteon, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.fluvoxaminefluvoxamine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated.sodium oxybateramelteon, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.Serious - Use Alternative (17)abametapirabametapir will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, ramelteon. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.fentanylfentanyl, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl intranasalfentanyl intranasal, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transdermalfentanyl transdermal, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transmucosalfentanyl transmucosal, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.givosirangivosiran will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.hydrocodonehydrocodone, ramelteon. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.lemborexantlemborexant, ramelteon. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.leniolisibleniolisib will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid leniolisib with CYP1A2 substrates that have a narrow therapeutic indexmetoclopramide intranasalramelteon, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.olopatadine intranasalramelteon and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. oxycodoneramelteon and oxycodone both increase sedation. Avoid or Use Alternate Drug. Additive CNS depression may lead to hypotension, profound sedation, respiratory depression, or comapefloxacinpefloxacin will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.selinexorselinexor, ramelteon. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sufentanil SLsufentanil SL, ramelteon. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.valerianvalerian and ramelteon both increase sedation. Avoid or Use Alternate Drug.Monitor Closely (205)acrivastineacrivastine and ramelteon both increase sedation. Use Caution/Monitor.alfentanilalfentanil and ramelteon both increase sedation. Use Caution/Monitor.alprazolamalprazolam and ramelteon both increase sedation. Use Caution/Monitor.amitriptylineamitriptyline and ramelteon both increase sedation. Use Caution/Monitor.amobarbitalamobarbital will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.amobarbital and ramelteon both increase sedation. Use Caution/Monitor.amoxapineamoxapine and ramelteon both increase sedation. Use Caution/Monitor.apomorphineapomorphine and ramelteon both increase sedation. Use Caution/Monitor.aripiprazolearipiprazole and ramelteon both increase sedation. Use Caution/Monitor.armodafinilarmodafinil will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.asenapineasenapine and ramelteon both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and ramelteon both increase sedation. Use Caution/Monitor.avapritinibavapritinib and ramelteon both increase sedation. Use Caution/Monitor.azelastineazelastine and ramelteon both increase sedation. Use Caution/Monitor.baclofenbaclofen and ramelteon both increase sedation. Use Caution/Monitor.belladonna and opiumbelladonna and opium and ramelteon both increase sedation. Use Caution/Monitor.benperidolbenperidol and ramelteon both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen and ramelteon both increase sedation. Use Caution/Monitor.benzphetamineramelteon increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.brexanolonebrexanolone, ramelteon. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazolebrexpiprazole and ramelteon both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and ramelteon both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and ramelteon both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and ramelteon both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and ramelteon both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and ramelteon both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantbuprenorphine subdermal implant and ramelteon both increase sedation. Use Caution/Monitor.buprenorphine transdermalbuprenorphine transdermal and ramelteon both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionramelteon increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.buprenorphine, long-acting injection and ramelteon both increase sedation. Use Caution/Monitor.butabarbitalbutabarbital will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butabarbital and ramelteon both increase sedation. Use Caution/Monitor.butalbitalbutalbital will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.butalbital and ramelteon both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and ramelteon both increase sedation. Use Caution/Monitor.cannabidiolcannabidiol, ramelteon. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.carbamazepinecarbamazepine will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.carbamazepine will decrease the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxaminecarbinoxamine and ramelteon both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and ramelteon both increase sedation. Use Caution/Monitor.chloral hydratechloral hydrate and ramelteon both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and ramelteon both increase sedation. Use Caution/Monitor.chlorpheniraminechlorpheniramine and ramelteon both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and ramelteon both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and ramelteon both increase sedation. Use Caution/Monitor.cigarette smokingcigarette smoking will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidinecimetidine will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.cimetidine will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizinecinnarizine and ramelteon both increase sedation. Use Caution/Monitor.ciprofloxacinciprofloxacin will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Ciprofloxacin may decrease the metabolism of ramelteon; if ciprofloxacin is coadministered with ramelteon, monitor the patient closely for toxicity.clemastineclemastine and ramelteon both increase sedation. Use Caution/Monitor.clomipramineclomipramine and ramelteon both increase sedation. Use Caution/Monitor.clonazepamclonazepam and ramelteon both increase sedation. Use Caution/Monitor.clorazepateclorazepate and ramelteon both increase sedation. Use Caution/Monitor.clozapineclozapine and ramelteon both increase sedation. Use Caution/Monitor.codeinecodeine and ramelteon both increase sedation. Use Caution/Monitor.cyclizinecyclizine and ramelteon both increase sedation. Use Caution/Monitor.cyclobenzaprinecyclobenzaprine and ramelteon both increase sedation. Use Caution/Monitor.cyproheptadinecyproheptadine and ramelteon both increase sedation. Use Caution/Monitor.dantrolenedantrolene and ramelteon both increase sedation. Use Caution/Monitor.daridorexantramelteon and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. deferasiroxdeferasirox increases levels of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.desipraminedesipramine and ramelteon both increase sedation. Use Caution/Monitor.deutetrabenazineramelteon and deutetrabenazine both increase sedation. Use Caution/Monitor.dexchlorpheniraminedexchlorpheniramine and ramelteon both increase sedation. Use Caution/Monitor.dexfenfluramineramelteon increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidinedexmedetomidine and ramelteon both increase sedation. Use Caution/Monitor.dextromoramidedextromoramide and ramelteon both increase sedation. Use Caution/Monitor.diamorphinediamorphine and ramelteon both increase sedation. Use Caution/Monitor.diazepamdiazepam and ramelteon both increase sedation. Use Caution/Monitor.diazepam intranasaldiazepam intranasal, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.difelikefalindifelikefalin and ramelteon both increase sedation. Use Caution/Monitor.difenoxin hcldifenoxin hcl and ramelteon both increase sedation. Use Caution/Monitor.dimenhydrinatedimenhydrinate and ramelteon both increase sedation. Use Caution/Monitor.diphenhydraminediphenhydramine and ramelteon both increase sedation. Use Caution/Monitor.diphenoxylate hcldiphenoxylate hcl and ramelteon both increase sedation. Use Caution/Monitor.dipipanonedipipanone and ramelteon both increase sedation. Use Caution/Monitor.donepezildonepezil will increase the level or effect of ramelteon by unspecified interaction mechanism. Use Caution/Monitor. AUC and Cmax increased by 100% and 87% respectively.dopexamineramelteon increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxepindoxepin and ramelteon both increase sedation. Use Caution/Monitor.doxepin will increase the level or effect of ramelteon by unspecified interaction mechanism. Use Caution/Monitor. AUC and Cmax increased by 66% and 69% respectively.doxylaminedoxylamine and ramelteon both increase sedation. Use Caution/Monitor.droperidoldroperidol and ramelteon both increase sedation. Use Caution/Monitor.efavirenzefavirenz will increase the level or effect of ramelteon by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.epcoritamabepcoritamab, ramelteon. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Epcoritamab causes release of cytokines that may suppress activity of CYP enzymes, resulting in increased exposure of CYP substrates. For certain CYP substrates, minimal changes in their concentration may lead to serious adverse reactions. If needed, modify therapy as recommended in the substrate's prescribing information. .erythromycin baseerythromycin base will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.erythromycin base will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.erythromycin ethylsuccinateerythromycin ethylsuccinate will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.erythromycin ethylsuccinate will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.erythromycin lactobionateerythromycin lactobionate will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.erythromycin lactobionate will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.erythromycin stearateerythromycin stearate will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.erythromycin stearate will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.esketamine intranasalesketamine intranasal, ramelteon. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.estazolamestazolam and ramelteon both increase sedation. Use Caution/Monitor.ethanolethanol and ramelteon both increase sedation. Use Caution/Monitor.ethinylestradiolethinylestradiol will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.etomidateetomidate and ramelteon both increase sedation. Use Caution/Monitor.fenfluramineramelteon increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fexinidazolefexinidazole will increase the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.flibanserinramelteon and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.fluoxetinefluoxetine will increase the level or effect of ramelteon