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Identification
NameRamelteon
Accession NumberDB00980  (APRD01213)
TypeSmall Molecule
GroupsApproved, Investigational
DescriptionRamelteon is the first in a new class of sleep agents that selectively binds to the melatonin receptors in the suprachiasmatic nucleus (SCN). It is used for insomnia, particularly delayed sleep onset. Ramelteon has not been shown to produce dependence and has shown no potential for abuse.
Structure
Thumb
Synonyms
Rozerem
External Identifiers
  • TAK-375
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Rozeremtablet, film coated8 mg/1oralRebel Distributors Corp2005-07-22Not applicableUs
Rozeremtablet, film coated8 mg/1oralTakeda Pharmaceuticals America, Inc.2005-07-22Not applicableUs
Rozeremtablet, film coated8 mg/1oralLake Erie Medical DBA Quality Care Products LLC2011-05-18Not applicableUs
Rozeremtablet, film coated8 mg/1oralAvera Mc Kennan Hospital2015-03-05Not applicableUs
Rozeremtablet, film coated8 mg/1oralPhysicians Total Care, Inc.2006-08-01Not applicableUs
Rozeremtablet, film coated8 mg/1oralbryant ranch prepack2005-07-22Not applicableUs
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixturesNot Available
SaltsNot Available
Categories
UNII901AS54I69
CAS number196597-26-9
WeightAverage: 259.3434
Monoisotopic: 259.157228921
Chemical FormulaC16H21NO2
InChI KeyInChIKey=YLXDSYKOBKBWJQ-LBPRGKRZSA-N
InChI
InChI=1S/C16H21NO2/c1-2-15(18)17-9-7-12-4-3-11-5-6-14-13(16(11)12)8-10-19-14/h5-6,12H,2-4,7-10H2,1H3,(H,17,18)/t12-/m0/s1
IUPAC Name
N-{2-[(8S)-1H,2H,6H,7H,8H-indeno[5,4-b]furan-8-yl]ethyl}propanamide
SMILES
CCC(=O)NCC[C@@H]1CCC2=C1C1=C(OCC1)C=C2
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as benzofurans. These are organic compounds containing a benzene ring fused to a furan. Furan is a five-membered aromatic ring with four carbon atoms and one oxygen atom.
KingdomOrganic compounds
Super ClassOrganoheterocyclic compounds
ClassBenzofurans
Sub ClassNot Available
Direct ParentBenzofurans
Alternative Parents
Substituents
  • Indane
  • Benzofuran
  • Alkyl aryl ether
  • Benzenoid
  • Secondary carboxylic acid amide
  • Carboxamide group
  • Oxacycle
  • Ether
  • Carboxylic acid derivative
  • Carboxylic acid amide
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Carbonyl group
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available
Pharmacology
IndicationFor the treatment of insomnia characterized by difficulty with sleep onset.
PharmacodynamicsRamelteon is the first selective melatonin agonist. It works by mimicking melatonin (MT), a naturally occuring hormone that is produced during the sleep period and thought to be responsible for the regulation of circadian rhythm underlying the normal sleep-wake cycle. Ramelteon has a high affinity for the MT1 and MT2 receptors. The MT1 and MT2 receptors are located in the brain's suprachiasmatic nuclei (SCN),which is known as the body's "master clock" because it regulates the 24-hour sleep-wake cycle. Ramelteon has an active metabolite that is less potent but circulates in higher concentrations than the parent compound. The metabolite also has weak affinity for the 5HT2b receptor.
Mechanism of actionRamelteon is a melatonin receptor agonist with both high affinity for melatonin MT1 and MT2 receptors, and lower selectivity for the MT3 receptor. Melatonin production is concurrent with nocturnal sleep, meaning that an increase in melatonin levels is related to the onset of self-reported sleepiness and an increase in sleep propensity. MT1 receptors are believed to be responsible for regulation of sleepiness and facilitation of sleep onset, and MT2 receptors are believed to mediate phase-shifting effects of melatonin on the circadian rhythm. While MT1 and MT2 receptors are associated with the sleep-wake cycle, MT3 has a completely different profile, and therefore is not likely to be involved in the sleep-wake cycle. Remelteon has no appreciable affinity for the gamma-aminobutyric acid (GABA) receptor complex or receptors that bind neuropeptides, cytokines, serotonin, dopamine, norepinephrine, acetylcholine, or opiates.
Related Articles
AbsorptionRapid, total absorption is at least 84%.
Volume of distribution
  • 73.6 L
Protein binding~82% (in human serum)
Metabolism

Hepatic

Route of eliminationFollowing oral administration of radiolabeled ramelteon, 84% of total radioactivity was excreted in urine and approximately 4% in feces, resulting in a mean recovery of 88%. Less than 0.1% of the dose was excreted in urine and feces as the parent compound.
Half life~1-2.6 hours
ClearanceNot Available
ToxicityNot Available
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+1.0
Blood Brain Barrier+0.9934
Caco-2 permeable+0.5893
P-glycoprotein substrateSubstrate0.5211
P-glycoprotein inhibitor INon-inhibitor0.8548
P-glycoprotein inhibitor IINon-inhibitor0.7877
Renal organic cation transporterNon-inhibitor0.6381
CYP450 2C9 substrateNon-substrate0.7876
CYP450 2D6 substrateNon-substrate0.6392
CYP450 3A4 substrateSubstrate0.512
CYP450 1A2 substrateInhibitor0.7314
CYP450 2C9 inhibitorNon-inhibitor0.6471
CYP450 2D6 inhibitorNon-inhibitor0.5916
CYP450 2C19 inhibitorInhibitor0.8314
CYP450 3A4 inhibitorNon-inhibitor0.9196
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.7763
Ames testNon AMES toxic0.7016
CarcinogenicityNon-carcinogens0.8206
BiodegradationReady biodegradable0.6635
Rat acute toxicity2.1034 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.7898
hERG inhibition (predictor II)Inhibitor0.5
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
Manufacturers
  • Takeda global research development center inc
Packagers
Dosage forms
FormRouteStrength
Tablet, film coatedoral8 mg/1
Prices
Unit descriptionCostUnit
Rozerem 8 mg tablet5.17USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US6034239 No1999-07-222019-07-22Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
logP2.4Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0164 mg/mLALOGPS
logP3.03ALOGPS
logP2.57ChemAxon
logS-4.2ALOGPS
pKa (Strongest Acidic)15.82ChemAxon
pKa (Strongest Basic)-0.4ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area38.33 Å2ChemAxon
Rotatable Bond Count4ChemAxon
Refractivity75.52 m3·mol-1ChemAxon
Polarizability29.99 Å3ChemAxon
Number of Rings3ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
References
Synthesis Reference

Vinod Kumar Kansal, Dhirenkumar N. Mistry, Sanjay L. Vasoya, “Intermediates and processes for the synthesis of Ramelteon.” U.S. Patent US20080242877, issued October 02, 2008.

US20080242877
General References
  1. Karim A, Tolbert D, Cao C: Disposition kinetics and tolerance of escalating single doses of ramelteon, a high-affinity MT1 and MT2 melatonin receptor agonist indicated for treatment of insomnia. J Clin Pharmacol. 2006 Feb;46(2):140-8. [PubMed:16432265 ]
  2. Miyamoto M: Pharmacology of ramelteon, a selective MT1/MT2 receptor agonist: a novel therapeutic drug for sleep disorders. CNS Neurosci Ther. 2009 Winter;15(1):32-51. doi: 10.1111/j.1755-5949.2008.00066.x. [PubMed:19228178 ]
  3. Pandi-Perumal SR, Srinivasan V, Spence DW, Moscovitch A, Hardeland R, Brown GM, Cardinali DP: Ramelteon: a review of its therapeutic potential in sleep disorders. Adv Ther. 2009 Jun;26(6):613-26. doi: 10.1007/s12325-009-0041-6. Epub 2009 Jun 30. [PubMed:19568703 ]
  4. Borja NL, Daniel KL: Ramelteon for the treatment of insomnia. Clin Ther. 2006 Oct;28(10):1540-55. [PubMed:17157111 ]
  5. Roth T, Stubbs C, Walsh JK: Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Sleep. 2005 Mar;28(3):303-7. [PubMed:16173650 ]
  6. Simpson D, Curran MP: Ramelteon: a review of its use in insomnia. Drugs. 2008;68(13):1901-19. [PubMed:18729542 ]
External Links
ATC CodesN05CH02
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (2.36 MB)
MSDSNot Available
Interactions
Drug Interactions
Drug
7-NitroindazoleThe risk or severity of adverse effects can be increased when 7-Nitroindazole is combined with Ramelteon.
AbirateroneThe serum concentration of Ramelteon can be increased when it is combined with Abiraterone.
AcepromazineThe risk or severity of adverse effects can be increased when Acepromazine is combined with Ramelteon.
AceprometazineThe risk or severity of adverse effects can be increased when Aceprometazine is combined with Ramelteon.
adipiplonThe risk or severity of adverse effects can be increased when adipiplon is combined with Ramelteon.
AgomelatineThe risk or severity of adverse effects can be increased when Agomelatine is combined with Ramelteon.
AlfaxaloneThe risk or severity of adverse effects can be increased when Alfaxalone is combined with Ramelteon.
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Ramelteon.
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Alphacetylmethadol is combined with Ramelteon.
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Ramelteon.
AmiodaroneThe serum concentration of Ramelteon can be increased when it is combined with Amiodarone.
AmisulprideThe risk or severity of adverse effects can be increased when Amisulpride is combined with Ramelteon.
AmitriptylineThe risk or severity of adverse effects can be increased when Amitriptyline is combined with Ramelteon.
AmobarbitalThe risk or severity of adverse effects can be increased when Amobarbital is combined with Ramelteon.
AmoxapineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Amoxapine.
AmperozideThe risk or severity of adverse effects can be increased when Amperozide is combined with Ramelteon.
AprepitantThe serum concentration of Ramelteon can be increased when it is combined with Aprepitant.
AripiprazoleThe risk or severity of adverse effects can be increased when Aripiprazole is combined with Ramelteon.
ArmodafinilThe metabolism of Ramelteon can be decreased when combined with Armodafinil.
ArticaineThe risk or severity of adverse effects can be increased when Articaine is combined with Ramelteon.
AsenapineThe risk or severity of adverse effects can be increased when Asenapine is combined with Ramelteon.
AtazanavirThe serum concentration of Ramelteon can be increased when it is combined with Atazanavir.
AtomoxetineThe metabolism of Ramelteon can be decreased when combined with Atomoxetine.
AzaperoneThe risk or severity of adverse effects can be increased when Azaperone is combined with Ramelteon.
AzelastineRamelteon may increase the central nervous system depressant (CNS depressant) activities of Azelastine.
AzelastineThe risk or severity of adverse effects can be increased when Azelastine is combined with Ramelteon.
AzithromycinThe metabolism of Ramelteon can be decreased when combined with Azithromycin.
BaclofenThe risk or severity of adverse effects can be increased when Baclofen is combined with Ramelteon.
BarbitalThe risk or severity of adverse effects can be increased when Barbital is combined with Ramelteon.
BenzocaineThe risk or severity of adverse effects can be increased when Benzocaine is combined with Ramelteon.
Benzyl alcoholThe risk or severity of adverse effects can be increased when Benzyl alcohol is combined with Ramelteon.
BexaroteneThe serum concentration of Ramelteon can be decreased when it is combined with Bexarotene.
BoceprevirThe serum concentration of Ramelteon can be increased when it is combined with Boceprevir.
BortezomibThe metabolism of Ramelteon can be decreased when combined with Bortezomib.
BosentanThe serum concentration of Ramelteon can be decreased when it is combined with Bosentan.
BrexpiprazoleThe risk or severity of adverse effects can be increased when Ramelteon is combined with Brexpiprazole.
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
BrimonidineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Brimonidine.
BromazepamThe risk or severity of adverse effects can be increased when Bromazepam is combined with Ramelteon.
BrompheniramineThe risk or severity of adverse effects can be increased when Brompheniramine is combined with Ramelteon.
BrotizolamThe risk or severity of adverse effects can be increased when Brotizolam is combined with Ramelteon.
BupivacaineThe risk or severity of adverse effects can be increased when Bupivacaine is combined with Ramelteon.
BuprenorphineThe risk or severity of adverse effects can be increased when Buprenorphine is combined with Ramelteon.
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Ramelteon.
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Ramelteon.
ButacaineThe risk or severity of adverse effects can be increased when Butacaine is combined with Ramelteon.
ButalbitalThe risk or severity of adverse effects can be increased when Butalbital is combined with Ramelteon.
ButambenThe risk or severity of adverse effects can be increased when Butamben is combined with Ramelteon.
ButethalThe risk or severity of adverse effects can be increased when Butethal is combined with Ramelteon.
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Ramelteon.
CaffeineThe metabolism of Ramelteon can be decreased when combined with Caffeine.
CapecitabineThe serum concentration of Ramelteon can be increased when it is combined with Capecitabine.
CarbamazepineThe risk or severity of adverse effects can be increased when Carbamazepine is combined with Ramelteon.
CarbinoxamineThe risk or severity of adverse effects can be increased when Carbinoxamine is combined with Ramelteon.
CarfentanilThe risk or severity of adverse effects can be increased when Carfentanil is combined with Ramelteon.
CarisoprodolThe risk or severity of adverse effects can be increased when Carisoprodol is combined with Ramelteon.
CeritinibThe serum concentration of Ramelteon can be increased when it is combined with Ceritinib.
CetirizineThe risk or severity of adverse effects can be increased when Cetirizine is combined with Ramelteon.
Chloral hydrateThe risk or severity of adverse effects can be increased when Chloral hydrate is combined with Ramelteon.
ChloramphenicolThe metabolism of Ramelteon can be decreased when combined with Chloramphenicol.
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Ramelteon.
ChlormezanoneThe risk or severity of adverse effects can be increased when Chlormezanone is combined with Ramelteon.
ChloroprocaineThe risk or severity of adverse effects can be increased when Chloroprocaine is combined with Ramelteon.
ChlorphenamineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Chlorphenamine.
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Ramelteon.
ChlorprothixeneThe risk or severity of adverse effects can be increased when Chlorprothixene is combined with Ramelteon.
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Chlorzoxazone is combined with Ramelteon.
CholecalciferolThe metabolism of Ramelteon can be decreased when combined with Cholecalciferol.
CimetidineThe metabolism of Ramelteon can be decreased when combined with Cimetidine.
CinchocaineThe risk or severity of adverse effects can be increased when Cinchocaine is combined with Ramelteon.
CitalopramThe risk or severity of adverse effects can be increased when Ramelteon is combined with Citalopram.
CitalopramThe metabolism of Ramelteon can be decreased when combined with Citalopram.
ClarithromycinThe serum concentration of Ramelteon can be increased when it is combined with Clarithromycin.
ClemastineThe metabolism of Ramelteon can be decreased when combined with Clemastine.
ClemastineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Clemastine.
ClidiniumThe risk or severity of adverse effects can be increased when Clidinium is combined with Ramelteon.
ClobazamThe risk or severity of adverse effects can be increased when Clobazam is combined with Ramelteon.
clomethiazoleThe risk or severity of adverse effects can be increased when clomethiazole is combined with Ramelteon.
ClomipramineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Clomipramine.
ClonazepamThe risk or severity of adverse effects can be increased when Ramelteon is combined with Clonazepam.
ClonidineThe risk or severity of adverse effects can be increased when Clonidine is combined with Ramelteon.
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Ramelteon.
ClotrimazoleThe metabolism of Ramelteon can be decreased when combined with Clotrimazole.
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Ramelteon.
CobicistatThe serum concentration of Ramelteon can be increased when it is combined with Cobicistat.
CocaineThe risk or severity of adverse effects can be increased when Cocaine is combined with Ramelteon.
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Ramelteon.
ConivaptanThe serum concentration of Ramelteon can be increased when it is combined with Conivaptan.
CrizotinibThe metabolism of Ramelteon can be decreased when combined with Crizotinib.
CyclizineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Cyclizine.
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Ramelteon.
CyclosporineThe metabolism of Ramelteon can be decreased when combined with Cyclosporine.
CyproheptadineThe risk or severity of adverse effects can be increased when Cyproheptadine is combined with Ramelteon.
Cyproterone acetateThe serum concentration of Ramelteon can be decreased when it is combined with Cyproterone acetate.
DabrafenibThe serum concentration of Ramelteon can be decreased when it is combined with Dabrafenib.
DantroleneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Dantrolene.
DapiprazoleThe risk or severity of adverse effects can be increased when Dapiprazole is combined with Ramelteon.
DapoxetineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Dapoxetine.
DarunavirThe serum concentration of Ramelteon can be increased when it is combined with Darunavir.
DasatinibThe serum concentration of Ramelteon can be increased when it is combined with Dasatinib.
DeferasiroxThe serum concentration of Ramelteon can be decreased when it is combined with Deferasirox.
DelavirdineThe serum concentration of Ramelteon can be increased when it is combined with Delavirdine.
deramciclaneThe risk or severity of adverse effects can be increased when deramciclane is combined with Ramelteon.
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Ramelteon.
DesipramineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Desipramine.
DesloratadineThe risk or severity of adverse effects can be increased when Desloratadine is combined with Ramelteon.
DetomidineThe risk or severity of adverse effects can be increased when Detomidine is combined with Ramelteon.
DexamethasoneThe serum concentration of Ramelteon can be decreased when it is combined with Dexamethasone.
DexbrompheniramineThe risk or severity of adverse effects can be increased when Dexbrompheniramine is combined with Ramelteon.
DexmedetomidineThe risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Ramelteon.
DextromoramideThe risk or severity of adverse effects can be increased when Dextromoramide is combined with Ramelteon.
DextropropoxypheneThe risk or severity of adverse effects can be increased when Dextropropoxyphene is combined with Ramelteon.
DezocineThe risk or severity of adverse effects can be increased when Dezocine is combined with Ramelteon.
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Ramelteon.
DifenoxinThe risk or severity of adverse effects can be increased when Ramelteon is combined with Difenoxin.
DihydrocodeineThe risk or severity of adverse effects can be increased when Dihydrocodeine is combined with Ramelteon.
DihydroergotamineThe metabolism of Ramelteon can be decreased when combined with Dihydroergotamine.
DihydroetorphineThe risk or severity of adverse effects can be increased when Dihydroetorphine is combined with Ramelteon.
DihydromorphineThe risk or severity of adverse effects can be increased when Dihydromorphine is combined with Ramelteon.
DiltiazemThe metabolism of Ramelteon can be decreased when combined with Diltiazem.
DimenhydrinateThe risk or severity of adverse effects can be increased when Ramelteon is combined with Dimenhydrinate.
DiphenhydramineThe risk or severity of adverse effects can be increased when Diphenhydramine is combined with Ramelteon.
DiphenoxylateThe risk or severity of adverse effects can be increased when Diphenoxylate is combined with Ramelteon.
DoramectinThe risk or severity of adverse effects can be increased when Doramectin is combined with Ramelteon.
DoxepinThe risk or severity of adverse effects can be increased when Ramelteon is combined with Doxepin.
DoxycyclineThe metabolism of Ramelteon can be decreased when combined with Doxycycline.
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
DoxylamineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Doxylamine.
DPDPEThe risk or severity of adverse effects can be increased when DPDPE is combined with Ramelteon.
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
DronedaroneThe metabolism of Ramelteon can be decreased when combined with Dronedarone.
DroperidolThe risk or severity of adverse effects can be increased when Droperidol is combined with Ramelteon.
DrotebanolThe risk or severity of adverse effects can be increased when Drotebanol is combined with Ramelteon.
DyclonineThe risk or severity of adverse effects can be increased when Dyclonine is combined with Ramelteon.
EcgonineThe risk or severity of adverse effects can be increased when Ecgonine is combined with Ramelteon.
ECGONINE METHYL ESTERThe risk or severity of adverse effects can be increased when ECGONINE METHYL ESTER is combined with Ramelteon.
EfavirenzThe serum concentration of Ramelteon can be decreased when it is combined with Efavirenz.
EfavirenzThe risk or severity of adverse effects can be increased when Ramelteon is combined with Efavirenz.
EnfluraneThe risk or severity of adverse effects can be increased when Enflurane is combined with Ramelteon.
EntacaponeThe risk or severity of adverse effects can be increased when Entacapone is combined with Ramelteon.
EnzalutamideThe serum concentration of Ramelteon can be decreased when it is combined with Enzalutamide.
ErythromycinThe metabolism of Ramelteon can be decreased when combined with Erythromycin.
EscitalopramThe risk or severity of adverse effects can be increased when Ramelteon is combined with Escitalopram.
Eslicarbazepine acetateThe serum concentration of Ramelteon can be decreased when it is combined with Eslicarbazepine acetate.
EsomeprazoleThe metabolism of Ramelteon can be decreased when combined with Esomeprazole.
EstazolamThe risk or severity of adverse effects can be increased when Estazolam is combined with Ramelteon.
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Ramelteon.
EthanolRamelteon may increase the central nervous system depressant (CNS depressant) activities of Ethanol.
EthanolThe risk or severity of adverse effects can be increased when Ethanol is combined with Ramelteon.
EthchlorvynolThe risk or severity of adverse effects can be increased when Ethchlorvynol is combined with Ramelteon.
EthosuximideThe risk or severity of adverse effects can be increased when Ethosuximide is combined with Ramelteon.
EthotoinThe risk or severity of adverse effects can be increased when Ethotoin is combined with Ramelteon.
Ethyl carbamateThe risk or severity of adverse effects can be increased when Ethyl carbamate is combined with Ramelteon.
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Ethyl loflazepate is combined with Ramelteon.
EthylmorphineThe risk or severity of adverse effects can be increased when Ethylmorphine is combined with Ramelteon.
EtidocaineThe risk or severity of adverse effects can be increased when Etidocaine is combined with Ramelteon.
EtifoxineThe risk or severity of adverse effects can be increased when Etifoxine is combined with Ramelteon.
EtizolamThe risk or severity of adverse effects can be increased when Etizolam is combined with Ramelteon.
EtomidateThe risk or severity of adverse effects can be increased when Etomidate is combined with Ramelteon.
EtoperidoneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Etoperidone.
EtorphineThe risk or severity of adverse effects can be increased when Etorphine is combined with Ramelteon.
EtravirineThe serum concentration of Ramelteon can be decreased when it is combined with Etravirine.
EzogabineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Ezogabine.
FelbamateThe risk or severity of adverse effects can be increased when Felbamate is combined with Ramelteon.
FencamfamineThe risk or severity of adverse effects can be increased when Fencamfamine is combined with Ramelteon.
FenfluramineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Fenfluramine.
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Ramelteon.
FexofenadineThe risk or severity of adverse effects can be increased when Fexofenadine is combined with Ramelteon.
FlibanserinThe risk or severity of adverse effects can be increased when Ramelteon is combined with Flibanserin.
FloxuridineThe serum concentration of Ramelteon can be increased when it is combined with Floxuridine.
FluconazoleThe serum concentration of Ramelteon can be increased when it is combined with Fluconazole.
FludiazepamThe risk or severity of adverse effects can be increased when Fludiazepam is combined with Ramelteon.
FlumazenilFlumazenil may decrease the sedative activities of Ramelteon.
FlunarizineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Flunarizine.
FlunitrazepamThe risk or severity of adverse effects can be increased when Flunitrazepam is combined with Ramelteon.
FluorouracilThe serum concentration of Ramelteon can be increased when it is combined with Fluorouracil.
FluoxetineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Fluoxetine.
FluoxetineThe metabolism of Ramelteon can be decreased when combined with Fluoxetine.
FlupentixolThe risk or severity of adverse effects can be increased when Flupentixol is combined with Ramelteon.
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Ramelteon.
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Ramelteon.
FluspirileneThe risk or severity of adverse effects can be increased when Fluspirilene is combined with Ramelteon.
Fluticasone PropionateThe risk or severity of adverse effects can be increased when Fluticasone Propionate is combined with Ramelteon.
FluvoxamineThe serum concentration of Ramelteon can be increased when it is combined with Fluvoxamine.
FluvoxamineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Fluvoxamine.
FosamprenavirThe metabolism of Ramelteon can be decreased when combined with Fosamprenavir.
FosaprepitantThe serum concentration of Ramelteon can be increased when it is combined with Fosaprepitant.
FosphenytoinThe risk or severity of adverse effects can be increased when Ramelteon is combined with Fosphenytoin.
FospropofolThe risk or severity of adverse effects can be increased when Fospropofol is combined with Ramelteon.
Fusidic AcidThe serum concentration of Ramelteon can be increased when it is combined with Fusidic Acid.
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Ramelteon.
gabapentin enacarbilThe risk or severity of adverse effects can be increased when Ramelteon is combined with gabapentin enacarbil.
Gamma Hydroxybutyric AcidThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ramelteon.
GemfibrozilThe serum concentration of Ramelteon can be increased when it is combined with Gemfibrozil.
GlutethimideThe risk or severity of adverse effects can be increased when Glutethimide is combined with Ramelteon.
GuanfacineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Guanfacine.
HalazepamThe risk or severity of adverse effects can be increased when Halazepam is combined with Ramelteon.
HaloperidolThe risk or severity of adverse effects can be increased when Haloperidol is combined with Ramelteon.
HalothaneThe risk or severity of adverse effects can be increased when Halothane is combined with Ramelteon.
HeroinThe risk or severity of adverse effects can be increased when Heroin is combined with Ramelteon.
HexobarbitalThe risk or severity of adverse effects can be increased when Hexobarbital is combined with Ramelteon.
HydrocodoneThe risk or severity of adverse effects can be increased when Hydrocodone is combined with Ramelteon.
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Ramelteon.
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
HydroxyzineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Hydroxyzine.
IdelalisibThe serum concentration of Ramelteon can be increased when it is combined with Idelalisib.
IloperidoneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Iloperidone.
ImatinibThe metabolism of Ramelteon can be decreased when combined with Imatinib.
ImipramineThe risk or severity of adverse effects can be increased when Imipramine is combined with Ramelteon.
IndalpineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Indalpine.
IndinavirThe serum concentration of Ramelteon can be increased when it is combined with Indinavir.
IsavuconazoniumThe metabolism of Ramelteon can be decreased when combined with Isavuconazonium.
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Ramelteon.
IsoniazidThe metabolism of Ramelteon can be decreased when combined with Isoniazid.
IsradipineThe metabolism of Ramelteon can be decreased when combined with Isradipine.
ItraconazoleThe serum concentration of Ramelteon can be increased when it is combined with Itraconazole.
IvacaftorThe serum concentration of Ramelteon can be increased when it is combined with Ivacaftor.
KetamineThe risk or severity of adverse effects can be increased when Ketamine is combined with Ramelteon.
KetazolamThe risk or severity of adverse effects can be increased when Ketazolam is combined with Ramelteon.
KetobemidoneThe risk or severity of adverse effects can be increased when Ketobemidone is combined with Ramelteon.
KetoconazoleThe serum concentration of Ramelteon can be increased when it is combined with Ketoconazole.
LamotrigineThe risk or severity of adverse effects can be increased when Lamotrigine is combined with Ramelteon.
LevetiracetamThe risk or severity of adverse effects can be increased when Ramelteon is combined with Levetiracetam.
LevobupivacaineThe risk or severity of adverse effects can be increased when Levobupivacaine is combined with Ramelteon.
LevocabastineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Levocabastine.
LevocetirizineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Levocetirizine.
LevodopaThe risk or severity of adverse effects can be increased when Ramelteon is combined with Levodopa.
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Levomethadyl Acetate is combined with Ramelteon.
LevomilnacipranThe risk or severity of adverse effects can be increased when Ramelteon is combined with Levomilnacipran.
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Ramelteon.
LidocaineThe metabolism of Ramelteon can be decreased when combined with Lidocaine.
LidocaineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Lidocaine.
LithiumThe risk or severity of adverse effects can be increased when Lithium is combined with Ramelteon.
LofentanilThe risk or severity of adverse effects can be increased when Lofentanil is combined with Ramelteon.
LopinavirThe serum concentration of Ramelteon can be increased when it is combined with Lopinavir.
LoratadineThe risk or severity of adverse effects can be increased when Loratadine is combined with Ramelteon.
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Ramelteon.
LovastatinThe metabolism of Ramelteon can be decreased when combined with Lovastatin.
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Ramelteon.
Lu AA21004The risk or severity of adverse effects can be increased when Ramelteon is combined with Lu AA21004.
LuliconazoleThe serum concentration of Ramelteon can be increased when it is combined with Luliconazole.
LumacaftorThe serum concentration of Ramelteon can be decreased when it is combined with Lumacaftor.
LurasidoneThe risk or severity of adverse effects can be increased when Lurasidone is combined with Ramelteon.
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
Magnesium SulfateThe risk or severity of adverse effects can be increased when Ramelteon is combined with Magnesium Sulfate.
MaprotilineThe risk or severity of adverse effects can be increased when Maprotiline is combined with Ramelteon.
MeclizineThe risk or severity of adverse effects can be increased when Meclizine is combined with Ramelteon.
MedetomidineThe risk or severity of adverse effects can be increased when Medetomidine is combined with Ramelteon.
MelatoninThe risk or severity of adverse effects can be increased when Melatonin is combined with Ramelteon.
MelperoneThe risk or severity of adverse effects can be increased when Melperone is combined with Ramelteon.
MepivacaineThe risk or severity of adverse effects can be increased when Mepivacaine is combined with Ramelteon.
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Ramelteon.
MesoridazineThe risk or severity of adverse effects can be increased when Mesoridazine is combined with Ramelteon.
MetaxaloneThe risk or severity of adverse effects can be increased when Metaxalone is combined with Ramelteon.
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Ramelteon.
Methadyl AcetateThe risk or severity of adverse effects can be increased when Methadyl Acetate is combined with Ramelteon.
MethapyrileneThe risk or severity of adverse effects can be increased when Methapyrilene is combined with Ramelteon.
MethaqualoneThe risk or severity of adverse effects can be increased when Methaqualone is combined with Ramelteon.
MethocarbamolThe risk or severity of adverse effects can be increased when Methocarbamol is combined with Ramelteon.
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Ramelteon.
MethotrimeprazineThe risk or severity of adverse effects can be increased when Methotrimeprazine is combined with Ramelteon.
MethoxyfluraneThe risk or severity of adverse effects can be increased when Methoxyflurane is combined with Ramelteon.
MethsuximideThe risk or severity of adverse effects can be increased when Ramelteon is combined with Methsuximide.
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Methylphenobarbital is combined with Ramelteon.
MetyrosineRamelteon may increase the sedative activities of Metyrosine.
MexiletineThe metabolism of Ramelteon can be decreased when combined with Mexiletine.
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Ramelteon.
MifepristoneThe metabolism of Ramelteon can be decreased when combined with Mifepristone.
MilnacipranThe risk or severity of adverse effects can be increased when Ramelteon is combined with Milnacipran.
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
MirtazapineRamelteon may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.
MirtazapineThe risk or severity of adverse effects can be increased when Mirtazapine is combined with Ramelteon.
MitotaneThe serum concentration of Ramelteon can be decreased when it is combined with Mitotane.
MoclobemideThe metabolism of Ramelteon can be decreased when combined with Moclobemide.
ModafinilThe serum concentration of Ramelteon can be decreased when it is combined with Modafinil.
MolindoneThe risk or severity of adverse effects can be increased when Molindone is combined with Ramelteon.
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Ramelteon.
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Ramelteon.
NabiloneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Nabilone.
NafcillinThe serum concentration of Ramelteon can be decreased when it is combined with Nafcillin.
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Ramelteon.
NefazodoneThe serum concentration of Ramelteon can be increased when it is combined with Nefazodone.
NelfinavirThe serum concentration of Ramelteon can be increased when it is combined with Nelfinavir.
NetupitantThe serum concentration of Ramelteon can be increased when it is combined with Netupitant.
NevirapineThe metabolism of Ramelteon can be decreased when combined with Nevirapine.
NicardipineThe serum concentration of Ramelteon can be increased when it is combined with Nicardipine.
NilotinibThe metabolism of Ramelteon can be decreased when combined with Nilotinib.
NitrazepamThe risk or severity of adverse effects can be increased when Nitrazepam is combined with Ramelteon.
Nitrous oxideThe risk or severity of adverse effects can be increased when Nitrous oxide is combined with Ramelteon.
NormethadoneThe risk or severity of adverse effects can be increased when Normethadone is combined with Ramelteon.
NortriptylineThe risk or severity of adverse effects can be increased when Nortriptyline is combined with Ramelteon.
OlanzapineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Olanzapine.
OlaparibThe metabolism of Ramelteon can be decreased when combined with Olaparib.
OlopatadineThe risk or severity of adverse effects can be increased when Olopatadine is combined with Ramelteon.
OmeprazoleThe metabolism of Ramelteon can be decreased when combined with Omeprazole.
OndansetronThe risk or severity of adverse effects can be increased when Ondansetron is combined with Ramelteon.
OpiumThe risk or severity of adverse effects can be increased when Opium is combined with Ramelteon.
OrphenadrineRamelteon may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
OrphenadrineThe risk or severity of adverse effects can be increased when Orphenadrine is combined with Ramelteon.
OsanetantThe risk or severity of adverse effects can be increased when Osanetant is combined with Ramelteon.
OsimertinibThe serum concentration of Ramelteon can be increased when it is combined with Osimertinib.
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Ramelteon.
OxprenololThe risk or severity of adverse effects can be increased when Oxprenolol is combined with Ramelteon.
OxybuprocaineThe risk or severity of adverse effects can be increased when Oxybuprocaine is combined with Ramelteon.
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Ramelteon.
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Ramelteon.
PalbociclibThe serum concentration of Ramelteon can be increased when it is combined with Palbociclib.
PaliperidoneThe risk or severity of adverse effects can be increased when Paliperidone is combined with Ramelteon.
PantoprazoleThe metabolism of Ramelteon can be decreased when combined with Pantoprazole.
ParaldehydeRamelteon may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
ParaldehydeThe risk or severity of adverse effects can be increased when Paraldehyde is combined with Ramelteon.
ParoxetineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Paroxetine.
Peginterferon alfa-2bThe serum concentration of Ramelteon can be increased when it is combined with Peginterferon alfa-2b.
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Ramelteon.
PentobarbitalThe risk or severity of adverse effects can be increased when Pentobarbital is combined with Ramelteon.
PerampanelThe risk or severity of adverse effects can be increased when Ramelteon is combined with Perampanel.
PerospironeThe risk or severity of adverse effects can be increased when Perospirone is combined with Ramelteon.
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Ramelteon.
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Ramelteon.
PhenobarbitalThe risk or severity of adverse effects can be increased when Phenobarbital is combined with Ramelteon.
PhenoxyethanolThe risk or severity of adverse effects can be increased when Phenoxyethanol is combined with Ramelteon.
PhenytoinThe risk or severity of adverse effects can be increased when Phenytoin is combined with Ramelteon.
PimozideThe risk or severity of adverse effects can be increased when Pimozide is combined with Ramelteon.
PipamperoneThe risk or severity of adverse effects can be increased when Pipamperone is combined with Ramelteon.
PipotiazineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Pipotiazine.
PizotifenThe risk or severity of adverse effects can be increased when Ramelteon is combined with Pizotifen.
PomalidomideThe risk or severity of adverse effects can be increased when Ramelteon is combined with Pomalidomide.
PosaconazoleThe serum concentration of Ramelteon can be increased when it is combined with Posaconazole.
PramipexoleRamelteon may increase the sedative activities of Pramipexole.
PramocaineThe risk or severity of adverse effects can be increased when Pramocaine is combined with Ramelteon.
PrazepamThe risk or severity of adverse effects can be increased when Prazepam is combined with Ramelteon.
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Ramelteon.
PrilocaineThe risk or severity of adverse effects can be increased when Prilocaine is combined with Ramelteon.
PrimidoneThe risk or severity of adverse effects can be increased when Primidone is combined with Ramelteon.
ProcaineThe risk or severity of adverse effects can be increased when Procaine is combined with Ramelteon.
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Ramelteon.
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Ramelteon.
PromethazineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Promethazine.
ProparacaineThe risk or severity of adverse effects can be increased when Proparacaine is combined with Ramelteon.
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Ramelteon.
PropoxycaineThe risk or severity of adverse effects can be increased when Propoxycaine is combined with Ramelteon.
ProtriptylineThe risk or severity of adverse effects can be increased when Protriptyline is combined with Ramelteon.
PSD502The risk or severity of adverse effects can be increased when PSD502 is combined with Ramelteon.
QuazepamThe risk or severity of adverse effects can be increased when Quazepam is combined with Ramelteon.
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Ramelteon.
RanolazineThe metabolism of Ramelteon can be decreased when combined with Ranolazine.
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Ramelteon.
RemoxiprideThe risk or severity of adverse effects can be increased when Remoxipride is combined with Ramelteon.
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Ramelteon.
RifabutinThe metabolism of Ramelteon can be increased when combined with Rifabutin.
RifampicinThe metabolism of Ramelteon can be increased when combined with Rifampicin.
RifapentineThe metabolism of Ramelteon can be increased when combined with Rifapentine.
RisperidoneThe risk or severity of adverse effects can be increased when Risperidone is combined with Ramelteon.
RitonavirThe serum concentration of Ramelteon can be increased when it is combined with Ritonavir.
RomifidineThe risk or severity of adverse effects can be increased when Romifidine is combined with Ramelteon.
RopiniroleRamelteon may increase the sedative activities of Ropinirole.
RopiniroleThe metabolism of Ramelteon can be decreased when combined with Ropinirole.
RopivacaineThe risk or severity of adverse effects can be increased when Ropivacaine is combined with Ramelteon.
RotigotineRamelteon may increase the sedative activities of Rotigotine.
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Ramelteon.
S-EthylisothioureaThe risk or severity of adverse effects can be increased when S-Ethylisothiourea is combined with Ramelteon.
SaquinavirThe serum concentration of Ramelteon can be increased when it is combined with Saquinavir.
ScopolamineThe risk or severity of adverse effects can be increased when Scopolamine is combined with Ramelteon.
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Ramelteon.
SertindoleThe risk or severity of adverse effects can be increased when Sertindole is combined with Ramelteon.
SertralineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Sertraline.
SertralineThe metabolism of Ramelteon can be decreased when combined with Sertraline.
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Ramelteon.
SildenafilThe metabolism of Ramelteon can be decreased when combined with Sildenafil.
SiltuximabThe serum concentration of Ramelteon can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Ramelteon can be increased when it is combined with Simeprevir.
Sodium oxybateRamelteon may increase the central nervous system depressant (CNS depressant) activities of Sodium oxybate.
Sodium oxybateThe risk or severity of adverse effects can be increased when Sodium oxybate is combined with Ramelteon.
St. John's WortThe serum concentration of Ramelteon can be decreased when it is combined with St. John's Wort.
StiripentolThe risk or severity of adverse effects can be increased when Ramelteon is combined with Stiripentol.
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Ramelteon.
SulfadiazineThe serum concentration of Ramelteon can be increased when it is combined with Sulfadiazine.
SulfisoxazoleThe serum concentration of Ramelteon can be increased when it is combined with Sulfisoxazole.
SulpirideThe risk or severity of adverse effects can be increased when Sulpiride is combined with Ramelteon.
SuvorexantThe risk or severity of adverse effects can be increased when Ramelteon is combined with Suvorexant.
TapentadolThe risk or severity of adverse effects can be increased when Ramelteon is combined with Tapentadol.
TasimelteonThe risk or severity of adverse effects can be increased when Ramelteon is combined with Tasimelteon.
TelaprevirThe serum concentration of Ramelteon can be increased when it is combined with Telaprevir.
TelithromycinThe serum concentration of Ramelteon can be increased when it is combined with Telithromycin.
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Ramelteon.
TenofovirThe metabolism of Ramelteon can be decreased when combined with Tenofovir.
TeriflunomideThe serum concentration of Ramelteon can be decreased when it is combined with Teriflunomide.
TetrabenazineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Tetrabenazine.
TetracaineThe risk or severity of adverse effects can be increased when Tetracaine is combined with Ramelteon.
TetrodotoxinThe risk or severity of adverse effects can be increased when Tetrodotoxin is combined with Ramelteon.
ThalidomideRamelteon may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
ThalidomideThe risk or severity of adverse effects can be increased when Thalidomide is combined with Ramelteon.
TheophyllineThe metabolism of Ramelteon can be decreased when combined with Theophylline.
ThiamylalThe risk or severity of adverse effects can be increased when Thiamylal is combined with Ramelteon.
ThiopentalThe risk or severity of adverse effects can be increased when Thiopental is combined with Ramelteon.
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Ramelteon.
ThiothixeneThe risk or severity of adverse effects can be increased when Thiothixene is combined with Ramelteon.
TiagabineThe risk or severity of adverse effects can be increased when Tiagabine is combined with Ramelteon.
TiclopidineThe metabolism of Ramelteon can be decreased when combined with Ticlopidine.
TiletamineThe risk or severity of adverse effects can be increased when Tiletamine is combined with Ramelteon.
TizanidineThe risk or severity of adverse effects can be increased when Tizanidine is combined with Ramelteon.
TocilizumabThe serum concentration of Ramelteon can be decreased when it is combined with Tocilizumab.
TolbutamideThe serum concentration of Ramelteon can be increased when it is combined with Tolbutamide.
TolcaponeThe risk or severity of adverse effects can be increased when Tolcapone is combined with Ramelteon.
TopiramateThe risk or severity of adverse effects can be increased when Topiramate is combined with Ramelteon.
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Ramelteon.
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Trans-2-Phenylcyclopropylamine is combined with Ramelteon.
TranylcypromineThe risk or severity of adverse effects can be increased when Tranylcypromine is combined with Ramelteon.
TrazodoneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Trazodone.
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Ramelteon.
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Ramelteon.
TriflupromazineThe risk or severity of adverse effects can be increased when Triflupromazine is combined with Ramelteon.
TrimipramineThe risk or severity of adverse effects can be increased when Trimipramine is combined with Ramelteon.
TriprolidineThe risk or severity of adverse effects can be increased when Triprolidine is combined with Ramelteon.
Valproic AcidThe risk or severity of adverse effects can be increased when Valproic Acid is combined with Ramelteon.
VemurafenibThe serum concentration of Ramelteon can be increased when it is combined with Vemurafenib.
VenlafaxineThe metabolism of Ramelteon can be decreased when combined with Venlafaxine.
VerapamilThe metabolism of Ramelteon can be decreased when combined with Verapamil.
VigabatrinThe risk or severity of adverse effects can be increased when Ramelteon is combined with Vigabatrin.
VilazodoneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Vilazodone.
VoriconazoleThe serum concentration of Ramelteon can be increased when it is combined with Voriconazole.
VortioxetineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Vortioxetine.
XylazineThe risk or severity of adverse effects can be increased when Xylazine is combined with Ramelteon.
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Ramelteon.
ZiconotideThe risk or severity of adverse effects can be increased when Ramelteon is combined with Ziconotide.
ZimelidineThe risk or severity of adverse effects can be increased when Ramelteon is combined with Zimelidine.
ZiprasidoneThe metabolism of Ramelteon can be decreased when combined with Ziprasidone.
ZiprasidoneThe risk or severity of adverse effects can be increased when Ramelteon is combined with Ziprasidone.
ZolazepamThe risk or severity of adverse effects can be increased when Zolazepam is combined with Ramelteon.
ZolpidemThe risk or severity of adverse effects can be increased when Zolpidem is combined with Ramelteon.
ZonisamideThe risk or severity of adverse effects can be increased when Zonisamide is combined with Ramelteon.
ZopicloneThe risk or severity of adverse effects can be increased when Zopiclone is combined with Ramelteon.
ZotepineThe risk or severity of adverse effects can be increased when Zotepine is combined with Ramelteon.
ZuclopenthixolThe risk or severity of adverse effects can be increased when Zuclopenthixol is combined with Ramelteon.
Food Interactions
  • Avoid alcohol.
  • Do not take with or immediately after a high-fat meal.

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
multitarget
General Function:
Melatonin receptor activity
Specific Function:
High affinity receptor for melatonin. Likely to mediates the reproductive and circadian actions of melatonin. The activity of this receptor is mediated by pertussis toxin sensitive G proteins that inhibit adenylate cyclase activity.
Gene Name:
MTNR1B
Uniprot ID:
P49286
Molecular Weight:
40187.895 Da
References
  1. Kato K, Hirai K, Nishiyama K, Uchikawa O, Fukatsu K, Ohkawa S, Kawamata Y, Hinuma S, Miyamoto M: Neurochemical properties of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist. Neuropharmacology. 2005 Feb;48(2):301-10. [PubMed:15695169 ]
  2. Karim A, Tolbert D, Cao C: Disposition kinetics and tolerance of escalating single doses of ramelteon, a high-affinity MT1 and MT2 melatonin receptor agonist indicated for treatment of insomnia. J Clin Pharmacol. 2006 Feb;46(2):140-8. [PubMed:16432265 ]
  3. Greenblatt DJ, Harmatz JS, Karim A: Age and gender effects on the pharmacokinetics and pharmacodynamics of ramelteon, a hypnotic agent acting via melatonin receptors MT1 and MT2. J Clin Pharmacol. 2007 Apr;47(4):485-96. [PubMed:17389558 ]
  4. Roth T, Stubbs C, Walsh JK: Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Sleep. 2005 Mar;28(3):303-7. [PubMed:16173650 ]
  5. Miyamoto M: Effect of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist, on motor performance in mice. Neurosci Lett. 2006 Jul 24;402(3):201-4. Epub 2006 May 24. [PubMed:16730121 ]
  6. Authors unspecified: Ramelteon: TAK 375. Drugs R D. 2005;6(3):186-8. [PubMed:15869323 ]
  7. Miyamoto M: Pharmacology of ramelteon, a selective MT1/MT2 receptor agonist: a novel therapeutic drug for sleep disorders. CNS Neurosci Ther. 2009 Winter;15(1):32-51. doi: 10.1111/j.1755-5949.2008.00066.x. [PubMed:19228178 ]
  8. Miyamoto M: [A novel therapeutic drug: ramelteon]. Nihon Rinsho. 2009 Aug;67(8):1595-600. [PubMed:19768947 ]
  9. Pandi-Perumal SR, Srinivasan V, Spence DW, Moscovitch A, Hardeland R, Brown GM, Cardinali DP: Ramelteon: a review of its therapeutic potential in sleep disorders. Adv Ther. 2009 Jun;26(6):613-26. doi: 10.1007/s12325-009-0041-6. Epub 2009 Jun 30. [PubMed:19568703 ]
  10. Borja NL, Daniel KL: Ramelteon for the treatment of insomnia. Clin Ther. 2006 Oct;28(10):1540-55. [PubMed:17157111 ]
  11. Johnson MW, Suess PE, Griffiths RR: Ramelteon: a novel hypnotic lacking abuse liability and sedative adverse effects. Arch Gen Psychiatry. 2006 Oct;63(10):1149-57. [PubMed:17015817 ]
  12. Zammit G, Erman M, Wang-Weigand S, Sainati S, Zhang J, Roth T: Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med. 2007 Aug 15;3(5):495-504. [PubMed:17803013 ]
  13. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
multitarget
General Function:
Organic cyclic compound binding
Specific Function:
High affinity receptor for melatonin. Likely to mediates the reproductive and circadian actions of melatonin. The activity of this receptor is mediated by pertussis toxin sensitive G proteins that inhibit adenylate cyclase activity.
Gene Name:
MTNR1A
Uniprot ID:
P48039
Molecular Weight:
39374.315 Da
References
  1. Kato K, Hirai K, Nishiyama K, Uchikawa O, Fukatsu K, Ohkawa S, Kawamata Y, Hinuma S, Miyamoto M: Neurochemical properties of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist. Neuropharmacology. 2005 Feb;48(2):301-10. [PubMed:15695169 ]
  2. Karim A, Tolbert D, Cao C: Disposition kinetics and tolerance of escalating single doses of ramelteon, a high-affinity MT1 and MT2 melatonin receptor agonist indicated for treatment of insomnia. J Clin Pharmacol. 2006 Feb;46(2):140-8. [PubMed:16432265 ]
  3. Greenblatt DJ, Harmatz JS, Karim A: Age and gender effects on the pharmacokinetics and pharmacodynamics of ramelteon, a hypnotic agent acting via melatonin receptors MT1 and MT2. J Clin Pharmacol. 2007 Apr;47(4):485-96. [PubMed:17389558 ]
  4. Roth T, Stubbs C, Walsh JK: Ramelteon (TAK-375), a selective MT1/MT2-receptor agonist, reduces latency to persistent sleep in a model of transient insomnia related to a novel sleep environment. Sleep. 2005 Mar;28(3):303-7. [PubMed:16173650 ]
  5. Miyamoto M: Effect of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist, on motor performance in mice. Neurosci Lett. 2006 Jul 24;402(3):201-4. Epub 2006 May 24. [PubMed:16730121 ]
  6. Authors unspecified: Ramelteon: TAK 375. Drugs R D. 2005;6(3):186-8. [PubMed:15869323 ]
  7. Miyamoto M: Pharmacology of ramelteon, a selective MT1/MT2 receptor agonist: a novel therapeutic drug for sleep disorders. CNS Neurosci Ther. 2009 Winter;15(1):32-51. doi: 10.1111/j.1755-5949.2008.00066.x. [PubMed:19228178 ]
  8. Miyamoto M: [A novel therapeutic drug: ramelteon]. Nihon Rinsho. 2009 Aug;67(8):1595-600. [PubMed:19768947 ]
  9. Pandi-Perumal SR, Srinivasan V, Spence DW, Moscovitch A, Hardeland R, Brown GM, Cardinali DP: Ramelteon: a review of its therapeutic potential in sleep disorders. Adv Ther. 2009 Jun;26(6):613-26. doi: 10.1007/s12325-009-0041-6. Epub 2009 Jun 30. [PubMed:19568703 ]
  10. Borja NL, Daniel KL: Ramelteon for the treatment of insomnia. Clin Ther. 2006 Oct;28(10):1540-55. [PubMed:17157111 ]
  11. Johnson MW, Suess PE, Griffiths RR: Ramelteon: a novel hypnotic lacking abuse liability and sedative adverse effects. Arch Gen Psychiatry. 2006 Oct;63(10):1149-57. [PubMed:17015817 ]
  12. Zammit G, Erman M, Wang-Weigand S, Sainati S, Zhang J, Roth T: Evaluation of the efficacy and safety of ramelteon in subjects with chronic insomnia. J Clin Sleep Med. 2007 Aug 15;3(5):495-504. [PubMed:17803013 ]
  13. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. Most active in catalyzing 2-hydroxylation. Caffeine is metabolized primarily by cytochrome CYP1A2 in the liver through an initial N...
Gene Name:
CYP1A2
Uniprot ID:
P05177
Molecular Weight:
58293.76 Da
References
  1. Obach RS, Ryder TF: Metabolism of ramelteon in human liver microsomes and correlation with the effect of fluvoxamine on ramelteon pharmacokinetics. Drug Metab Dispos. 2010 Aug;38(8):1381-91. doi: 10.1124/dmd.110.034009. Epub 2010 May 17. [PubMed:20478852 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Steroid hydroxylase activity
Specific Function:
Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and imipramine.
Gene Name:
CYP2C19
Uniprot ID:
P33261
Molecular Weight:
55930.545 Da
References
  1. Obach RS, Ryder TF: Metabolism of ramelteon in human liver microsomes and correlation with the effect of fluvoxamine on ramelteon pharmacokinetics. Drug Metab Dispos. 2010 Aug;38(8):1381-91. doi: 10.1124/dmd.110.034009. Epub 2010 May 17. [PubMed:20478852 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Obach RS, Ryder TF: Metabolism of ramelteon in human liver microsomes and correlation with the effect of fluvoxamine on ramelteon pharmacokinetics. Drug Metab Dispos. 2010 Aug;38(8):1381-91. doi: 10.1124/dmd.110.034009. Epub 2010 May 17. [PubMed:20478852 ]
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Drug created on June 13, 2005 07:24 / Updated on September 27, 2016 02:26