Fluvoxamine Tablets and Ramelteon

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using ramelteon together with fluvoxaMINE is not recommended. Combining these medications may significantly increase the blood levels of ramelteon to dangerous levels. Your doctor may be able to prescribe alternative treatments that do not interact. You should avoid the use of alcohol while being treated with ramelteon. Avoid driving or operating hazardous machinery until you know how the medication affects you, and do not exceed the dosage or frequency of use prescribed by your doctor. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

CONTRAINDICATED: Coadministration with fluvoxamine may significantly increase the plasma concentrations and pharmacologic effects of ramelteon. The mechanism is fluvoxamine inhibition of the CYP450 1A2-mediated metabolism of ramelteon. According to the product labeling, administration of ramelteon (16 mg single oral dose) following pretreatment with fluvoxamine (100 mg orally twice daily for 3 days) resulted in a 70-fold increase in ramelteon peak plasma concentration (Cmax) and a 190-fold increase in systemic exposure (AUC) compared to administration of ramelteon alone. Fluvoxamine pharmacokinetics were not significantly altered by ramelteon.

MANAGEMENT: The use of ramelteon in combination with fluvoxamine is considered contraindicated. Other SSRIs such as citalopram, escitalopram, fluoxetine, paroxetine, or sertraline may be safer alternatives in ramelteon-treated patients, since they are generally believed to have little, if any, effect on CYP450 1A2.

Fluvoxamine Tablets

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: Fluvoxamine

What is Fluvoxamine Tablets?

Ramelteon

Generic Name: ramelteon

Brand name: Rozerem

Synonyms: n.a.

What is Ramelteon?