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class="vector-toc-list"> <li id="toc-Delirium" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Delirium"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3.1</span> <span>Delirium</span> </div> </a> <ul id="toc-Delirium-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Bipolar_disorder" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Bipolar_disorder"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3.2</span> <span>Bipolar disorder</span> </div> </a> <ul id="toc-Bipolar_disorder-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Available_forms" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Available_forms"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Available forms</span> </div> </a> <ul id="toc-Available_forms-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Contraindications" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Contraindications"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Contraindications</span> </div> </a> <ul id="toc-Contraindications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Adverse_effects" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Adverse_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Adverse effects</span> </div> </a> <ul id="toc-Adverse_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Overdose" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Overdose"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Overdose</span> </div> </a> <ul id="toc-Overdose-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Interactions" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Interactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Interactions</span> </div> </a> <ul id="toc-Interactions-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pharmacology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pharmacology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Pharmacology</span> </div> </a> <button aria-controls="toc-Pharmacology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Pharmacology subsection</span> </button> <ul id="toc-Pharmacology-sublist" class="vector-toc-list"> <li id="toc-Pharmacodynamics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pharmacodynamics"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Pharmacodynamics</span> </div> </a> <ul id="toc-Pharmacodynamics-sublist" class="vector-toc-list"> <li id="toc-Mechanism_of_action" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Mechanism_of_action"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1.1</span> <span>Mechanism of action</span> </div> </a> <ul id="toc-Mechanism_of_action-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pharmacokinetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pharmacokinetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Pharmacokinetics</span> </div> </a> <ul id="toc-Pharmacokinetics-sublist" class="vector-toc-list"> <li id="toc-Absorption" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Absorption"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.1</span> <span>Absorption</span> </div> </a> <ul id="toc-Absorption-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Distribution" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Distribution"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.2</span> <span>Distribution</span> </div> </a> <ul id="toc-Distribution-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Metabolism" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Metabolism"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.3</span> <span>Metabolism</span> </div> </a> <ul id="toc-Metabolism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Elimination" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Elimination"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.4</span> 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class="vector-toc-numb">8</span> <span>Society and culture</span> </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" 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class="firstHeading mw-first-heading"><span class="mw-page-title-main">Ramelteon</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 18 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-18" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">18 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B1%D8%A7%D9%85%D9%84%D8%AA%D9%8A%D9%88%D9%86" title="راملتيون – Arabic" lang="ar" hreflang="ar" data-title="راملتيون" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Ramelteon" title="Ramelteon – German" lang="de" hreflang="de" data-title="Ramelteon" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B1%D8%A7%D9%85%D9%84%D8%AA%D8%A6%D9%88%D9%86" title="راملتئون – Persian" lang="fa" hreflang="fa" data-title="راملتئون" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Ramelteon" title="Ramelteon – French" lang="fr" hreflang="fr" data-title="Ramelteon" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Italian" lang="it" hreflang="it" data-title="Ramelteon" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Dutch" lang="nl" hreflang="nl" data-title="Ramelteon" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%A9%E3%83%A1%E3%83%AB%E3%83%86%E3%82%AA%E3%83%B3" title="ラメルテオン – Japanese" lang="ja" hreflang="ja" data-title="ラメルテオン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B0%E0%AC%BE%E0%AC%AE%E0%AD%87%E0%AC%B2%E0%AC%9F%E0%AD%87%E0%AC%85%E0%AC%A8" title="ରାମେଲଟେଅନ – Odia" lang="or" hreflang="or" data-title="ରାମେଲଟେଅନ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Polish" lang="pl" hreflang="pl" data-title="Ramelteon" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Ramelteona" title="Ramelteona – Portuguese" lang="pt" hreflang="pt" data-title="Ramelteona" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Romanian" lang="ro" hreflang="ro" data-title="Ramelteon" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BC%D0%B5%D0%BB%D1%82%D0%B5%D0%BE%D0%BD" title="Рамелтеон – Russian" lang="ru" hreflang="ru" data-title="Рамелтеон" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Simple English" lang="en-simple" hreflang="en-simple" data-title="Ramelteon" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Serbian" lang="sr" hreflang="sr" data-title="Ramelteon" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Ramelteon" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Turkish" lang="tr" hreflang="tr" data-title="Ramelteon" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Ramelteon" title="Ramelteon – Vietnamese" lang="vi" hreflang="vi" data-title="Ramelteon" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%9B%B7%E7%BE%8E%E6%9B%BF%E8%83%BA" title="雷美替胺 – Chinese" lang="zh" hreflang="zh" data-title="雷美替胺" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q417689#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> 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screen{html.skin-theme-clientpref-night .mw-parser-output .dark_mode_safe img{background-color:var(--background-color-inverted,#f8f9fa)}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .dark_mode_safe img{background-color:var(--background-color-inverted,#f8f9fa)}}</style> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox" style="border-spacing:2px;"><caption class="infobox-title"><span title="International nonproprietary name (INN): Ramelteon">Ramelteon</span></caption><tbody><tr><td colspan="2" class="infobox-image"><span class="mw-default-size skin-invert-image" typeof="mw:File/Frameless"><a href="/wiki/File:Ramelteon_skeletal_formula.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Ramelteon_skeletal_formula.svg/220px-Ramelteon_skeletal_formula.svg.png" decoding="async" width="220" height="131" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Ramelteon_skeletal_formula.svg/330px-Ramelteon_skeletal_formula.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/0d/Ramelteon_skeletal_formula.svg/440px-Ramelteon_skeletal_formula.svg.png 2x" data-file-width="512" data-file-height="305" /></a></span></td></tr><tr><td colspan="2" class="infobox-image"><span class="dark_mode_safe" typeof="mw:File"><a href="/wiki/File:Ramelteon_ball-and-stick_model.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Ramelteon_ball-and-stick_model.png/200px-Ramelteon_ball-and-stick_model.png" decoding="async" width="200" height="172" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/44/Ramelteon_ball-and-stick_model.png/300px-Ramelteon_ball-and-stick_model.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/44/Ramelteon_ball-and-stick_model.png/400px-Ramelteon_ball-and-stick_model.png 2x" data-file-width="1718" data-file-height="1479" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Clinical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_nomenclature#Trade_names" title="Drug nomenclature">Trade names</a></th><td class="infobox-data">Rozerem, others</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">Other names</th><td class="infobox-data">TAK-375</td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/American_Society_of_Health-System_Pharmacists" title="American Society of Health-System Pharmacists">AHFS</a>/<a href="/wiki/Drugs.com" title="Drugs.com">Drugs.com</a></th><td class="infobox-data"><span title="www.drugs.com"><a rel="nofollow" class="external text" href="https://www.drugs.com/monograph/ramelteon.html">Monograph</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span title="medlineplus.gov"><a rel="nofollow" class="external text" href="https://medlineplus.gov/druginfo/meds/a605038.html">a605038</a></span></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">License data</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"> <ul><li><small><abbr class="country-name" title="United States">US</abbr></small> <a href="/wiki/DailyMed" title="DailyMed">DailyMed</a>: <span title="dailymed.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Ramelteon">Ramelteon</a></span></li></ul></div> </td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Substance_dependence" title="Substance dependence">Dependence<br />liability</a></th><td class="infobox-data">Low<sup id="cite_ref-Yang2022_1-0" class="reference"><a href="#cite_note-Yang2022-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of<br />administration</a></th><td class="infobox-data"><a href="/wiki/Oral_administration" title="Oral administration">By mouth</a></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC code</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><a href="/wiki/ATC_code_N05" title="ATC code N05">N05CH02</a> (<span title="www.whocc.no"><a rel="nofollow" class="external text" href="https://www.whocc.no/atc_ddd_index/?code=N05CH02">WHO</a></span>) </li></ul></div></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Legal status</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Regulation_of_therapeutic_goods" title="Regulation of therapeutic goods">Legal status</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"> <ul><li><small><abbr class="country-name" title="Brazil">BR</abbr>:</small> <a href="/wiki/Brazilian_Controlled_Drugs_and_Substances_Act#Class_C1" title="Brazilian Controlled Drugs and Substances Act">Class C1</a> (Other controlled substances)<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li> <li><small><abbr class="country-name" title="United States">US</abbr>:</small> <a href="/wiki/Prescription_drug" title="Prescription drug">℞-only</a><sup id="cite_ref-Rozerem_FDA_label_3-0" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li></ul></div> </td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;"><a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">Pharmacokinetic</a> data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Bioavailability" title="Bioavailability">Bioavailability</a></th><td class="infobox-data">1.8%<sup id="cite_ref-Rozerem_FDA_label_3-1" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">Protein binding</a></th><td class="infobox-data">82% (mainly <a href="/wiki/Human_serum_albumin" title="Human serum albumin">albumin</a>)<sup id="cite_ref-Rozerem_FDA_label_3-2" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Drug_metabolism" title="Drug metabolism">Metabolism</a></th><td class="infobox-data"><a href="/wiki/Liver" title="Liver">Liver</a> (<a href="/wiki/CYP1A2" title="CYP1A2">CYP1A2</a> major, <a href="/wiki/CYP2C" class="mw-redirect" title="CYP2C">CYP2C</a> and <a href="/wiki/CYP3A4" title="CYP3A4">CYP3A4</a> minor)<sup id="cite_ref-Rozerem_FDA_label_3-8" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Metabolite" title="Metabolite">Metabolites</a></th><td class="infobox-data">M-II (active metabolite)<sup id="cite_ref-Rozerem_FDA_label_3-3" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Biological_half-life" title="Biological half-life">Elimination <span class="nowrap">half-life</span></a></th><td class="infobox-data">Ramelteon: 1–2.6 hours<sup id="cite_ref-Rozerem_FDA_label_3-4" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><br />M-II: 2–5 hours<sup id="cite_ref-Rozerem_FDA_label_3-5" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Excretion" title="Excretion">Excretion</a></th><td class="infobox-data"><a href="/wiki/Kidney" title="Kidney">Kidney</a>: 84%<sup id="cite_ref-Rozerem_FDA_label_3-6" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><br /><a href="/wiki/Feces" title="Feces">Feces</a>: 4%<sup id="cite_ref-Rozerem_FDA_label_3-7" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Identifiers</th></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/IUPAC_nomenclature_of_chemistry" title="IUPAC nomenclature of chemistry">IUPAC name</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all; text-align:left; padding-left:1.5em; text-indent:-1.5em;"><li style="line-height: inherit; margin: 0"><div style="font-size: 97%;">(<i>S</i>)-<i>N</i>-[2-(1,6,7,8-tetrahydro-2<i>H</i>-indeno-[5,4-<i>b</i>]<br />furan-8-yl)ethyl]propionamide</div></li></ul> </div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CAS_Registry_Number" title="CAS Registry Number">CAS Number</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="commonchemistry.cas.org"><a rel="nofollow" class="external text" href="https://commonchemistry.cas.org/detail?cas_rn=196597-26-9">196597-26-9</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/PubChem#CID" title="PubChem">PubChem</a> <span style="font-weight:normal"><abbr title="Compound ID">CID</abbr></span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="pubchem.ncbi.nlm.nih.gov"><a rel="nofollow" class="external text" href="https://pubchem.ncbi.nlm.nih.gov/compound/208902">208902</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Guide_to_Pharmacology" title="Guide to Pharmacology">IUPHAR/BPS</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.guidetopharmacology.org"><a rel="nofollow" class="external text" href="https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=1356">1356</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/DrugBank" title="DrugBank">DrugBank</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.drugbank.ca"><a rel="nofollow" class="external text" href="https://www.drugbank.ca/drugs/DB00980">DB00980</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChemSpider" title="ChemSpider">ChemSpider</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.chemspider.com"><a rel="nofollow" class="external text" href="https://www.chemspider.com/Chemical-Structure.9033484.html">9033484</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Unique_Ingredient_Identifier" title="Unique Ingredient Identifier">UNII</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="precision.fda.gov"><a rel="nofollow" class="external text" href="https://precision.fda.gov/uniisearch/srs/unii/901AS54I69">901AS54I69</a></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/KEGG" title="KEGG">KEGG</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.kegg.jp"><a rel="nofollow" class="external text" href="https://www.kegg.jp/entry/D02689">D02689</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ChEMBL" title="ChEMBL">ChEMBL</a></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="www.ebi.ac.uk"><a rel="nofollow" class="external text" href="https://www.ebi.ac.uk/chembl/explore/compound/ChEMBL133775">ChEMBL133775</a></span><sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/CompTox_Chemicals_Dashboard" title="CompTox Chemicals Dashboard">CompTox Dashboard</a> <span style="font-weight:normal">(<abbr title="U.S. Environmental Protection Agency">EPA</abbr>)</span></th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="comptox.epa.gov"><a rel="nofollow" class="external text" href="https://comptox.epa.gov/dashboard/chemical/details/DTXSID6045951">DTXSID6045951</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q417689#P3117" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></li></ul></div></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/ECHA_InfoCard" class="mw-redirect" title="ECHA InfoCard"><span title="echa.europa.eu">ECHA InfoCard</span></a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="https://echa.europa.eu/substance-information/-/substanceinfo/100.215.666">100.215.666</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q417689#P2566" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></td></tr><tr><th colspan="2" class="infobox-header" style="background:#ddd;color:inherit;">Chemical and physical data</th></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Chemical_formula" title="Chemical formula">Formula</a></th><td class="infobox-data"><span title="Carbon">C</span><sub>16</sub><span title="Hydrogen">H</span><sub>21</sub><span title="Nitrogen">N</span><span title="Oxygen">O</span><sub>2</sub></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;"><a href="/wiki/Molar_mass" title="Molar mass">Molar mass</a></th><td class="infobox-data"><span class="nowrap"><span data-sort-value="7002259349000000000♠"></span>259.349</span> g·mol<sup>−1</sup></td></tr><tr><th scope="row" class="infobox-label" style="line-height:1.2em;">3D model (<a href="/wiki/JSmol" class="mw-redirect" title="JSmol">JSmol</a>)</th><td class="infobox-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"><div class="plainlist"><ul><li><span title="chemapps.stolaf.edu (3D interactive model)"><a rel="nofollow" class="external text" href="https://chemapps.stolaf.edu/jmol/jmol.php?model=CCC%28%3DO%29NCC%5BC%40%40H%5D1CCc2ccc3c%28c21%29CCO3">Interactive image</a></span></li></ul></div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/Simplified_molecular-input_line-entry_system" class="mw-redirect" title="Simplified molecular-input line-entry system">SMILES</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">CCC(=O)NCC[C@@H]1CCc2ccc3c(c21)CCO3</div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-full-data"><div class="collapsible-list mw-collapsible mw-collapsed" style="text-align: left;"> <div style="line-height: 1.6em; font-weight: bold;"><div><a href="/wiki/International_Chemical_Identifier" title="International Chemical Identifier">InChI</a></div></div> <ul class="mw-collapsible-content" style="margin-top: 0; margin-bottom: 0; line-height: inherit; list-style: none; margin-left: 0; word-break:break-all;"><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">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-/m1/s1<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li><li style="line-height: inherit; margin: 0"><div style="word-wrap:break-word; text-indent:-1.5em; text-align:left; padding-left:1.5em; font-size:97%; line-height:120%;">Key:YLXDSYKOBKBWJQ-GFCCVEGCSA-N<sup> <span typeof="mw:File"><span><img alt="check" src="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/7px-Yes_check.svg.png" decoding="async" width="7" height="7" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/11px-Yes_check.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png 2x" data-file-width="600" data-file-height="600" /></span></span><span style="display:none">Y</span></sup></div></li></ul> </div></td></tr><tr><td colspan="2" class="infobox-below"><style data-mw-deduplicate="TemplateStyles:r886047488">.mw-parser-output .nobold{font-weight:normal}</style><span class="nobold">  <span class="reflink plainlinks nourlexpansion"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Special:ComparePages&rev1=464379960&page2=Ramelteon">(verify)</a></span></span></td></tr></tbody></table> <p><b>Ramelteon</b>, sold under the brand name <b>Rozerem</b> among others, is a <a href="/wiki/Melatonin_agonist" class="mw-redirect" title="Melatonin agonist">melatonin agonist</a> <a href="/wiki/Medication" title="Medication">medication</a> which is used in the treatment of <a href="/wiki/Insomnia" title="Insomnia">insomnia</a>.<sup id="cite_ref-Rozerem_FDA_label_3-9" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid18728808_5-0" class="reference"><a href="#cite_note-pmid18728808-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> It is indicated specifically for the treatment of insomnia characterized by difficulties with <a href="/wiki/Sleep_onset" title="Sleep onset">sleep onset</a>.<sup id="cite_ref-Rozerem_FDA_label_3-10" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> It reduces the time taken to fall asleep, but the degree of clinical benefit is small.<sup id="cite_ref-pmid24656909_6-0" class="reference"><a href="#cite_note-pmid24656909-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The medication is approved for long-term use.<sup id="cite_ref-Rozerem_FDA_label_3-11" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon is taken <a href="/wiki/Oral_administration" title="Oral administration">by mouth</a>.<sup id="cite_ref-Rozerem_FDA_label_3-12" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Side_effect" title="Side effect">Side effects</a> of ramelteon include <a href="/wiki/Somnolence" title="Somnolence">somnolence</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, exacerbated insomnia, and changes in <a href="/wiki/Hormone" title="Hormone">hormone</a> levels.<sup id="cite_ref-Rozerem_FDA_label_3-13" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon is an <a href="/wiki/Structural_analog" title="Structural analog">analogue</a> of <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a> and is a <a href="/wiki/Binding_selectivity" title="Binding selectivity">selective</a> <a href="/wiki/Agonist" title="Agonist">agonist</a> of the <a href="/wiki/Melatonin_receptor" title="Melatonin receptor">melatonin</a> <a href="/wiki/MT1_receptor" class="mw-redirect" title="MT1 receptor">MT<sub>1</sub></a> and <a href="/wiki/MT2_receptor" class="mw-redirect" title="MT2 receptor">MT<sub>2</sub> receptors</a>.<sup id="cite_ref-Rozerem_FDA_label_3-14" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Elimination_half-life" class="mw-redirect" title="Elimination half-life">half-life</a> and <a href="/wiki/Duration_of_action" class="mw-redirect" title="Duration of action">duration</a> of ramelteon are much longer than those of melatonin.<sup id="cite_ref-pmid18368944_7-0" class="reference"><a href="#cite_note-pmid18368944-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Ramelteon is not a <a href="/wiki/Benzodiazepine" title="Benzodiazepine">benzodiazepine</a> or <a href="/wiki/Z-drug" class="mw-redirect" title="Z-drug">Z-drug</a> and does not interact with <a href="/wiki/GABA_receptor" title="GABA receptor">GABA receptors</a>, instead having a distinct <a href="/wiki/Mechanism_of_action" title="Mechanism of action">mechanism of action</a>.<sup id="cite_ref-Rozerem_FDA_label_3-15" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid29487083_8-0" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>Ramelteon was first described in 2002<sup id="cite_ref-pmid12213063_9-0" class="reference"><a href="#cite_note-pmid12213063-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> and was approved for medical use in 2005.<sup id="cite_ref-FDA2005_10-0" class="reference"><a href="#cite_note-FDA2005-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Unlike certain other sleep medications, ramelteon is not a <a href="/wiki/Controlled_substance" title="Controlled substance">controlled substance</a> in nearly every country and has no known <a href="/wiki/Misuse_liability" class="mw-redirect" title="Misuse liability">potential for misuse</a>.<sup id="cite_ref-Rozerem_FDA_label_3-16" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Insomnia">Insomnia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=2" title="Edit section: Insomnia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is approved for the treatment of <a href="/wiki/Insomnia" title="Insomnia">insomnia</a> characterized by difficulty with <a href="/wiki/Sleep_onset" title="Sleep onset">sleep onset</a> in adults.<sup id="cite_ref-Rozerem_FDA_label_3-17" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid18728808_5-1" class="reference"><a href="#cite_note-pmid18728808-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In regulatory <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a>, it was found to significantly reduce <a href="/wiki/Latency_to_persistent_sleep" class="mw-redirect" title="Latency to persistent sleep">latency to persistent sleep</a> (LPS).<sup id="cite_ref-Rozerem_FDA_label_3-18" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> A 2009 <a href="/wiki/Pooled_analysis" title="Pooled analysis">pooled analysis</a> of four <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a> found that ramelteon at a dose of 8 mg reduced <a href="/wiki/Sleep_onset" title="Sleep onset">sleep onset</a> by 13 minutes (30% decrease) relative to <a href="/wiki/Placebo" title="Placebo">placebo</a> on the first and second nights of use.<sup id="cite_ref-pmid19327100_11-0" class="reference"><a href="#cite_note-pmid19327100-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Subsequent <a href="/wiki/Meta-analysis" title="Meta-analysis">meta-analyses</a> of longer-duration use have found that ramelteon decreases <a href="/wiki/Subjective_sleep_latency" class="mw-redirect" title="Subjective sleep latency">subjective sleep latency</a> by about 4 to 7 minutes.<sup id="cite_ref-pmid24656909_6-1" class="reference"><a href="#cite_note-pmid24656909-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid22897464_12-0" class="reference"><a href="#cite_note-pmid22897464-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Meta-analyses are mixed on whether ramelteon increases <a href="/wiki/Total_sleep_time" class="mw-redirect" title="Total sleep time">total sleep time</a>.<sup id="cite_ref-pmid22897464_12-1" class="reference"><a href="#cite_note-pmid22897464-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid24656909_6-2" class="reference"><a href="#cite_note-pmid24656909-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Ramelteon also improves <a href="/wiki/Sleep_quality" class="mw-redirect" title="Sleep quality">sleep quality</a> (<a href="/wiki/Standardized_mean_difference" class="mw-redirect" title="Standardized mean difference"><abbr title="standardized mean difference">SMD</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip standardized mean difference</span> –0.074, 95% <a href="/wiki/Confidence_interval" title="Confidence interval"><abbr title="confidence interval">CI</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip confidence interval</span> –0.13 to –0.02) and <a href="/wiki/Sleep_efficiency" title="Sleep efficiency">sleep efficiency</a>.<sup id="cite_ref-pmid24656909_6-3" class="reference"><a href="#cite_note-pmid24656909-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The clinical improvement in insomnia with ramelteon is small and of questionable benefit.<sup id="cite_ref-pmid24656909_6-4" class="reference"><a href="#cite_note-pmid24656909-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid29487083_8-1" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>Ramelteon is approved in the United States but was not approved in the European Union owing to concerns that it lacked effectiveness.<sup id="cite_ref-pmid29487083_8-2" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Committee_for_Medicinal_Products_for_Human_Use" title="Committee for Medicinal Products for Human Use">Committee for Medicinal Products for Human Use</a> (CHMP) of the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA) noted that ramelteon had only been found to improve sleep onset and not other sleep outcomes, only one of three clinical trials actually found that it improved sleep onset, and that the improvement in sleep onset was too small to be clinically meaningful.<sup id="cite_ref-pmid29487083_8-3" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The CHMP also noted that the long-term effectiveness of ramelteon had not been demonstrated.<sup id="cite_ref-pmid29487083_8-4" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/American_Academy_of_Sleep_Medicine" title="American Academy of Sleep Medicine">American Academy of Sleep Medicine</a>'s 2017 <a href="/wiki/Clinical_practice_guideline" class="mw-redirect" title="Clinical practice guideline">clinical practice guidelines</a> recommended the use of ramelteon in the treatment of sleep-onset insomnia.<sup id="cite_ref-pmid27998379_13-0" class="reference"><a href="#cite_note-pmid27998379-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> It rated the recommendation as weak and the <a href="/wiki/Quality_of_evidence" class="mw-redirect" title="Quality of evidence">quality of evidence</a> as very low but concluded that the potential benefits outweighed the potential harms.<sup id="cite_ref-pmid27998379_13-1" class="reference"><a href="#cite_note-pmid27998379-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> The guidelines found that ramelteon reduces sleep latency by 9<span class="nowrap"> </span>minutes (95% <a href="/wiki/Confidence_interval" title="Confidence interval"><abbr title="confidence interval">CI</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip confidence interval</span> 6–12<span class="nowrap"> </span>minutes) but does not improve sleep quality.<sup id="cite_ref-pmid27998379_13-2" class="reference"><a href="#cite_note-pmid27998379-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In contrast to ramelteon, the guidelines did not recommend the use of <a href="/wiki/Melatonin_(supplement/medication)" class="mw-redirect" title="Melatonin (supplement/medication)">melatonin</a>.<sup id="cite_ref-pmid27998379_13-3" class="reference"><a href="#cite_note-pmid27998379-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Circadian_rhythm_sleep_disorders">Circadian rhythm sleep disorders</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=3" title="Edit section: Circadian rhythm sleep disorders"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Melatonin_receptor_agonist" title="Melatonin receptor agonist">Melatonin receptor agonists</a> like <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a> and <a href="/wiki/Tasimelteon" title="Tasimelteon">tasimelteon</a> are considered to be effective in regulating <a href="/wiki/Sleep%E2%80%93wake_cycle" class="mw-redirect" title="Sleep–wake cycle">sleep–wake cycles</a> and in the treatment of <a href="/wiki/Circadian_rhythm_sleep_disorder" title="Circadian rhythm sleep disorder">circadian rhythm sleep disorders</a> like <a href="/wiki/Delayed_sleep_phase_disorder" title="Delayed sleep phase disorder">delayed sleep phase disorder</a>.<sup id="cite_ref-pmid27500861_14-0" class="reference"><a href="#cite_note-pmid27500861-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid28648359_15-0" class="reference"><a href="#cite_note-pmid28648359-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Ramelteon has been assessed in only a few studies in the treatment of circadian rhythm sleep disorders, including <a href="/wiki/Jet_lag_disorder" class="mw-redirect" title="Jet lag disorder">jet lag disorder</a>, <a href="/wiki/Shift_work_disorder" class="mw-redirect" title="Shift work disorder">shift work disorder</a>, and <a href="/wiki/Non-24-hour_sleep%E2%80%93wake_disorder" title="Non-24-hour sleep–wake disorder">non-24-hour sleep–wake disorder</a>.<sup id="cite_ref-pmid27500861_14-1" class="reference"><a href="#cite_note-pmid27500861-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> These studies have been of varying <a href="/wiki/Quality_of_evidence" class="mw-redirect" title="Quality of evidence">quality</a> and their findings in terms of effectiveness have been mixed.<sup id="cite_ref-pmid27500861_14-2" class="reference"><a href="#cite_note-pmid27500861-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Ramelteon is approved only for treatment of insomnia and is not approved for treatment of circadian rhythm sleep disorders.<sup id="cite_ref-pmid27500861_14-3" class="reference"><a href="#cite_note-pmid27500861-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-AdisInsight_16-0" class="reference"><a href="#cite_note-AdisInsight-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> It was previously under development for treatment of circadian rhythm sleep disorders, but development for these indications was discontinued.<sup id="cite_ref-AdisInsight_16-1" class="reference"><a href="#cite_note-AdisInsight-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_uses">Other uses</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=4" title="Edit section: Other uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Delirium">Delirium</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=5" title="Edit section: Delirium"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A systematic review, published in 2014, concluded "ramelteon was found to be beneficial in preventing delirium in medically ill individuals when compared to placebo."<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> A 2022 systematic review and meta-analysis found that the <a href="/wiki/Polypharmacy" title="Polypharmacy">combination</a> of ramelteon and the <a href="/wiki/Orexin_receptor_antagonist" class="mw-redirect" title="Orexin receptor antagonist">orexin receptor antagonist</a> <a href="/wiki/Suvorexant" title="Suvorexant">suvorexant</a> may reduce the incidence of <a href="/wiki/Delirium" title="Delirium">delirium</a> in adults <a href="/wiki/Hospitalization" class="mw-redirect" title="Hospitalization">hospitalized</a> patients whereas suvorexant alone was ineffective.<sup id="cite_ref-pmid34881812_18-0" class="reference"><a href="#cite_note-pmid34881812-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Bipolar_disorder">Bipolar disorder</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=6" title="Edit section: Bipolar disorder"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon has received attention in <a href="/wiki/Psychiatry" title="Psychiatry">psychiatry</a> as a possible add-on treatment for <a href="/wiki/Mania" title="Mania">mania</a> in <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>.<sup id="cite_ref-repurposed2021_19-0" class="reference"><a href="#cite_note-repurposed2021-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> However, to date, the scarce available evidence fails to support the clinical utility of ramelteon and other melatonin receptor agonists such as <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a> for mania.<sup id="cite_ref-repurposed2021_19-1" class="reference"><a href="#cite_note-repurposed2021-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Available_forms">Available forms</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=7" title="Edit section: Available forms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is available in the form of 8 mg <a href="/wiki/Oral_administration" title="Oral administration">oral</a> <a href="/wiki/Film-coated" class="mw-redirect" title="Film-coated">film-coated</a> <a href="/wiki/Tablet_(pharmacy)" title="Tablet (pharmacy)">tablets</a>.<sup id="cite_ref-Rozerem_FDA_label_3-19" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Contraindications">Contraindications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=8" title="Edit section: Contraindications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is not recommended for use in people with severe <a href="/wiki/Sleep_apnea" title="Sleep apnea">sleep apnea</a>.<sup id="cite_ref-Rozerem_FDA_label_3-20" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Adverse_effects">Adverse effects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=9" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Side_effect" title="Side effect">Side effects</a> of ramelteon include <a href="/wiki/Somnolence" title="Somnolence">somnolence</a> (3% vs. 2% for <a href="/wiki/Placebo" title="Placebo">placebo</a>), <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a> (3% vs. 2% for placebo), <a href="/wiki/Dizziness" title="Dizziness">dizziness</a> (4% vs. 3% for placebo), <a href="/wiki/Nausea" title="Nausea">nausea</a> (3% vs. 2% for placebo), and exacerbated insomnia (3% vs. 2% for placebo).<sup id="cite_ref-Rozerem_FDA_label_3-21" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Overall, side effects occurred in 6% with ramelteon and 2% with placebo in <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a>.<sup id="cite_ref-Rozerem_FDA_label_3-22" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Side effects leading to <a href="/wiki/Drug_discontinuation" class="mw-redirect" title="Drug discontinuation">discontinuation</a> occurred in 1% or fewer people.<sup id="cite_ref-Rozerem_FDA_label_3-23" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Rarely, <a href="/wiki/Anaphylactic_reaction" class="mw-redirect" title="Anaphylactic reaction">anaphylactic reactions</a>, <a href="/wiki/Abnormal_thinking" class="mw-redirect" title="Abnormal thinking">abnormal thinking</a>, and worsening of <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a> or <a href="/wiki/Suicidal_thinking" class="mw-redirect" title="Suicidal thinking">suicidal thinking</a> in patients with pre-existing depression may occur with ramelteon.<sup id="cite_ref-Rozerem_FDA_label_3-24" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon has been found to slightly increase <a href="/wiki/Prolactin" title="Prolactin">prolactin</a> levels in women (+34% vs. –4% with placebo) but not in men and to decrease free <a href="/wiki/Testosterone" title="Testosterone">testosterone</a> levels (by 3–6% in younger men and by 13–18% in older men).<sup id="cite_ref-Rozerem_FDA_label_3-25" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid19090503_20-0" class="reference"><a href="#cite_note-pmid19090503-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid19284927_21-0" class="reference"><a href="#cite_note-pmid19284927-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p><p>Ramelteon has not been shown to produce <a href="/wiki/Drug_dependence" class="mw-redirect" title="Drug dependence">dependence</a> and has shown no <a href="/wiki/Misuse_potential" class="mw-redirect" title="Misuse potential">potential for abuse</a>.<sup id="cite_ref-Rozerem_FDA_label_3-26" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Drug_withdrawal" title="Drug withdrawal">withdrawal</a> and <a href="/wiki/Rebound_insomnia" class="mw-redirect" title="Rebound insomnia">rebound insomnia</a> that is typical with <a href="/wiki/GABAA_receptor_positive_allosteric_modulator" title="GABAA receptor positive allosteric modulator">GABA<sub>A</sub> receptor positive modulators</a> like <a href="/wiki/Benzodiazepine" title="Benzodiazepine">benzodiazepines</a> and <a href="/wiki/Z-drug" class="mw-redirect" title="Z-drug">Z-drugs</a> is not present in ramelteon.<sup id="cite_ref-Rozerem_FDA_label_3-27" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Increased incidence of <a href="/wiki/Liver_tumor" title="Liver tumor">liver</a> and <a href="/wiki/Testicular_tumor" class="mw-redirect" title="Testicular tumor">testicular tumors</a> have been observed with ramelteon in rodents but only at doses equivalent to at least 20 times greater than the recommended dose in humans.<sup id="cite_ref-Rozerem_FDA_label_3-28" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Overdose">Overdose</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=10" title="Edit section: Overdose"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon has been assessed at doses of up to 64 mg in clinical studies.<sup id="cite_ref-Rozerem_FDA_label_3-29" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Interactions">Interactions</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=11" title="Edit section: Interactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon has been evaluated for potential drug interactions with the following medications and showed no significant effects: <a href="/wiki/Omeprazole" title="Omeprazole">omeprazole</a>, <a href="/wiki/Theophylline" title="Theophylline">theophylline</a>, <a href="/wiki/Dextromethorphan" title="Dextromethorphan">dextromethorphan</a>, and <a href="/wiki/Midazolam" title="Midazolam">midazolam</a>, <a href="/wiki/Digoxin" title="Digoxin">digoxin</a> and <a href="/wiki/Warfarin" title="Warfarin">warfarin</a>. There were no clinically meaningful effects when ramelteon was coadministered with any of these drugs.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (April 2020)">medical citation needed</span></a></i>]</sup> </p><p>A drug interaction study showed that there were no clinically meaningful effects or an increase in adverse events when ramelteon and the SSRI <a href="/wiki/Prozac" class="mw-redirect" title="Prozac">Prozac</a> (fluoxetine) were coadministered. When coadministered with ramelteon, <a href="/wiki/Fluvoxamine" title="Fluvoxamine">fluvoxamine</a> (strong <a href="/wiki/CYP1A2" title="CYP1A2">CYP1A2</a> inhibitor) increased <a href="/wiki/Area_under_the_curve_(pharmacokinetics)" title="Area under the curve (pharmacokinetics)">AUC</a> approximately 190-fold, and the <a href="/wiki/Cmax_(pharmacology)" title="Cmax (pharmacology)">C<sub>max</sub></a> increased approximately 70-fold, compared to ramelteon administered alone. Ramelteon and <a href="/wiki/Fluvoxamine" title="Fluvoxamine">fluvoxamine</a> should not be coadministered.<sup id="cite_ref-Rozerem_FDA_label_3-30" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Ramelteon has significant <a href="/wiki/Drug%E2%80%93drug_interaction" class="mw-redirect" title="Drug–drug interaction">drug–drug interaction</a> with the following drugs: <a href="/wiki/Amiodarone" title="Amiodarone">amiodarone</a>, <a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>, <a href="/wiki/Fluvoxamine" title="Fluvoxamine">fluvoxamine</a>, <a href="/wiki/Ticlopidine" title="Ticlopidine">ticlopidine</a>. </p><p>Ramelteon should be administered with caution in patients taking other <a href="/wiki/CYP1A2" title="CYP1A2">CYP1A2</a> inhibitors, strong <a href="/wiki/CYP3A4" title="CYP3A4">CYP3A4</a> inhibitors such as <a href="/wiki/Ketoconazole" title="Ketoconazole">ketoconazole</a>, and strong <a href="/wiki/CYP2C9" title="CYP2C9">CYP2C9</a> inhibitors such as <a href="/wiki/Fluconazole" title="Fluconazole">fluconazole</a>.<sup id="cite_ref-Rozerem_FDA_label_3-31" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Efficacy may be reduced when ramelteon is used in combination with potent <a href="/wiki/Cytochrome_P450_oxidase" class="mw-redirect" title="Cytochrome P450 oxidase">CYP</a> enzyme inducers such as <a href="/wiki/Rifampin" class="mw-redirect" title="Rifampin">rifampin</a>, since ramelteon concentrations may be decreased.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (April 2020)">medical citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pharmacology">Pharmacology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=12" title="Edit section: Pharmacology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Pharmacodynamics">Pharmacodynamics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=13" title="Edit section: Pharmacodynamics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is a <a href="/wiki/Melatonin_receptor_agonist" title="Melatonin receptor agonist">melatonin receptor agonist</a> with both high affinity for <a href="/wiki/Melatonin_receptor" title="Melatonin receptor">melatonin MT<sub>1</sub> and MT<sub>2</sub> receptors</a> and <a href="/wiki/Functional_selectivity" title="Functional selectivity">selectivity</a> over the non-human MT<sub>3</sub> receptor. Ramelteon demonstrates <a href="/wiki/Full_agonist" class="mw-redirect" title="Full agonist">full agonist</a> activity <i>in vitro</i> in cells expressing human MT<sub>1</sub> or MT<sub>2</sub> receptors, and high selectivity for human MT<sub>1</sub> and MT<sub>2</sub> receptors compared to the non-human MT<sub>3</sub> receptor.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Affinity_(pharmacology)" class="mw-redirect" title="Affinity (pharmacology)">affinity</a> of ramelteon for the MT<sub>1</sub> and MT<sub>2</sub> receptors is 3 to 16 times higher than that of melatonin.<sup id="cite_ref-pmid29487083_8-5" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Ramelteon has 8-fold higher affinity for the MT<sub>1</sub> receptor over the MT<sub>2</sub> receptor.<sup id="cite_ref-pmid29487083_8-6" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The binding profile of ramelteon distinguishes it from <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a>, <a href="/wiki/Tasimelteon" title="Tasimelteon">tasimelteon</a>, and <a href="/wiki/Agomelatine" title="Agomelatine">agomelatine</a>.<sup id="cite_ref-pmid29487083_8-7" class="reference"><a href="#cite_note-pmid29487083-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid25534555_23-0" class="reference"><a href="#cite_note-pmid25534555-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Remelteon has a clinically irrelevant affinity for the serotonin <a href="/wiki/5HT1A_receptor" class="mw-redirect" title="5HT1A receptor">5-HT<sub>1A</sub> receptor</a> (Ki = 5.6 μM).<sup id="cite_ref-overview_24-0" class="reference"><a href="#cite_note-overview-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p>The major <a href="/wiki/Metabolite" title="Metabolite">metabolite</a> of ramelteon, M-II, is active and has approximately one-tenth and one-fifth the binding affinity of the parent molecule for the human MT<sub>1</sub> and MT<sub>2</sub> receptors, respectively, and is 17- to 25-fold less potent than ramelteon in <i>in vitro</i> functional assays. Although the potency of M-II at MT<sub>1</sub> and MT<sub>2</sub> receptors is lower than the parent drug, M-II circulates at higher concentrations than the parent producing 20- to 100-fold greater mean systemic exposure when compared to ramelteon. M-II has weak affinity for the serotonin <a href="/wiki/5HT2B_receptor" class="mw-redirect" title="5HT2B receptor">5-HT<sub>2B</sub> receptor</a>, but no appreciable affinity for other receptors or enzymes. Similar to ramelteon, M-II does not interfere with the activity of a number of endogenous enzymes.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (April 2020)">medical citation needed</span></a></i>]</sup> </p><p>Ramelteon has no appreciable affinity for the <a href="/wiki/GABA_receptor" title="GABA receptor">GABA receptors</a> or for receptors that bind <a href="/wiki/Neuropeptide" title="Neuropeptide">neuropeptides</a>, <a href="/wiki/Cytokine" title="Cytokine">cytokines</a>, <a href="/wiki/Serotonin" title="Serotonin">serotonin</a>, <a href="/wiki/Dopamine" title="Dopamine">dopamine</a>, <a href="/wiki/Noradrenaline" class="mw-redirect" title="Noradrenaline">noradrenaline</a>, <a href="/wiki/Acetylcholine" title="Acetylcholine">acetylcholine</a>, and <a href="/wiki/Opioid" title="Opioid">opioids</a>. Ramelteon also does not interfere with the activity of a number of selected enzymes in a standard panel.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (April 2020)">medical citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Mechanism_of_action">Mechanism of action</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=14" title="Edit section: Mechanism of action"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The activity of ramelteon at the MT<sub>1</sub> and MT<sub>2</sub> receptors in the suprachiasmatic nucleus of the hypothalamus is believed to contribute to its sleep-promoting properties, as these receptors, acted upon by endogenous melatonin, are thought to be involved in the maintenance of the <a href="/wiki/Circadian_rhythm" title="Circadian rhythm">circadian rhythm</a> underlying the normal <a href="/wiki/Sleep%E2%80%93wake_cycle" class="mw-redirect" title="Sleep–wake cycle">sleep–wake cycle</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Pharmacokinetics">Pharmacokinetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=15" title="Edit section: Pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Absorption">Absorption</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=16" title="Edit section: Absorption"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The total <a href="/wiki/Absorption_(pharmacokinetics)" class="mw-redirect" title="Absorption (pharmacokinetics)">absorption</a> of ramelteon is 84% while its <a href="/wiki/Oral_administration" title="Oral administration">oral</a> <a href="/wiki/Bioavailability" title="Bioavailability">bioavailability</a> is 1.8%.<sup id="cite_ref-Rozerem_FDA_label_3-32" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The low bioavailability of ramelteon is due to extensive <a href="/wiki/First-pass_metabolism" class="mw-redirect" title="First-pass metabolism">first-pass metabolism</a>.<sup id="cite_ref-Rozerem_FDA_label_3-33" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon has a higher lipophilicity than melatonin and thus permeates more easily into tissue.<sup id="cite_ref-overview_24-1" class="reference"><a href="#cite_note-overview-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> The absorption of ramelteon is rapid, with <a href="/wiki/Tmax_(pharmacology)" class="mw-redirect" title="Tmax (pharmacology)">peak levels</a> being reached after approximately 0.75 hours (range 0.5–1.5 hours).<sup id="cite_ref-Rozerem_FDA_label_3-34" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Food increases peak concentrations of ramelteon by 22% and overall exposure by 31% and delays the time to peak levels by approximately 0.75 hours.<sup id="cite_ref-Rozerem_FDA_label_3-35" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">pharmacokinetics</a> of ramelteon are linear across a dose range of 4 to 64 mg.<sup id="cite_ref-Rozerem_FDA_label_3-36" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> There is substantial <a href="/wiki/Interindividual_variability" class="mw-redirect" title="Interindividual variability">interindividual variability</a> in the peak concentrations and <a href="/wiki/Area-under-the-curve_(pharmacokinetics)" class="mw-redirect" title="Area-under-the-curve (pharmacokinetics)">area-under-the-curve levels</a> of ramelteon which is consistent with high first-pass metabolism.<sup id="cite_ref-Rozerem_FDA_label_3-37" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Distribution">Distribution</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=17" title="Edit section: Distribution"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <a href="/wiki/Volume_of_distribution" title="Volume of distribution">volume of distribution</a> of ramelteon is 73.6 L, which suggests substantial <a href="/wiki/Tissue_distribution" class="mw-redirect" title="Tissue distribution">tissue distribution</a>.<sup id="cite_ref-Rozerem_FDA_label_3-38" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Plasma_protein_binding" title="Plasma protein binding">plasma protein binding</a> of ramelteon is 82% independently of concentration.<sup id="cite_ref-Rozerem_FDA_label_3-39" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon is primarily bound to <a href="/wiki/Human_serum_albumin" title="Human serum albumin">albumin</a> (70%).<sup id="cite_ref-Rozerem_FDA_label_3-40" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The medication is not selectively distributed to <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a>.<sup id="cite_ref-Rozerem_FDA_label_3-41" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Metabolism">Metabolism</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=18" title="Edit section: Metabolism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is <a href="/wiki/Metabolism" title="Metabolism">metabolized</a> in the <a href="/wiki/Liver" title="Liver">liver</a> primarily by <a href="/wiki/Oxidation" class="mw-redirect" title="Oxidation">oxidation</a> via <a href="/wiki/Hydroxylation" title="Hydroxylation">hydroxylation</a> and <a href="/wiki/Carbonylation" title="Carbonylation">carbonylation</a>.<sup id="cite_ref-Rozerem_FDA_label_3-42" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> It is also secondarily metabolized to produce <a href="/wiki/Glucuronide" title="Glucuronide">glucuronide</a> <a href="/wiki/Conjugation_(biochemistry)" class="mw-redirect" title="Conjugation (biochemistry)">conjugates</a>.<sup id="cite_ref-Rozerem_FDA_label_3-43" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Ramelteon is metabolized mainly by <a href="/wiki/CYP1A2" title="CYP1A2">CYP1A2</a> while <a href="/wiki/CYP2C" class="mw-redirect" title="CYP2C">CYP2C</a> <a href="/wiki/Enzyme" title="Enzyme">enzymes</a> and <a href="/wiki/CYP3A4" title="CYP3A4">CYP3A4</a> are involved to a minor extent.<sup id="cite_ref-Rozerem_FDA_label_3-44" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Metabolite" title="Metabolite">metabolites</a> of ramelteon include M-I, M-II, M-III, and M-IV.<sup id="cite_ref-Rozerem_FDA_label_3-45" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Exposure to M-II is approximately 20- to 100-fold higher than to ramelteon.<sup id="cite_ref-Rozerem_FDA_label_3-46" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Elimination">Elimination</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=19" title="Edit section: Elimination"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon is <a href="/wiki/Excretion" title="Excretion">excreted</a> 84% in <a href="/wiki/Urine" title="Urine">urine</a> and 4% in <a href="/wiki/Feces" title="Feces">feces</a>.<sup id="cite_ref-Rozerem_FDA_label_3-47" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Less than 0.1% of drug is excreted as unchanged ramelteon.<sup id="cite_ref-Rozerem_FDA_label_3-48" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Elimination_(pharmacology)" title="Elimination (pharmacology)">Elimination</a> of ramelteon is essentially complete by 96 hours following a single dose.<sup id="cite_ref-Rozerem_FDA_label_3-49" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Elimination_half-life" class="mw-redirect" title="Elimination half-life">elimination half-life</a> of ramelteon is 1 to 2.6 hours while the half-life of M-II, the major active metabolite of ramelteon, is 2 to 5 hours.<sup id="cite_ref-Rozerem_FDA_label_3-50" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid18368944_7-1" class="reference"><a href="#cite_note-pmid18368944-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The half-lives of ramelteon and M-II are substantially longer than that of <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a>, which has a half-life in the range of 20 to 45 minutes.<sup id="cite_ref-pmid18368944_7-2" class="reference"><a href="#cite_note-pmid18368944-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Levels of ramelteon and its metabolites at or below the limit of detectability within 24 hours following a dose.<sup id="cite_ref-Rozerem_FDA_label_3-51" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Special_populations">Special populations</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=20" title="Edit section: Special populations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Peak levels of ramelteon and overall exposure are about 86% and 97% higher, respectively, in elderly adults compared to younger adults.<sup id="cite_ref-Rozerem_FDA_label_3-52" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Conversely, peak levels of M-II are 13% and overall exposure 30% higher in elderly adults than in younger adults.<sup id="cite_ref-Rozerem_FDA_label_3-53" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Elimination_half-life" class="mw-redirect" title="Elimination half-life">elimination half-life</a> of ramelteon is 2.6 hours in elderly adults.<sup id="cite_ref-Rozerem_FDA_label_3-54" class="reference"><a href="#cite_note-Rozerem_FDA_label-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=21" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon was first described in the medical literature in 2002.<sup id="cite_ref-pmid12213063_9-1" class="reference"><a href="#cite_note-pmid12213063-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> It was approved for use in the United States in July 2005.<sup id="cite_ref-FDA2005_10-1" class="reference"><a href="#cite_note-FDA2005-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=22" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon has no <a href="/wiki/Abuse_potential" class="mw-redirect" title="Abuse potential">potential for abuse</a> or <a href="/wiki/Drug_dependence" class="mw-redirect" title="Drug dependence">drug dependence</a> and is not a <a href="/wiki/Controlled_substance" title="Controlled substance">controlled substance</a>.<sup id="cite_ref-pmid16332146_25-0" class="reference"><a href="#cite_note-pmid16332146-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=23" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Ramelteon, along with other melatonin receptor agonists like <a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">melatonin</a>, has been repurposed in clinical trials as an adjunctive treatment for acute <a href="/wiki/Manic_episode" class="mw-redirect" title="Manic episode">manic episodes</a> in subjects with <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>.<sup id="cite_ref-repurposed2021_19-2" class="reference"><a href="#cite_note-repurposed2021-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Nonetheless, meta-analytic evidence is based on very few trials and does not allow supporting the use of melatonin receptor agonists as adjunctive options for mania in clinical practice, although the small <a href="/wiki/Sample_size" class="mw-redirect" title="Sample size">sample size</a> do not allow ruling out their beneficial effect.<sup id="cite_ref-repurposed2021_19-3" class="reference"><a href="#cite_note-repurposed2021-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Ramelteon&action=edit&section=24" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Yang2022-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-Yang2022_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFKimYang2022" class="citation journal cs1">Kim HK, Yang KI (December 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810491">"Melatonin and melatonergic drugs in sleep disorders"</a>. <i>Translational and Clinical Pharmacology</i>. <b>30</b> (4): <span class="nowrap">163–</span>171. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.12793%2Ftcp.2022.30.e21">10.12793/tcp.2022.30.e21</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810491">9810491</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36632077">36632077</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Translational+and+Clinical+Pharmacology&rft.atitle=Melatonin+and+melatonergic+drugs+in+sleep+disorders&rft.volume=30&rft.issue=4&rft.pages=%3Cspan+class%3D%22nowrap%22%3E163-%3C%2Fspan%3E171&rft.date=2022-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9810491%23id-name%3DPMC&rft_id=info%3Apmid%2F36632077&rft_id=info%3Adoi%2F10.12793%2Ftcp.2022.30.e21&rft.aulast=Kim&rft.aufirst=HK&rft.au=Yang%2C+KI&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9810491&rfr_id=info%3Asid%2Fen.wikipedia.org%3ARamelteon" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAnvisa2023" class="citation web cs1 cs1-prop-foreign-lang-source"><a href="/wiki/Brazilian_Health_Regulatory_Agency" title="Brazilian Health Regulatory Agency">Anvisa</a> (31 March 2023). <a rel="nofollow" class="external text" href="https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992">"RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial"</a> [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). <a href="/wiki/Di%C3%A1rio_Oficial_da_Uni%C3%A3o" title="Diário Oficial da União">Diário Oficial da União</a> (published 4 April 2023). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230803143925/https://www.in.gov.br/en/web/dou/-/resolucao-rdc-n-784-de-31-de-marco-de-2023-474904992">Archived</a> from the original on 3 August 2023<span class="reference-accessdate">. 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href="#cite_ref-Rozerem_FDA_label_3-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-20"><sup><i><b>u</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-21"><sup><i><b>v</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-22"><sup><i><b>w</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-23"><sup><i><b>x</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-24"><sup><i><b>y</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-25"><sup><i><b>z</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-26"><sup><i><b>aa</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-27"><sup><i><b>ab</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-28"><sup><i><b>ac</b></i></sup></a> <a href="#cite_ref-Rozerem_FDA_label_3-29"><sup><i><b>ad</b></i></sup></a> <a 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title="2,2,2-Trichloroethanol">Trichloroethanol</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Barbiturate" title="Barbiturate">Barbiturates</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Allobarbital" title="Allobarbital">Allobarbital</a></li> <li><a href="/wiki/Amobarbital" title="Amobarbital">Amobarbital</a></li> <li><a href="/wiki/Aprobarbital" title="Aprobarbital">Aprobarbital</a></li> <li><a href="/wiki/Barbital" title="Barbital">Barbital</a></li> <li><a href="/wiki/Butabarbital" title="Butabarbital">Butabarbital</a></li> <li><a href="/wiki/Butobarbital" title="Butobarbital">Butobarbital</a></li> <li><a href="/wiki/Cyclobarbital" title="Cyclobarbital">Cyclobarbital</a></li> <li><a href="/wiki/Ethallobarbital" title="Ethallobarbital">Ethallobarbital</a></li> <li><a href="/wiki/Heptabarb" title="Heptabarb">Heptabarb</a></li> <li><a href="/wiki/Hexobarbital" title="Hexobarbital">Hexobarbital</a></li> <li><a href="/wiki/Mephobarbital" class="mw-redirect" title="Mephobarbital">Mephobarbital</a></li> <li><a href="/wiki/Methohexital" title="Methohexital">Methohexital</a></li> <li><a href="/wiki/Narcobarbital" title="Narcobarbital">Narcobarbital</a></li> <li><a href="/wiki/Pentobarbital" title="Pentobarbital">Pentobarbital</a></li> <li><a href="/wiki/Phenallymal" class="mw-redirect" title="Phenallymal">Phenallymal</a></li> <li><a href="/wiki/Phenobarbital" title="Phenobarbital">Phenobarbital</a></li> <li><a href="/wiki/Propylbarbital" title="Propylbarbital">Propylbarbital</a></li> <li><a href="/wiki/Proxibarbal" class="mw-redirect" title="Proxibarbal">Proxibarbal</a></li> <li><a href="/wiki/Reposal" title="Reposal">Reposal</a></li> <li><a href="/wiki/Secobarbital" title="Secobarbital">Secobarbital</a></li> <li><a href="/wiki/Talbutal" title="Talbutal">Talbutal</a></li> <li><a href="/wiki/Thiamylal" title="Thiamylal">Thiamylal</a></li> <li><a href="/wiki/Sodium_thiopental" title="Sodium thiopental">Thiopental</a></li> <li><a href="/wiki/Thiotetrabarbital" title="Thiotetrabarbital">Thiotetrabarbital</a></li> <li><a href="/wiki/Vinbarbital" title="Vinbarbital">Vinbarbital</a></li> <li><a href="/wiki/Vinylbital" title="Vinylbital">Vinylbital</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Benzodiazepine" title="Benzodiazepine">Benzodiazepines</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brotizolam" title="Brotizolam">Brotizolam</a></li> <li><a href="/wiki/Cinolazepam" title="Cinolazepam">Cinolazepam</a></li> <li><a href="/wiki/Climazolam" title="Climazolam">Climazolam</a></li> <li><a href="/wiki/Clonazolam" title="Clonazolam">Clonazolam</a></li> <li><a href="/wiki/Doxefazepam" title="Doxefazepam">Doxefazepam</a></li> <li><a href="/wiki/Estazolam" title="Estazolam">Estazolam</a></li> <li><a href="/wiki/Flubromazolam" title="Flubromazolam">Flubromazolam</a></li> <li><a href="/wiki/Flunitrazolam" title="Flunitrazolam">Flunitrazolam</a></li> <li><a href="/wiki/Flunitrazepam" title="Flunitrazepam">Flunitrazepam</a></li> <li><a href="/wiki/Flurazepam" title="Flurazepam">Flurazepam</a></li> <li><a href="/wiki/Flutemazepam" title="Flutemazepam">Flutemazepam</a></li> <li><a href="/wiki/Flutoprazepam" title="Flutoprazepam">Flutoprazepam</a></li> <li><a href="/wiki/Loprazolam" title="Loprazolam">Loprazolam</a></li> <li><a href="/wiki/Lormetazepam" title="Lormetazepam">Lormetazepam</a></li> <li><a href="/wiki/Midazolam" title="Midazolam">Midazolam</a></li> <li><a href="/wiki/Nimetazepam" title="Nimetazepam">Nimetazepam</a></li> <li><a href="/wiki/Nitemazepam" title="Nitemazepam">Nitemazepam</a></li> <li><a href="/wiki/Nitrazepam" title="Nitrazepam">Nitrazepam</a></li> <li><a href="/wiki/Nitrazolam" title="Nitrazolam">Nitrazolam</a></li> <li><a href="/wiki/Quazepam" title="Quazepam">Quazepam</a></li> <li><a href="/wiki/Temazepam" title="Temazepam">Temazepam</a></li> <li><a href="/wiki/Triazolam" title="Triazolam">Triazolam</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Carbamate" title="Carbamate">Carbamates</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carisoprodol" title="Carisoprodol">Carisoprodol</a></li> <li><a href="/wiki/Emylcamate" title="Emylcamate">Emylcamate</a></li> <li><a href="/wiki/Ethinamate" title="Ethinamate">Ethinamate</a></li> <li><a href="/wiki/Hexapropymate" title="Hexapropymate">Hexapropymate</a></li> <li><a href="/wiki/Meprobamate" title="Meprobamate">Meprobamate</a></li> <li><a href="/wiki/Methocarbamol" title="Methocarbamol">Methocarbamol</a></li> <li><a href="/wiki/Phenprobamate" title="Phenprobamate">Phenprobamate</a></li> <li><a href="/wiki/Procymate" title="Procymate">Procymate</a></li> <li><a href="/wiki/Tybamate" title="Tybamate">Tybamate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Imidazole" title="Imidazole">Imidazoles</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Etomidate" title="Etomidate">Etomidate</a></li> <li><a href="/wiki/Metomidate" title="Metomidate">Metomidate</a></li> <li><a href="/wiki/Propoxate" title="Propoxate">Propoxate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Monoureide" class="mw-redirect" title="Monoureide">Monoureides</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acecarbromal" title="Acecarbromal">Acecarbromal</a></li> <li><a href="/wiki/Apronal" title="Apronal">Apronal (apronalide)</a></li> <li><a href="/wiki/Bromisoval" title="Bromisoval">Bromisoval</a></li> <li><a href="/w/index.php?title=Capuride&action=edit&redlink=1" class="new" title="Capuride (page does not exist)">Capuride</a></li> <li><a href="/wiki/Carbromal" title="Carbromal">Carbromal</a></li> <li><a href="/w/index.php?title=Ectylurea&action=edit&redlink=1" class="new" title="Ectylurea (page does not exist)">Ectylurea</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Neuroactive_steroid" class="mw-redirect" title="Neuroactive steroid">Neuroactive steroids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acebrochol" title="Acebrochol">Acebrochol</a></li> <li><a href="/wiki/Allopregnanolone" title="Allopregnanolone">Allopregnanolone</a></li> <li><a href="/wiki/Alfadolone" title="Alfadolone">Alphadolone</a></li> <li><a href="/wiki/Alphaxolone" class="mw-redirect" title="Alphaxolone">Alphaxolone</a></li> <li><a href="/wiki/Eltanolone" class="mw-redirect" title="Eltanolone">Eltanolone</a></li> <li><a href="/wiki/Hydroxydione" title="Hydroxydione">Hydroxydione</a></li> <li><a href="/wiki/Minaxolone" title="Minaxolone">Minaxolone</a></li> <li><a href="/wiki/Progesterone" title="Progesterone">Progesterone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Nonbenzodiazepine" title="Nonbenzodiazepine">Nonbenzodiazepines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eszopiclone" title="Eszopiclone">Eszopiclone</a></li> <li><a href="/wiki/Indiplon" title="Indiplon">Indiplon</a></li> <li><a href="/wiki/Lirequinil" title="Lirequinil">Lirequinil</a></li> <li><a href="/wiki/Necopidem" title="Necopidem">Necopidem</a></li> <li><a href="/wiki/Pazinaclone" title="Pazinaclone">Pazinaclone</a></li> <li><a href="/wiki/Saripidem" title="Saripidem">Saripidem</a></li> <li><a href="/wiki/Suproclone" title="Suproclone">Suproclone</a></li> <li><a href="/wiki/Suriclone" title="Suriclone">Suriclone</a></li> <li><a href="/wiki/Zaleplon" title="Zaleplon">Zaleplon</a></li> <li><a href="/wiki/Zolpidem" title="Zolpidem">Zolpidem</a></li> <li><a href="/wiki/Zopiclone" title="Zopiclone">Zopiclone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Phenol" title="Phenol">Phenols</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Propofol" title="Propofol">Propofol</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Piperidinedione" class="mw-redirect" title="Piperidinedione">Piperidinediones</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Glutethimide" title="Glutethimide">Glutethimide</a></li> <li><a href="/wiki/Methyprylon" title="Methyprylon">Methyprylon</a></li> <li><a href="/wiki/Pyrithyldione" title="Pyrithyldione">Pyrithyldione</a></li> <li><a href="/wiki/Piperidione" title="Piperidione">Piperidione</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Quinazolinone" title="Quinazolinone">Quinazolinones</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Afloqualone" title="Afloqualone">Afloqualone</a></li> <li><a href="/wiki/Cloroqualone" title="Cloroqualone">Cloroqualone</a></li> <li><a href="/wiki/Diproqualone" title="Diproqualone">Diproqualone</a></li> <li><a href="/wiki/Etaqualone" title="Etaqualone">Etaqualone</a></li> <li><a href="/wiki/Mebroqualone" title="Mebroqualone">Mebroqualone</a></li> <li><a href="/wiki/Mecloqualone" title="Mecloqualone">Mecloqualone</a></li> <li><a href="/wiki/Methaqualone" title="Methaqualone">Methaqualone</a></li> <li><a href="/wiki/Methylmethaqualone" title="Methylmethaqualone">Methylmethaqualone</a></li> <li><a href="/wiki/Nitromethaqualone" title="Nitromethaqualone">Nitromethaqualone</a></li> <li><a href="/wiki/SL-164" title="SL-164">SL-164</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;">Others</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acetophenone" title="Acetophenone">Acetophenone</a></li> <li><a href="/wiki/Acetylglycinamide_chloral_hydrate" title="Acetylglycinamide chloral hydrate">Acetylglycinamide chloral hydrate</a></li> <li><a href="/wiki/Bromide" title="Bromide">Bromide</a> compounds <ul><li><a href="/wiki/Lithium_bromide" title="Lithium bromide">Lithium bromide</a></li> <li><a href="/wiki/Potassium_bromide" title="Potassium bromide">Potassium bromide</a></li> <li><a href="/wiki/Sodium_bromide" title="Sodium bromide">Sodium bromide</a></li></ul></li> <li><a href="/wiki/Centalun" title="Centalun">Centalun</a></li> <li><a href="/wiki/Chloral_betaine" title="Chloral betaine">Chloral betaine</a></li> <li><a href="/wiki/Chloral_hydrate" title="Chloral hydrate">Chloral hydrate</a></li> <li><a href="/wiki/Chloralose" title="Chloralose">Chloralose</a></li> <li><a href="/wiki/Clomethiazole" title="Clomethiazole">Clomethiazole</a></li> <li><a href="/wiki/Dichloralphenazone" title="Dichloralphenazone">Dichloralphenazone</a></li> <li><a href="/wiki/Gaboxadol" title="Gaboxadol">Gaboxadol</a></li> <li><a href="/wiki/Kavalactone" title="Kavalactone">Kavalactones</a></li> <li><a href="/wiki/Loreclezole" title="Loreclezole">Loreclezole</a></li> <li><a href="/wiki/Paraldehyde" title="Paraldehyde">Paraldehyde</a></li> <li><a href="/wiki/Petrichloral" title="Petrichloral">Petrichloral</a></li> <li><a href="/w/index.php?title=Sulfonylalkane&action=edit&redlink=1" class="new" title="Sulfonylalkane (page does not exist)">Sulfonylalkanes</a> <ul><li><a href="/wiki/Sulfonmethane" title="Sulfonmethane">Sulfonmethane (sulfonal)</a></li> <li><a href="/wiki/Tetronal" title="Tetronal">Tetronal</a></li> <li><a href="/wiki/Trional" title="Trional">Trional</a></li></ul></li> <li><a href="/wiki/Triclofos" title="Triclofos">Triclofos</a></li> <li><a href="/wiki/Sesquiterpene" title="Sesquiterpene">Sesquiterpene</a> <ul><li><a href="/wiki/Isovaleramide" title="Isovaleramide">Isovaleramide</a></li> <li><a href="/wiki/Isovaleric_acid" title="Isovaleric acid">Isovaleric acid</a></li> <li><a href="/wiki/Valerenic_acid" title="Valerenic acid">Valerenic acid</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/GABAB_receptor" title="GABAB receptor">GABA<sub>B</sub></a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/1,4-Butanediol" title="1,4-Butanediol">1,4-Butanediol</a></li> <li><a href="/wiki/4-Fluorophenibut" title="4-Fluorophenibut">4-Fluorophenibut</a></li> <li><a href="/wiki/Aceburic_acid" title="Aceburic acid">Aceburic acid</a></li> <li><a href="/wiki/Baclofen" title="Baclofen">Baclofen</a></li> <li><a href="/wiki/GABOB" class="mw-redirect" title="GABOB">GABOB</a></li> <li><a href="/wiki/Gamma-Hydroxybutyric_acid" class="mw-redirect" title="Gamma-Hydroxybutyric acid">GHB</a> (<a href="/wiki/Sodium_oxybate" title="Sodium oxybate">sodium oxybate</a>)</li> <li><a href="/wiki/Gamma-Butyrolactone" class="mw-redirect" title="Gamma-Butyrolactone">GBL</a></li> <li><a href="/wiki/Gamma-Valerolactone" class="mw-redirect" title="Gamma-Valerolactone">GVL</a></li> <li><a href="/wiki/Phenibut" title="Phenibut">Phenibut</a></li> <li><a href="/wiki/Tolibut" title="Tolibut">Tolibut</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/H1_receptor" class="mw-redirect" title="H1 receptor">H<sub>1</sub></a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Histamine_antagonist" class="mw-redirect" title="Histamine antagonist">Antihistamines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Captodiame" title="Captodiame">Captodiame</a></li> <li><a href="/wiki/Cyproheptadine" title="Cyproheptadine">Cyproheptadine</a></li> <li><a href="/wiki/Diphenhydramine" title="Diphenhydramine">Diphenhydramine</a></li> <li><a href="/wiki/Doxylamine" title="Doxylamine">Doxylamine</a></li> <li><a href="/wiki/Hydroxyzine" title="Hydroxyzine">Hydroxyzine</a></li> <li><a href="/wiki/Methapyrilene" title="Methapyrilene">Methapyrilene</a></li> <li><a href="/wiki/Perlapine" title="Perlapine">Perlapine</a></li> <li><a href="/wiki/Pheniramine" title="Pheniramine">Pheniramine</a></li> <li><a href="/wiki/Promethazine" title="Promethazine">Promethazine</a></li> <li><a href="/wiki/Propiomazine" title="Propiomazine">Propiomazine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Antidepressant" title="Antidepressant">Antidepressants</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Serotonin_antagonists_and_reuptake_inhibitors" class="mw-redirect" title="Serotonin antagonists and reuptake inhibitors">Serotonin antagonists and reuptake inhibitors</a> <ul><li><a href="/wiki/Etoperidone" title="Etoperidone">Etoperidone</a></li> <li><a href="/wiki/Nefazodone" title="Nefazodone">Nefazodone</a></li> <li><a href="/wiki/Trazodone" title="Trazodone">Trazodone</a></li></ul></li> <li><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a> <ul><li><a href="/wiki/Amitriptyline" title="Amitriptyline">Amitriptyline</a></li> <li><a href="/wiki/Doxepin" title="Doxepin">Doxepin</a></li> <li><a href="/wiki/Trimipramine" title="Trimipramine">Trimipramine</a>, etc.</li></ul></li> <li><a href="/wiki/Tetracyclic_antidepressant" title="Tetracyclic antidepressant">Tetracyclic antidepressants</a> <ul><li><a href="/wiki/Mianserin" title="Mianserin">Mianserin</a></li> <li><a href="/wiki/Mirtazapine" title="Mirtazapine">Mirtazapine</a>, etc.</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Typical_antipsychotic" title="Typical antipsychotic">Typical antipsychotics</a> <ul><li><a href="/wiki/Chlorpromazine" title="Chlorpromazine">Chlorpromazine</a></li> <li><a href="/wiki/Thioridazine" title="Thioridazine">Thioridazine</a>, etc.</li></ul></li> <li><a href="/wiki/Atypical_antipsychotic" title="Atypical antipsychotic">Atypical antipsychotics</a> <ul><li><a href="/wiki/Olanzapine" title="Olanzapine">Olanzapine</a></li> <li><a href="/wiki/Quetiapine" title="Quetiapine">Quetiapine</a></li> <li><a href="/wiki/Risperidone" title="Risperidone">Risperidone</a>, etc.</li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Alpha-2_adrenergic_receptor" title="Alpha-2 adrenergic receptor">α<sub>2</sub>-Adrenergic</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clonidine" title="Clonidine">Clonidine</a></li> <li><a href="/wiki/Detomidine" title="Detomidine">Detomidine</a></li> <li><a href="/wiki/Dexmedetomidine" title="Dexmedetomidine">Dexmedetomidine</a></li> <li><a href="/wiki/Lofexidine" title="Lofexidine">Lofexidine</a></li> <li><a href="/wiki/Medetomidine" title="Medetomidine">Medetomidine</a></li> <li><a href="/wiki/Romifidine" title="Romifidine">Romifidine</a></li> <li><a href="/wiki/Tizanidine" title="Tizanidine">Tizanidine</a></li> <li><a href="/wiki/Xylazine" title="Xylazine">Xylazine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/5-HT2A_receptor" title="5-HT2A receptor">5-HT<sub>2A</sub></a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Antidepressant" title="Antidepressant">Antidepressants</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Trazodone" title="Trazodone">Trazodone</a></li> <li><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a> <ul><li><a href="/wiki/Amitriptyline" title="Amitriptyline">Amitriptyline</a></li> <li><a href="/wiki/Doxepin" title="Doxepin">Doxepin</a></li> <li><a href="/wiki/Trimipramine" title="Trimipramine">Trimipramine</a>, etc.</li></ul></li> <li><a href="/wiki/Tetracyclic_antidepressant" title="Tetracyclic antidepressant">Tetracyclic antidepressants</a> <ul><li><a href="/wiki/Mianserin" title="Mianserin">Mianserin</a></li> <li><a href="/wiki/Mirtazapine" title="Mirtazapine">Mirtazapine</a>, etc.</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotics</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Typical_antipsychotic" title="Typical antipsychotic">Typical antipsychotics</a> <ul><li><a href="/wiki/Chlorpromazine" title="Chlorpromazine">Chlorpromazine</a></li> <li><a href="/wiki/Thioridazine" title="Thioridazine">Thioridazine</a>, etc.</li></ul></li> <li><a href="/wiki/Atypical_antipsychotic" title="Atypical antipsychotic">Atypical antipsychotics</a> <ul><li><a href="/wiki/Olanzapine" title="Olanzapine">Olanzapine</a></li> <li><a href="/wiki/Quetiapine" title="Quetiapine">Quetiapine</a></li> <li><a href="/wiki/Risperidone" title="Risperidone">Risperidone</a>, etc.</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;">Others</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Niaprazine" title="Niaprazine">Niaprazine</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Melatonin_receptor" title="Melatonin receptor">Melatonin</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agomelatine" title="Agomelatine">Agomelatine</a></li> <li><a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">Melatonin</a></li> <li><a class="mw-selflink selflink">Ramelteon</a></li> <li><a href="/wiki/Tasimelteon" title="Tasimelteon">Tasimelteon</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Orexin_receptor" title="Orexin receptor">Orexin</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Daridorexant" title="Daridorexant">Daridorexant</a></li> <li><a href="/wiki/Lemborexant" title="Lemborexant">Lemborexant</a></li> <li><a href="/wiki/Suvorexant" title="Suvorexant">Suvorexant</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Gabapentinoid" title="Gabapentinoid"><abbr title="alpha2delta subunit">α<sub>2</sub>δ</abbr> <abbr title="voltage-gated calcium channel">VDCC</abbr></a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gabapentin" title="Gabapentin">Gabapentin</a></li> <li><a href="/wiki/Gabapentin_enacarbil" title="Gabapentin enacarbil">Gabapentin enacarbil</a></li> <li><a href="/wiki/Mirogabalin" title="Mirogabalin">Mirogabalin</a></li> <li><a href="/wiki/Phenibut" title="Phenibut">Phenibut</a></li> <li><a href="/wiki/Pregabalin" title="Pregabalin">Pregabalin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;">Others</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cannabidiol" title="Cannabidiol">Cannabidiol</a> <ul><li><a href="/wiki/Cannabis_(drug)" title="Cannabis (drug)">Cannabis</a></li></ul></li> <li><a href="/w/index.php?title=Chlorophenylalkyldiol&action=edit&redlink=1" class="new" title="Chlorophenylalkyldiol (page does not exist)">Chlorophenylalkyldiols</a> <ul><li><a href="/wiki/Fenpentadiol" title="Fenpentadiol">Fenpentadiol</a></li> <li><a href="/wiki/Metaglycodol" title="Metaglycodol">Metaglycodol</a></li> <li><a href="/wiki/Phenaglycodol" title="Phenaglycodol">Phenaglycodol</a></li></ul></li> <li><a href="/wiki/2,2-Diethyl-1,3-propanediol" class="mw-redirect" title="2,2-Diethyl-1,3-propanediol">Diethylpropanediol</a></li> <li><a href="/wiki/Evoxine" title="Evoxine">Evoxine</a></li> <li><a href="/wiki/Fenadiazole" title="Fenadiazole">Fenadiazole</a></li> <li><a href="/wiki/Guaifenesin" title="Guaifenesin">Guaifenesin</a>-related <a href="/wiki/Muscle_relaxant" title="Muscle relaxant">muscle relaxants</a> <ul><li><a href="/wiki/Chlorphenesin" class="mw-redirect" title="Chlorphenesin">Chlorphenesin</a></li> <li><a href="/wiki/Mephenesin" title="Mephenesin">Mephenesin</a></li> <li><a href="/wiki/Mephenoxalone" title="Mephenoxalone">Mephenoxalone</a></li> <li><a href="/wiki/Metaxalone" title="Metaxalone">Metaxalone</a></li> <li><a href="/wiki/Methocarbamol" title="Methocarbamol">Methocarbamol</a></li></ul></li> <li><a href="/wiki/Midaflur" title="Midaflur">Midaflur</a></li> <li><a href="/wiki/Opioid" title="Opioid">Opioids</a> (e.g., <a href="/wiki/Morphine" title="Morphine">morphine</a>)</li> <li><a href="/wiki/Passiflora" title="Passiflora">Passion flower</a></li> <li><a href="/wiki/Scopolamine" title="Scopolamine">Scopolamine</a></li> <li><a href="/wiki/Trazodone" title="Trazodone">Trazodone</a></li> <li><a href="/wiki/UMB68" class="mw-redirect" title="UMB68">UMB68</a></li> <li><a href="/wiki/Valnoctamide" title="Valnoctamide">Valnoctamide</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Insomnia_medications306" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Insomnia_medications" title="Template:Insomnia medications"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Insomnia_medications" title="Template talk:Insomnia medications"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Insomnia_medications" title="Special:EditPage/Template:Insomnia medications"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Insomnia_medications306" style="font-size:114%;margin:0 4em"><a href="/wiki/Hypnotic" title="Hypnotic">Insomnia medications</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/GABAA_receptor_positive_allosteric_modulator" title="GABAA receptor positive allosteric modulator">GABA<sub>A</sub> receptor<br />positive modulators</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Benzodiazepine" title="Benzodiazepine">Benzodiazepines</a>:</i> <a href="/wiki/Brotizolam" title="Brotizolam">Brotizolam</a></li> <li><a href="/wiki/Cinolazepam" title="Cinolazepam">Cinolazepam</a></li> <li><a href="/wiki/Climazolam" title="Climazolam">Climazolam</a></li> <li><a href="/wiki/Clorazepate" title="Clorazepate">Clorazepate</a></li> <li><a href="/wiki/Doxefazepam" title="Doxefazepam">Doxefazepam</a></li> <li><a href="/wiki/Estazolam" title="Estazolam">Estazolam</a></li> <li><a href="/wiki/Etizolam" title="Etizolam">Etizolam</a></li> <li><a href="/wiki/Flunitrazepam" title="Flunitrazepam">Flunitrazepam</a></li> <li><a href="/wiki/Flurazepam" title="Flurazepam">Flurazepam</a></li> <li><a href="/wiki/Flutoprazepam" title="Flutoprazepam">Flutoprazepam</a></li> <li><a href="/wiki/Haloxazolam" title="Haloxazolam">Haloxazolam</a></li> <li><a href="/wiki/Loprazolam" title="Loprazolam">Loprazolam</a></li> <li><a href="/wiki/Lormetazepam" title="Lormetazepam">Lormetazepam</a></li> <li><a href="/wiki/Midazolam" title="Midazolam">Midazolam</a></li> <li><a href="/wiki/Nimetazepam" title="Nimetazepam">Nimetazepam</a></li> <li><a href="/wiki/Nitrazepam" title="Nitrazepam">Nitrazepam</a></li> <li><a href="/wiki/Quazepam" title="Quazepam">Quazepam</a></li> <li><a href="/wiki/Temazepam" title="Temazepam">Temazepam</a></li> <li><a href="/wiki/Triazolam" title="Triazolam">Triazolam</a></li></ul> <ul><li><i><a href="/wiki/Nonbenzodiazepine" title="Nonbenzodiazepine">Nonbenzodiazepines</a>/<a href="/wiki/Z-drug" class="mw-redirect" title="Z-drug">Z-drugs</a>:</i> <a href="/wiki/Eszopiclone" title="Eszopiclone">Eszopiclone</a></li> <li><a href="/wiki/Zaleplon" title="Zaleplon">Zaleplon</a></li> <li><a href="/wiki/Zolpidem" title="Zolpidem">Zolpidem</a></li> <li><a href="/wiki/Zopiclone" title="Zopiclone">Zopiclone</a></li></ul> <ul><li><i>Others:</i> <a href="/wiki/Alcohol_(chemistry)" title="Alcohol (chemistry)">Alcohols</a> (e.g., <a href="/wiki/Ethchlorvynol" title="Ethchlorvynol">ethchlorvynol</a>, <a href="/wiki/Tert-Amyl_alcohol" title="Tert-Amyl alcohol">amylene hydrate</a>, <a href="/wiki/Ethanol" title="Ethanol">ethanol</a>)</li> <li><a href="/wiki/Barbiturate" title="Barbiturate">Barbiturates</a> (e.g., <a href="/wiki/Amobarbital" title="Amobarbital">amobarbital</a>, <a href="/wiki/Pentobarbital" title="Pentobarbital">pentobarbital</a>, <a href="/wiki/Phenobarbital" title="Phenobarbital">phenobarbital</a>, <a href="/wiki/Secobarbital" title="Secobarbital">secobarbital</a>)</li> <li><a href="/wiki/Bromide" title="Bromide">Bromides</a> (e.g., <a href="/wiki/Potassium_bromide" title="Potassium bromide">potassium bromide</a>, <a href="/wiki/Sodium_bromide" title="Sodium bromide">sodium bromide</a>)</li> <li><a href="/wiki/Carbamate" title="Carbamate">Carbamates</a> (e.g., <a href="/wiki/Meprobamate" title="Meprobamate">meprobamate</a>)</li> <li><a href="/wiki/Chloral_hydrate" title="Chloral hydrate">Chloral hydrate</a></li> <li><a href="/wiki/Clomethiazole" title="Clomethiazole">Clomethiazole</a></li> <li><a href="/wiki/Kava" title="Kava">Kava</a></li> <li><a href="/wiki/Neurosteroid" title="Neurosteroid">Neurosteroids</a> (e.g., <a href="/wiki/Progesterone_(medication)" title="Progesterone (medication)">progesterone</a>, <a href="/wiki/Zuranolone" title="Zuranolone">zuranolone</a><sup>†</sup>)</li> <li><a href="/wiki/Paraldehyde" title="Paraldehyde">Paraldehyde</a></li> <li><a href="/wiki/Piperidinedione" class="mw-redirect" title="Piperidinedione">Piperidinediones</a> (e.g., <a href="/wiki/Glutethimide" title="Glutethimide">glutethimide</a>)</li> <li><a href="/wiki/Quinazolinone" title="Quinazolinone">Quinazolinones</a> (e.g., <a href="/wiki/Methaqualone" title="Methaqualone">methaqualone</a>)</li> <li><a href="/wiki/Sulfonmethane" title="Sulfonmethane">Sulfonmethane</a></li> <li><a href="/wiki/Valerian_(herb)" title="Valerian (herb)">Valerian</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/H1_antagonist" title="H1 antagonist">Antihistamines</a> (<a href="/wiki/H1_receptor" class="mw-redirect" title="H1 receptor">H<sub>1</sub> receptor</a><br /><a href="/wiki/Inverse_agonist" title="Inverse agonist">inverse agonists</a>)</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alimemazine" title="Alimemazine">Alimemazine</a></li> <li><a href="/wiki/Captodiame" title="Captodiame">Captodiame</a></li> <li><a href="/wiki/Dimenhydrinate" title="Dimenhydrinate">Dimenhydrinate</a></li> <li><a href="/wiki/Diphenhydramine" title="Diphenhydramine">Diphenhydramine</a></li> <li><a href="/wiki/Doxylamine" title="Doxylamine">Doxylamine</a></li> <li><a href="/wiki/Etodroxizine" title="Etodroxizine">Etodroxizine</a></li> <li><a href="/wiki/Hydroxyzine" title="Hydroxyzine">Hydroxyzine</a></li> <li><a href="/wiki/Meclizine" title="Meclizine">Meclizine</a></li> <li><a href="/wiki/Methapyrilene" title="Methapyrilene">Methapyrilene</a></li> <li><a href="/wiki/Pheniramine" title="Pheniramine">Pheniramine</a></li> <li><a href="/wiki/Phenyltoloxamine" title="Phenyltoloxamine">Phenyltoloxamine</a></li> <li><a href="/wiki/Pimethixene" title="Pimethixene">Pimethixene</a></li> <li><a href="/wiki/Promethazine" title="Promethazine">Promethazine</a></li> <li><a href="/wiki/Propiomazine" title="Propiomazine">Propiomazine</a></li> <li><a href="/wiki/Pyrilamine" class="mw-redirect" title="Pyrilamine">Pyrilamine</a></li> <li><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a> (e.g., <a href="/wiki/Amitriptyline" title="Amitriptyline">amitriptyline</a>, <a href="/wiki/Doxepin" title="Doxepin">doxepin</a>, <a href="/wiki/Trimipramine" title="Trimipramine">trimipramine</a>)</li> <li><a href="/wiki/Tetracyclic_antidepressant" title="Tetracyclic antidepressant">Tetracyclic antidepressants</a> (e.g., <a href="/wiki/Mirtazapine" title="Mirtazapine">mirtazapine</a>)</li> <li><a href="/wiki/Triprolidine" title="Triprolidine">Triprolidine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Orexin_receptor_antagonist" class="mw-redirect" title="Orexin receptor antagonist">Orexin receptor antagonists</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Daridorexant" title="Daridorexant">Daridorexant</a></li> <li><a href="/wiki/Lemborexant" title="Lemborexant">Lemborexant</a></li> <li><a href="/wiki/Seltorexant" title="Seltorexant">Seltorexant</a><sup>†</sup></li> <li><a href="/wiki/Suvorexant" title="Suvorexant">Suvorexant</a></li> <li><a href="/wiki/Vornorexant" title="Vornorexant">Vornorexant</a><sup>†</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Melatonin_receptor_agonist" title="Melatonin receptor agonist">Melatonin receptor agonists</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Melatonin_(medication)" class="mw-redirect" title="Melatonin (medication)">Melatonin</a></li> <li><a class="mw-selflink selflink">Ramelteon</a></li> <li><a href="/wiki/Tasimelteon" title="Tasimelteon">Tasimelteon</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Miscellaneous</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotics</a> (e.g., <a href="/wiki/Quetiapine" title="Quetiapine">quetiapine</a>, <a href="/wiki/Olanzapine" title="Olanzapine">olanzapine</a>, <a href="/wiki/Risperidone" title="Risperidone">risperidone</a>, <a href="/wiki/Chlorpromazine" title="Chlorpromazine">chlorpromazine</a>)</li> <li><a href="/wiki/Withania_somnifera" title="Withania somnifera">Ashwagandha</a></li> <li><a href="/wiki/Benzoctamine" title="Benzoctamine">Benzoctamine</a></li> <li><a href="/wiki/Cannabinoid" title="Cannabinoid">Cannabinoids</a> (e.g., <a href="/wiki/Cannabis_(drug)" title="Cannabis (drug)">cannabis</a>, <a href="/wiki/Dronabinol" title="Dronabinol">dronabinol (<abbr title="tetrahydrocannabinol">THC</abbr>)</a>, <a href="/wiki/Nabilone" title="Nabilone">nabilone</a>)</li> <li><a href="/wiki/Chamomile" title="Chamomile">Chamomile</a></li> <li><a href="/wiki/Fenadiazole" title="Fenadiazole">Fenadiazole</a></li> <li><a href="/wiki/Gabapentinoid" title="Gabapentinoid">Gabapentinoids</a> (e.g., <a href="/wiki/Gabapentin" title="Gabapentin">gabapentin</a>, <a href="/wiki/Pregabalin" title="Pregabalin">pregabalin</a>, <a href="/wiki/Phenibut" title="Phenibut">phenibut</a>)</li> <li><a href="/wiki/Hops" title="Hops">Hops</a></li> <li><a href="/wiki/Lavandula" title="Lavandula">Lavender</a></li> <li><a href="/wiki/Menthyl_isovalerate" title="Menthyl isovalerate">Menthyl isovalerate</a></li> <li><a href="/wiki/Niaprazine" title="Niaprazine">Niaprazine</a></li> <li><a href="/wiki/Opioid" title="Opioid">Opioids</a> (e.g., <a href="/wiki/Hydrocodone" title="Hydrocodone">hydrocodone</a>, <a href="/wiki/Oxycodone" title="Oxycodone">oxycodone</a>, <a href="/wiki/Morphine" title="Morphine">morphine</a>)</li> <li><a href="/wiki/Passiflora" title="Passiflora">Passion flower</a></li> <li><a href="/wiki/Scopolamine" title="Scopolamine">Scopolamine</a></li> <li><a href="/wiki/Neurotransmitter#Serotonin_precursors" title="Neurotransmitter">Serotonin precursors</a> (<a href="/wiki/Tryptophan" title="Tryptophan">tryptophan</a>, <a href="/wiki/5-hydroxytryptophan" class="mw-redirect" title="5-hydroxytryptophan"><abbr title="5-hydroxytryptophan">5-HTP</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip 5-hydroxytryptophan</span>)</li> <li><a href="/wiki/Sodium_oxybate" title="Sodium oxybate">Sodium oxybate (<abbr title="γ-aminobutyric acid">GHB</abbr>)</a></li> <li><a href="/wiki/Sympatholytic" title="Sympatholytic">Sympatholytics</a> (e.g., <a href="/wiki/Clonidine" title="Clonidine">clonidine</a>, <a href="/wiki/Guanfacine" title="Guanfacine">guanfacine</a>, <a href="/wiki/Prazosin" title="Prazosin">prazosin</a>)</li> <li><a href="/wiki/Theanine" title="Theanine">Theanine</a></li> <li><a href="/wiki/Trazodone" title="Trazodone">Trazodone</a></li> <li><a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">Tricyclic antidepressants</a> (e.g., <a href="/wiki/Amitriptyline" title="Amitriptyline">amitriptyline</a>, <a href="/wiki/Doxepin" title="Doxepin">doxepin</a>, <a href="/wiki/Trimipramine" title="Trimipramine">trimipramine</a>)</li> <li><a href="/wiki/Tetracyclic_antidepressant" title="Tetracyclic antidepressant">Tetracyclic antidepressants</a> (e.g., <a href="/wiki/Mirtazapine" title="Mirtazapine">mirtazapine</a>)</li> <li><a href="/wiki/Valnoctamide" title="Valnoctamide">Valnoctamide</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Melatonin_receptor_modulators1178" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Melatonin_receptor_modulators" title="Template:Melatonin receptor modulators"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Melatonin_receptor_modulators" title="Template talk:Melatonin receptor modulators"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Melatonin_receptor_modulators" title="Special:EditPage/Template:Melatonin receptor modulators"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Melatonin_receptor_modulators1178" style="font-size:114%;margin:0 4em"><a href="/wiki/Melatonin_receptor" title="Melatonin receptor">Melatonin receptor</a> <a href="/wiki/Receptor_modulator" title="Receptor modulator">modulators</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Melatonin_receptor_1" class="mw-redirect" title="Melatonin receptor 1"><abbr title="Melatonin receptor 1">MT<sub>1</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Melatonin receptor 1</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/2-Iodomelatonin" title="2-Iodomelatonin">2-Iodomelatonin</a></li> <li><a href="/wiki/6-Hydroxymelatonin" title="6-Hydroxymelatonin">6-Hydroxymelatonin</a></li> <li><a href="/wiki/Agomelatine" title="Agomelatine">Agomelatine</a></li> <li><a href="/wiki/Fabomotizole" title="Fabomotizole">Fabomotizole (afobazole)</a></li> <li><a href="/wiki/GR-196,429" title="GR-196,429">GR-196,429</a></li> <li><a href="/wiki/Melatonin" title="Melatonin">Melatonin</a></li> <li><a href="/wiki/N-Acetylserotonin" title="N-Acetylserotonin">N-Acetylserotonin (normelatonin)</a></li> <li><a href="/wiki/Piromelatine" title="Piromelatine">Piromelatine</a></li> <li><a class="mw-selflink selflink">Ramelteon</a></li> <li><a href="/wiki/Tasimelteon" title="Tasimelteon">Tasimelteon</a></li> <li><a href="/wiki/TIK-301" title="TIK-301">TIK-301 (LY-156,735)</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/wiki/Luzindole" title="Luzindole">Luzindole</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Melatonin_receptor_2" class="mw-redirect" title="Melatonin receptor 2"><abbr title="Melatonin receptor 2">MT<sub>2</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Melatonin receptor 2</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/2-Iodomelatonin" title="2-Iodomelatonin">2-Iodomelatonin</a></li> <li><a href="/wiki/6-Hydroxymelatonin" title="6-Hydroxymelatonin">6-Hydroxymelatonin</a></li> <li><a href="/wiki/Agomelatine" title="Agomelatine">Agomelatine</a></li> <li><a href="/wiki/GR-196,429" title="GR-196,429">GR-196,429</a></li> <li><a href="/wiki/Melatonin" title="Melatonin">Melatonin</a></li> <li><a href="/wiki/N-Acetylserotonin" title="N-Acetylserotonin">N-Acetylserotonin (normelatonin)</a></li> <li><a href="/wiki/Piromelatine" title="Piromelatine">Piromelatine</a></li> <li><a class="mw-selflink selflink">Ramelteon</a></li> <li><a href="/wiki/Tasimelteon" title="Tasimelteon">Tasimelteon</a></li> <li><a href="/wiki/TIK-301" title="TIK-301">TIK-301 (LY-156,735)</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/wiki/Luzindole" title="Luzindole">Luzindole</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;">Unsorted</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/w/index.php?title=2-Phenylmelatonin&action=edit&redlink=1" class="new" title="2-Phenylmelatonin (page does not exist)">2-Phenylmelatonin</a></li> <li><a href="/w/index.php?title=5-Methoxyluzindole&action=edit&redlink=1" class="new" title="5-Methoxyluzindole (page does not exist)">5-Methoxyluzindole</a></li> <li><a href="/w/index.php?title=6-Chloromelatonin&action=edit&redlink=1" class="new" title="6-Chloromelatonin (page does not exist)">6-Chloromelatonin</a></li> <li><a href="/w/index.php?title=6-Fluoromelatonin&action=edit&redlink=1" class="new" title="6-Fluoromelatonin (page does not exist)">6-Fluoromelatonin</a></li> <li><a href="/w/index.php?title=6-Methoxymelatonin&action=edit&redlink=1" class="new" title="6-Methoxymelatonin (page does not exist)">6-Methoxymelatonin</a></li> <li><a href="/w/index.php?title=6,7-Dichloro-2-methylmelatonin&action=edit&redlink=1" class="new" title="6,7-Dichloro-2-methylmelatonin (page does not exist)">6,7-Dichloro-2-methylmelatonin</a></li> <li><a href="/w/index.php?title=8-M-PDOT&action=edit&redlink=1" class="new" title="8-M-PDOT (page does not exist)">8-M-PDOT</a></li> <li><a href="/w/index.php?title=AMMTC&action=edit&redlink=1" class="new" title="AMMTC (page does not exist)">AMMTC</a></li> <li><a href="/w/index.php?title=GR-135,531&action=edit&redlink=1" class="new" title="GR-135,531 (page does not exist)">GR-135,531</a> (of <a href="/wiki/Melatonin_receptor_1C" title="Melatonin receptor 1C"><abbr title="melatonin receptor 1C">MT<sub>3</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip melatonin receptor 1C</span>)</li> <li><a href="/wiki/N-Acetyltryptamine" title="N-Acetyltryptamine">N-Acetyltryptamine</a></li> <li><a href="/w/index.php?title=N-Butanoylmelatonin&action=edit&redlink=1" class="new" title="N-Butanoylmelatonin (page does not exist)">N-Butanoylmelatonin</a></li> <li><a href="/w/index.php?title=N-Propionylmelatonin&action=edit&redlink=1" class="new" title="N-Propionylmelatonin (page does not exist)">N-Propionylmelatonin</a></li> <li><a href="/w/index.php?title=S-24268&action=edit&redlink=1" class="new" title="S-24268 (page does not exist)">S-24268</a></li> <li><a href="/w/index.php?title=S-25150&action=edit&redlink=1" class="new" title="S-25150 (page does not exist)">S-25150</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=4-P-ADOT&action=edit&redlink=1" class="new" title="4-P-ADOT (page does not exist)">4-P-ADOT</a></li> <li><a href="/w/index.php?title=4-P-PDOT&action=edit&redlink=1" class="new" title="4-P-PDOT (page does not exist)">4-P-PDOT</a></li> <li><a href="/w/index.php?title=DH-97&action=edit&redlink=1" class="new" title="DH-97 (page does not exist)">DH-97</a></li> <li><a href="/wiki/N-Acetyltryptamine" title="N-Acetyltryptamine">N-Acetyltryptamine</a> (of <abbr title="melatonin receptor 1C">MT<sub>3</sub></abbr>)</li> <li><a href="/wiki/Prazosin" title="Prazosin">Prazosin</a> (of <abbr title="melatonin receptor 1C">MT<sub>3</sub></abbr>)</li> <li><a href="/w/index.php?title=S-20928&action=edit&redlink=1" class="new" title="S-20928 (page does not exist)">S-20928</a></li> <li><a href="/w/index.php?title=S-22153&action=edit&redlink=1" class="new" title="S-22153 (page does not exist)">S-22153</a></li> <li><a href="/w/index.php?title=S-24601&action=edit&redlink=1" class="new" title="S-24601 (page does not exist)">S-24601</a></li> <li><a href="/w/index.php?title=S-25567&action=edit&redlink=1" class="new" title="S-25567 (page does not exist)">S-25567</a></li> <li><a href="/w/index.php?title=S-26131&action=edit&redlink=1" class="new" title="S-26131 (page does not exist)">S-26131</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><i><b>See also:</b> <a href="/wiki/Template:Receptor_modulators" title="Template:Receptor modulators">Receptor/signaling 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