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Indications

Melatonin is used for short-term help with sleep problems. It is used for primary insomnia (poor quality sleep) in adults aged 55 years and over, to reduce jet lag after travel across time zones, and, on a doctor's advice, for sleep problems in some children with conditions such as ADHD or autism, and for people whose body clock is out of rhythm (for example shift workers).

How It Works

Melatonin is a hormone that the brain's pineal gland naturally releases in the evening when it gets dark. It tells the body that it is night and time to sleep. Taking melatonin adds to this signal and can help reset the body clock, shorten the time it takes to fall asleep and improve sleep quality. It is not a strong sedative like sleeping pills.

Dosage and Administration

Adults 55 and over with insomnia: usually 2 mg prolonged-release once a day, 1 to 2 hours before bedtime and after food, for up to 13 weeks. Jet lag: usually 2 to 5 mg taken at local bedtime for a few days after arrival. Swallow prolonged-release tablets whole. Children: only as prescribed. Follow the label or your doctor's advice; higher doses are not usually more effective.

Interactions

• Fluvoxamine greatly increases melatonin levels; avoid together.
• Sedatives, sleeping pills (such as Zolpidem and Zopiclone), benzodiazepines and alcohol add to drowsiness.
• Some antibiotics (Ciprofloxacin), oral contraceptives and Cimetidine can raise levels; Carbamazepine and Rifampicin can lower them.
• It may affect blood thinners such as Warfarin and blood sugar control in diabetes.
• Smoking can reduce its effect.

Contraindications

• Allergy to melatonin or any ingredient.
• Prolonged-release tablets: rare hereditary problems of galactose intolerance (they may contain lactose).

Side Effects

Usually mild: daytime sleepiness, headache, dizziness, nausea, irritability, vivid dreams and stomach discomfort.

Get urgent medical help for swelling of the face, lips or throat, difficulty breathing, chest pain, fainting, or severe confusion or mood changes.

Pregnancy and Lactation

There is not enough information on safety in pregnancy, so it is not recommended unless the doctor advises. It passes into breast milk; avoid while breastfeeding unless your doctor says otherwise.

Precautions and Warnings

• It can cause drowsiness; do not drive or use machines after taking it.
• Use with care in liver disease, kidney disease, autoimmune disease, epilepsy and depression.
• Melatonin is not a treatment for sleep problems caused by another illness; see a doctor if sleep problems persist.

Overdose

Taking too much may cause marked drowsiness, headache and dizziness. Effects usually pass within about 12 hours. Seek medical advice if a large amount is taken, especially by a child.

Therapeutic Class

Hypnotic, melatonin receptor agonist (sleep hormone).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.