Caution should be used in patients with hepatic impairment extreme hepatic impairment is not recommended.In patients with respiratory disability, including sleep apnea or COPD, use caution not recommended in patients with serious sleep apnea.Endocrine effects include reduced testosterone and increased levels of prolactin unexplained effects on the reproductive axis in human development.Alcohol can make Ramelteon's side effects worse. During your care with Ramelteon, do not drink alcohol.Give your doctor a call if you get pregnant while taking Ramelteon. If you are pregnant, or expecting to become pregnant, or breast-feeding, tell your doctor.Tell your doctor whether you have ever thought or intended or attempted to kill yourself and whether you have or have ever had the chronic obstructive pulmonary disease (COPD, lung damage that makes it hard to breathe) or any other lung disease, sleep apnea (a condition in which you suddenly stop breathing several times during your period of time).Your doctor may tell you not to take Ramelteon while you are taking this medication. If you are taking fluvoxamine, tell your doctor if you have (Luvox).For a list of the ingredients, ask your pharmacist or consult the Drug Guide. If you are allergic to Ramelteon, any other drugs, or any of the ingredients in Ramelteon tablets, notify your doctor and pharmacist.In patients taking other CYP1A2 inhibiting medications, ROZEREM should be used with caution. In conjunction with fluvoxamine, ROZEREM should not be used.In patients with mild liver disease, ROZEREM should be used with caution. In patients with serious liver disease, ROZEREM is not recommended.Dosing In Patients With Hepatic Deficiency.The dosage of ROZEREM in total does not exceed 8 mg daily.It is best not to take ROZEREM with or directly after a high-fat meal ROZEREM's prescribed dosage is 8 mg taken within 30 minutes of bedtime.Ramelteon has no important affinity for neuropeptides, cytokines, serotonin, dopamine, norepinephrine, acetylcholine, or opiates that bind to the gamma-aminobutyric acid (GABA) receptor complex or receptors. Although the sleep-wake cycle is correlated with MT1 and MT2 receptors, MT3 has a totally different profile and is therefore not likely to be involved in the sleep-wake cycle. MT1 receptors are believed to be responsible for controlling sleepiness and promoting sleep onset, and the phase-shifting effects of melatonin on the circadian rhythm are believed to be mediated by MT2 receptors. The development of melatonin is simultaneous with nocturnal sleep, which means that a rise in melatonin levels is associated with the onset of self-reported sleepiness and an increase in the tendency to sleep. Ramelteon is a melatonin receptor with both a high affinity for melatonin MT1 and MT2 receptors and very low selectivity for the MT3 receptor.Read the details carefully and, if you have any questions, ask your doctor or pharmacist. When you begin treatment with Ramelteon and each time you refill your prescription, your doctor or pharmacist will send you the manufacturer's patient information sheet (Medication Guide).If your insomnia does not improve during this period or gets worse at some time during your care, call your doctor. After you begin treatment with ramelteon, your insomnia should improve within 7 to 10 days.If you are unable to stay asleep for 7 to 8 hours after taking the drug, do not use ramelteon.For this time, don't schedule any other things. You should finish any required bedtime preparations and go to bed after you take ramelteon. Soon after you take Ramelteon, you can become sleepy.Swallow whole tablets do not divide, chew, or crush them.Do take more or less of it more often than what is recommended by your physician. Carefully follow all the instructions given on the prescription label and ask your doctor or pharmacist to clarify any aspect that you do not understand or not clear. Do not take ramelteon with a meal or soon after. It is usually taken once a day, 30 minutes before bedtime at the latest. As a tablet to take by mouth, Ramelteon comes.Melatonin, a natural substance in the brain that is required for sleep, functions similarly. Ramelteon is in a class of medicines called agonists of the melatonin receptor. Ramelteon is used to help patients fall asleep more rapidly who have sleep-onset insomnia (difficulty falling asleep).

Rozerem side effect