Melatonin
Regulatory sources consulted
- EMA EPAR EMEA/H/C/004425
- AEMPS CIMA FT 07392003
- PubMed PMID:36064286 ↗
- PubMed PMID:40728459 ↗
- AEMPS CIMA · nº registro 07392003 ↗
- EMA EPAR · EMEA/H/C/004425 ↗
- RxNorm rxcui 6711 ↗
- PubMed PMID:30466801 ↗
Approved indications
- Treatment of insomnia in children and adolescents aged 2-18 years with Autism Spectrum Disorder (ASD), and/or neurogenetic disorders, where sleep hygiene measures have been insufficient.
- Short-term treatment of primary insomnia characterized by poor quality of sleep in patients who are aged 55 or over.
Contraindications
Absolute
- Hypersensitivity to the active substance or to any of the excipients.
Clinical warnings
- May cause drowsiness. Use with caution if the effects of drowsiness can be associated with a safety risk. — EMA SPC
- Use in patients with autoimmune diseases is not recommended. — EMA SPC
Drug interactions
- HighFluvoxamineN06AB08
Mechanism: Potent inhibition of CYP1A2 and CYP2C19, increasing melatonin AUC up to 17-fold.
Recommendation: The combination of melatonin and fluvoxamine should be avoided.
AEMPS CIMA FT 07392003
- ModerateCarbamazepine, RifampicinN03AF01
Mechanism: Inducers of CYP1A2/2C19 that can reduce plasma concentrations of melatonin.
Recommendation: Monitor clinical efficacy; a melatonin dose adjustment may be necessary.
AEMPS CIMA FT 07392003
Adverse events
Common (≥1%)
somnolence · headache · fatigue · mood swings
Pregnancy and lactation
As a precautionary measure, it is preferable to avoid the use of melatonin during pregnancy. Not recommended during breastfeeding.
Recent literature (PubMed)
Revisión sobre la fisiología de la melatonina y su uso en trastornos del sueño. Destaca que, a pesar de su base teórica para tratar el insomnio (especialmente en mayores), la evidencia científica que respalda su beneficio es limitada y las dosis y preparaciones óptimas no están claramente definidas.
Revisión sobre el papel de la nutrición en la calidad del sueño. Menciona que el triptófano es precursor de la serotonina y melatonina, y que una dieta adecuada puede mejorar el sueño.