mel-uh-TOH-nin

Therapeutic Classification: sedative/hypnotics

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

• Sleep disorders (including insomnia, jet lag and circadian rhythm disorders)

• Melatonin is a hormone secreted from the pineal gland in a 24-hour circadian rhythm, regulating the normal sleep/wake cycle. As a supplement, melatonin has both phase-shifting and sleep-promoting properties. In addition to promoting sleep, physiologic roles of melatonin include regulation of the secretion of growth hormone and gonadotropic hormones. It also possesses antioxidant activity.

• Improved sleep pattern.

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-life: Unknown.

Contraindicated in:

• Hypersensitivity
• Pregnancy and lactation.

Use Cautiously in:

• Seizure disorders
• Diabetes
• Hypertension.

CV: hypotension.

GI: abdominal cramps, nausea, vomiting.

Neuro: dizziness, drowsiness, headache.

Natural-Drug Products:

• Additive sedation with CNS depressants.
• May ↑ bleeding risk with antiplatelet agents and anticoagulants.
• May interfere with the glucose-lowering effects of hypoglycemic agents.
• May decrease effectiveness of nifedipine.

Natural-Natural Products:

• May have additive sedative effects with herbs that have sedative properties including 5–HTP, kava, St.John's wort, valerian and others.
• May increase risk of bleeding with herbs that have antiplatelet/anticoagulant properties such asclove, garlic, ginger, gingko, ginseng and others.

• PO (Adults): 0.3–10 mg daily at bedtime.

• Capsules: ^OTC;
• Tablets: ^OTC;
• Sublingual Tablets: ^OTC;
• Gummies: ^OTC;

• Assess sleep patterns before and periodically throughout therapy.

• Monitor blood glucose, coagulation panel, hormone panel, and lipid panel periodically during therapy.

• PO: Administer before bedtime.

• Instruct patient to take at bedtime as directed.
• Causes drowsiness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.
• Caution patient to avoid concurrent use of alcohol or other CNS depressants.
• Advise female patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

• Relief of insomnia.

pineal hormone, N-acetyl-5–methoxtryptamine