melatonin
General
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.
Pronunciation:
mel-uh-toh-nin
Trade Name(s)
- pineal hormone
- N-acetyl-5–methoxtryptamine
Ther. Class.
sedative/hypnotics
Common Uses
Sleep disorders (including insomnia, jet lag and circadian rhythm disorders)
Action
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.
Therapeutic Effect(s):
Improved sleep pattern.
Pharmacokinetics
Absorption: Unknown
Distribution: Unknown
Metabolism and Excretion: Unknown
Half-life: Unknown
TIME/ACTION PROFILE
ONSET | PEAK | DURATION | |
---|---|---|---|
PO | unknown | unknown | unknown |
Contraindication/Precautions
Contraindicated in:
- Hypersensitivity;
- Pregnancy and lactation.
Use Cautiously in:
- Seizure disorders;
- Diabetes;
- Hypertension.
Adverse Reactions/Side Effects
CV: hypotension
CNS: drowsiness, headache, dizziness
GI: nausea, vomiting, abdominal cramps
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Interactions
Natural Drug Interaction
- Additive sedation with CNS depressants..
- May increase bleeding risk with antiplatelet agents and anticoagulants..
- May interfere with the glucose lowering effects of hypoglycemic agents..
- May decrease effectiveness of nifedipine..
Natural-Natural:
Route/Dosage
PO (Adults): 0.3–10 mg daily at bedtime.
Availability
Capsules:
Tablets: 3 mg
Assessment
- Assess sleep patterns before and periodically throughout therapy.
Lab Test Considerations:
Monitor blood glucose, coagulation panel, hormone panel, and lipid panel periodically during therapy.
Potential Diagnoses
- Insomnia (Indications)
Implementation
- PO Administer before bedtime.
Patient/Family Teaching
- 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 breastfeeding.
Evaluation/Desired Outcomes
Relief of insomnia.
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