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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

ONSETPEAKDURATION
POunknownunknownunknown

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:

  • 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 as clove, garlic, ginger, gingko, ginseng and others.

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.

melatonin is a sample topic from the Davis's Drug Guide.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Learn more.

Citation

Quiring, Courtney, et al. "Melatonin." Davis's Drug Guide, 16th ed., F.A. Davis Company, 2019. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/109916/all/melatonin.
Quiring C, Sanoski CA, Vallerand AH. Melatonin. Davis's Drug Guide. 16th ed. F.A. Davis Company; 2019. https://anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/109916/all/melatonin. Accessed April 21, 2019.
Quiring, C., Sanoski, C. A., & Vallerand, A. H. (2019). Melatonin. In Davis's Drug Guide. Available from https://anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/109916/all/melatonin
Quiring C, Sanoski CA, Vallerand AH. Melatonin [Internet]. In: Davis's Drug Guide. F.A. Davis Company; 2019. [cited 2019 April 21]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/109916/all/melatonin.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - melatonin ID - 109916 A1 - Quiring,Courtney, AU - Sanoski,Cynthia A, AU - Vallerand,April Hazard, BT - Davis's Drug Guide UR - https://anesth.unboundmedicine.com/anesthesia/view/Davis-Drug-Guide/109916/all/melatonin PB - F.A. Davis Company ET - 16 DB - Anesthesia Central DP - Unbound Medicine ER -