雷美替胺(Ramelteon)的用法用量

Ramelteon (Ramelteon) is developed and produced by Takeda Pharmaceuticals of Japan. It was approved by the US FDA for marketing in July 2005. It needs to follow an individualized medication plan.

Ramelteon usage and dosage

1. Recommended dose for adults

Once a day, 8 mg each time.

2. Medication time

It must be taken within 30 minutes before you plan to fall asleep. Taking it too early may cause daytime drowsiness, while taking it too late may affect the timely effect of the medicine.

3. Treatment course restrictions

If the insomnia symptoms do not improve after taking it for 7-10 days, you should consult your doctor again to evaluate whether there are other potential physical or psychological diseases.

4. How to take

Swallow the whole tablet with warm water and do not chew, crush or break it to maintain the integrity of the drug film coating.

5. The total daily dose

should not exceed 8 mg. Increasing the dose will not bring additional sleep effects, but will increase the risk of side effects such as drowsiness, dizziness, and fatigue the next day.

The pictures are from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Dose adjustment of Ramelteon

1. Dose adjustment in patients with hepatic impairment

(1) Mild hepatic impairment (Child-Pugh class A): Usually no dose adjustment is required, but caution should be observed.

(2) Moderate liver damage (Child-Pugh class B): The exposure of ramelteon in such patients will increase more than ten times, and the risk of poisoning will be significantly increased, so its use should be avoided.

(3) Severe liver damage (Child-Pugh Class C): Absolutely prohibited from use, because the drug cannot be metabolized normally, which will cause a large amount of accumulation in the body and cause serious adverse reactions.

2. Dose adjustment in patients with renal insufficiency

No matter whether they are mild, moderate or severe renal insufficiency, or patients who require long-term hemodialysis, there is no clinically significant change in the blood concentration of the drug. Patients with all degrees of renal insufficiency do not need to adjust the dose.

Ramelteon (Ramelteon) is used in special populations

1. Elderly patients

Elderly patients may have elevated blood drug concentrations due to metabolic characteristics. When taking the drug, the patient's status needs to be closely observed and the drug administered with caution.

2. Pediatric patients (under 18 years old)

The safety and effectiveness have not been established, and the impact of ramelteon on the developing human reproductive axis is unclear.

3. Pregnant women

Human data are limited. Animal experiments show developmental toxicity at high doses. Animal experiments show that ramelteon may cause teratogenicity such as fetal diaphragm hernia and skeletal variation. It should not be used unless the potential benefit clearly outweighs the potential risk to the fetus.

4. Lactating women

It is not clear whether the drug is excreted in human milk, but animal experiments show that it will enter the milk. The benefits of treatment need to be weighed against the benefits of breastfeeding before deciding whether to continue breastfeeding or discontinue medication.

5. Patients with respiratory diseases

(1) Chronic obstructive pulmonary disease (COPD): Single-dose studies have shown that there is no significant respiratory depression on the blood oxygen saturation of patients with mild to severe COPD, but the impact of long-term or multiple-dose use is unclear and should be used with caution.

(2) Sleep apnea: For patients with mild to moderate obstructive sleep apnea, a single dose of medication has not been shown to aggravate the condition. However, it is not recommended for patients with severe sleep apnea because it has not been studied.