Melatonin Receptor Agonists
Ramelteon
Ramelteon (generic Rozerem) is a bedtime tablet for people who have trouble falling asleep. It acts on melatonin receptors, is not a controlled substance, and is sold as an FDA-rated generic by several manufacturers, so it can be refilled and transferred like any ordinary prescription.
This page is general information about a medication and how cash prices for it are set. It is not medical advice and does not replace the label, your prescriber or your pharmacist. How we handle medical information
Generic ramelteon is rated by the FDA as equivalent to Rozerem and made by several manufacturers; the brand is still sold.
About Ramelteon
Ramelteon activates the brain’s MT1 and MT2 melatonin receptors, which help set the timing of sleep. It has no appreciable affinity for the GABA receptor complex, and unlike many sleep medicines it is not a controlled substance. It is approved for insomnia marked by difficulty falling asleep. The dose is one 8 mg tablet within 30 minutes of going to bed, no more than 8 mg a day, and not with or right after a high-fat meal, which delays its peak.
Drowsiness, dizziness, tiredness, nausea and worsened insomnia are the most common side effects. Rare swelling of the tongue or throat has been reported, and anyone who has had that reaction must not take it again. Driving or eating while not fully awake has been reported with sleep medicines, more likely with alcohol or other sedatives. It can lower testosterone and raise prolactin, so missed periods, nipple discharge, lower sex drive or fertility problems should be reported. There is no boxed warning.
Fluvoxamine must not be taken with it, because it raises ramelteon levels enormously. It is not recommended in severe sleep apnea or severe liver impairment, and is used with caution in moderate liver impairment. If insomnia has not eased after seven to ten days, the label advises evaluating for an underlying medical or psychiatric cause.
Taking Ramelteon
- How to take it
- One tablet within 30 minutes of going to bed, not with or right after a high-fat meal. Do not drive or do anything that needs alertness after taking it.
- If you miss a dose
- It is taken only at bedtime. If you did not take it at bedtime and cannot fall asleep, you may take it only if you can stay in bed for 7 to 8 hours afterward.
- Storage
- At room temperature in the original container, tightly closed and protected from moisture, and out of reach of children.
- Interactions to know about
- It must not be taken with fluvoxamine. Fluconazole, ketoconazole, donepezil and doxepin raise its levels; rifampin can make it less effective. Avoid alcohol. Seek urgent care for swelling of the tongue or throat or trouble breathing, and report anything you did while not fully awake.
This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.
Why the cash price for Ramelteon differs from pharmacy to pharmacy
Generic ramelteon comes from several manufacturers, and pharmacies buy it at different costs and price it differently, so quotes for the same 8 mg tablet can vary widely; a pharmacy dispensing Rozerem, or pricing the generic off the brand’s list price, will quote far more. A pharmacy that rarely fills it may need to order it.
There is one strength taken nightly, so a thirty-day fill carries a full dispensing fee for few tablets. Because ramelteon is not controlled, it has none of the refill and transfer limits of controlled sleep medicines, so moving the prescription to a better-priced pharmacy is simple.
Upload it and licensed pharmacies reply with their own cash price. You pay the pharmacy, not us.
Ways to pay less for Ramelteon without insurance
- Ask for generic ramelteon, and make sure the prescription allows substitution rather than naming Rozerem only.
- Compare more than one pharmacy; generic quotes for ramelteon vary.
- Once it is clearly helping, ask the prescriber whether a ninety-day supply is appropriate.
- Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.
How Script Unlock gets you a cash price for Ramelteon
Prices on this site come from pharmacies responding to a real prescription. We do not publish estimated, average or "typical" prices, because none of those would be your price.
- 1You upload your prescription
A photo of your Ramelteon prescription is enough. Nothing is sold on the site; you are asking pharmacies to quote.
- 2Licensed pharmacies respond
Pharmacies that Script Unlock has verified see the request and each can reply with its own cash price for your exact drug, strength and quantity.
- 3You choose and pay the pharmacy
You compare the responses, pick a pharmacy, and pay that pharmacy directly when you collect. Script Unlock never takes a patient payment and never sets the price.
Questions to ask your pharmacist about Ramelteon
- 1.How close to bedtime should I take it, and how long after my evening meal?
- 2.Do any of my medicines, especially fluvoxamine, fluconazole or rifampin, interact with it?
- 3.Is it safe with alcohol or with my other sleep or anxiety medicines?
- 4.What should I do if my sleep has not improved after a week or two?
- 5.Which hormonal side effects should I report?
Where Ramelteon fits
Related medications
Sources
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.