Ramelteon (Rozerem) vs. Melatonin: How These Sleep Treatments Compare
Key takeaways:
Ramelteon (Rozerem) and melatonin are two treatment options to help you sleep. Ramelteon is a prescription-only medication, while melatonin is available over the counter (OTC) in a range of doses and dosage forms.
Both treatments work by stimulating the melatonin receptors (binding sites). But ramelteon is more potent and works faster than melatonin to help you fall asleep. You can take ramelteon long term with your prescriber’s approval. But you shouldn’t take melatonin for more than a week or two without talking to a healthcare professional.
Melatonin and ramelteon have different side effects and drug interactions to consider. Talk to a healthcare professional to determine if one may be a better choice for you based on your medical history and the other medications you’re taking.
Ramelteon is available as a brand-name medication as well as a lower-cost generic. Melatonin is sold OTC, but with a prescription from your provider you can save on the cost. GoodRx can help make your sleep medication more affordable.
Table of contents
If you’re having trouble sleeping and sleep hygiene tips aren’t making a difference, it may be time to try a sleep medication. Ramelteon (Rozerem) and melatonin are two options to consider. They’re both popular sleep aids, since neither is a controlled substance, unlike many prescription sleep medications.
While ramelteon and melatonin have some similarities, there are also a few key differences to consider. Here, we’ll take a closer look at six factors to help you choose between ramelteon versus melatonin to help you sleep.
1. Ramelteon is a prescription medication, while melatonin is an OTC supplement
Two of the main differences between ramelteon and melatonin are how you get them and what they’re approved for. Ramelteon is only available by prescription. This means you’ll need to talk to a healthcare professional and then pick the medication up from a pharmacy. Melatonin, on the other hand, is an over-the-counter (OTC) supplement. You don’t need a prescription to buy it, and melatonin supplements are sold in a variety of stores.
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Melatonin is sold OTC in a wide variety of doses and dosage forms to choose from. But ramelteon only comes as an 8 mg tablet that can’t be cut, chewed, or crushed. This can make a difference for you if you have trouble swallowing pills.
It may seem easier to go for melatonin since it’s an OTC option, but there are some risks with taking a supplement instead of a prescription medication. First, supplements aren’t well regulated. So it’s possible they may contain different ingredients or doses than what’s listed on their bottles.
Second, supplements aren’t FDA-approved for any medical use. This means that melatonin hasn’t been proved as a safe and effective treatment for insomnia. Most studies show that it works better for temporary sleep issues, such as those caused by jet lag or schedule changes. Ramelteon, however, is FDA-approved to treat insomnia that prevents you from falling asleep. Its safety and potency are also tightly regulated.
2. Ramelteon and melatonin work slightly differently to help you sleep
The way that ramelteon and melatonin work in the body is a little bit different. Before we get into that, let’s review how your body’s sleep-wake cycle, or circadian rhythm, usually works.
Your brain releases melatonin naturally in response to darkness. Melatonin helps your body become relaxed and ready for sleep. Melatonin supplements are a lab-made form of melatonin. So they act like natural melatonin in the body.
Ramelteon activates Type 1 and Type 2 melatonin receptors (binding sites) in the brain. Type 1 melatonin receptors help turn off signals that keep you awake. Type 2 melatonin receptors help calm your mind and regulate your sleep cycle. Melatonin also binds to these receptors, along with several others. But ramelteon is selective for just these receptors, and it’s about 17 times more potent than melatonin.
Good to know: Ramelteon is only approved for adults, while melatonin is considered safe for adults as well as children, if their pediatrician OKs it. Both are also safe options for older adults.
3. Ramelteon may start working faster than melatonin
You should take ramelteon within 30 minutes of going to bed. That’s because it’s absorbed quickly and reaches peak levels about 45 minutes after you take it. This helps it work faster to help you fall asleep.
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Melatonin supplements can take several hours to reach peak levels in the body. So it’s typically recommended to take them about 1 to 2 hours before bedtime so you aren’t lying in bed waiting for them to work.
That being said, ramelteon doesn’t last very long in the body after you take it. So it’s only approved to help you fall asleep faster. It won’t help you stay asleep through the night. Melatonin comes in long-acting dosage forms, such as extended-release (ER) capsules and topical patches. These options may help you fall asleep faster and stay asleep longer, even though they can take a bit longer to start working. So it may help to consider your specific sleep troubles when choosing between ramelteon versus melatonin.
4. Ramelteon is considered safe for long-term use; melatonin isn’t
Since melatonin isn’t an FDA-approved medication, we don’t have enough information to know if it’s safe to take long term. If you need to take a melatonin supplement every night for more than a week or two, there’s likely an underlying cause of your sleep problems. It’s best to talk to a healthcare professional who can determine the cause as well as the best treatment.
Ramelteon is considered safe and effective for long-term use. In studies, there wasn’t any evidence that taking ramelteon long term caused withdrawal symptoms or rebound insomnia. And it isn’t associated with dependence or misuse.
5. Ramelteon may have more serious side effects to consider than melatonin
Both ramelteon and melatonin may cause similar side effects, including daytime drowsiness, dizziness, and nausea. They can also cause new or worsening depression in rare cases.
Ramelteon has additional serious side effects to consider. It may worsen insomnia symptoms for some people. And it can raise the risk that you’ll do things such as drive, shop, or eat while you’re asleep, which could be dangerous or even fatal in some cases. Rarely, ramelteon can cause changes to your mood or behavior, such as agitation or hallucinations.
In most cases, you can manage melatonin side effects by reducing your dosage. But this isn’t an option with ramelteon. Your prescriber can talk through potential side effects and your risk for them to help you determine which treatment option suits you best.
6. Ramelteon and melatonin have different drug interactions to consider
The other medications you take may influence whether ramelteon or melatonin is a better choice for you. You shouldn’t combine either treatment with alcohol or other medications that make you sleepy. Each option also has additional interactions to consider.
Ramelteon interactions include:
Fluvoxamine (Luvox)
Donepezil (Aricept)
Doxepin (Silenor)
Fluconazole (Diflucan)
Ketoconazole
Rifampin (Rifadin)
Melatonin interactions include:
Certain antidepressants
Nifedipine (Procardia)
Medications that weaken your immune system
If you take any of the medications listed above, a different sleep medication may be a better option for you. Your healthcare team can review your current medication list to help you find the safest option.
How to save on the cost of ramelteon and melatonin
Ramelteon is available as a brand-name medication as well as a lower-cost generic. GoodRx can help you save over 90% off the average retail price of the generic version. If you’re uninsured or underinsured, you may be eligible for brand-name Rozerem’s patient assistance program, which offers financial assistance for those who qualify.
GoodRx can also help you save on the cost of OTC products, such as melatonin. Just have your prescriber write you a prescription for melatonin, and use a free GoodRx discount to save over 50% off the retail cost.
The bottom line
Ramelteon (Rozerem) and melatonin are two popular treatment options to help you sleep. But they have some differences to consider. Ramelteon is only available by prescription, and it’s FDA-approved for insomnia. Melatonin is an over-the-counter supplement that isn’t FDA-approved for any use.
Ramelteon and melatonin both work by activating melatonin receptors (binding sites) in your brain. But ramelteon is more potent and works faster to help you fall asleep. Melatonin can take longer to start working after you take it. But it also comes in long-acting dosage forms that may help you stay asleep. Ramelteon isn’t approved for this use.
Ramelteon is considered safe to take for up to 6 months with your prescriber’s OK. There’s not much information about the long-term safety of melatonin. But it’s best to avoid taking it for more than a week or two at a time without talking to a healthcare professional.
Ramelteon and melatonin also have different side effects and drug interactions to consider. A healthcare professional can help you choose the best option based on your medical history and the other medications you’re taking.
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References
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Richardson, G. S., et al. (2009). Safety and subjective sleep effects of ramelteon administration in adults and older adults with chronic primary insomnia: A 1-year, open-label study. The Journal of Clinical Psychiatry.
ScienceDirect. (n.d.). Ramelteon.
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