U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C16H21NO2
Molecular Weight 259.3434
Optical Activity ( - )
Defined Stereocenters 1 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of RAMELTEON

SMILES

CCC(=O)NCC[C@@H]1CCC2=CC=C3OCCC3=C12

InChI

InChIKey=YLXDSYKOBKBWJQ-LBPRGKRZSA-N
InChI=1S/C16H21NO2/c1-2-15(18)17-9-7-12-4-3-11-5-6-14-13(16(11)12)8-10-19-14/h5-6,12H,2-4,7-10H2,1H3,(H,17,18)/t12-/m0/s1

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including https://www.takeda.com/news/2011/20111007_3902.html

Ramelteon was approved by the United States (U.S.) in July 2005, and the Japanese Ministry of Health, Labour and Welfare in April 2010. It is currently available in the USA and Japan as ROZEREM and is indicated for the treatment of insomnia characterized by difficulty with sleep onset. In October 7, 2011, Takeda has decided to discontinue the development of ramelteon in Europe for the treatment of insomnia in order to best optimize Takeda’s resources for its research and development activities. Ramelteon is a melatonin receptor agonist with both high affinity for melatonin MT1 and MT2 receptors and selectivity over the MT3 receptor. Ramelteon demonstrates full agonist activity in vitro in cells expressing human MT1 or MT2 receptors, and high selectivity for human MT1 and MT2 receptors compared to the MT3 receptor. The activity of ramelteon at the MT1 and MT2 receptors is believed to contribute to its sleep-promoting properties since these receptors are acted upon by endogenous melatonin and are thought to be involved in the maintenance of the circadian rhythm underlying normal sleep-wake cycles. Ramelteon has no appreciable affinity for the GABA receptor complex or for receptors that bind neuropeptides, cytokines, serotonin, dopamine, noradrenaline, acetylcholine, and opiates.

Originator

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
ROZEREM

Approved Use

ROZEREM is indicated for the treatment of insomnia characterized by difficulty with sleep onset. The clinical trials performed in support of efficacy were up to 6 months in duration. The final formal assessments of sleep latency were performed after 2 days of treatment during the crossover study (elderly only), at 5 weeks in the 6-week studies (adults and elderly), and at the end of the 6-month study (adults and elderly) [see Clinical Studies (14)

Launch Date

1.12199034E12
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
25.9 ng/mL
64 mg single, oral
dose: 64 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
RAMELTEON serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
36.1 ng × h/mL
64 mg single, oral
dose: 64 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
RAMELTEON serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
1.9 h
64 mg single, oral
dose: 64 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
RAMELTEON serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
30%
64 mg single, oral
dose: 64 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
RAMELTEON serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
32 mg 1 times / day multiple, oral
Highest studied dose
Dose: 32 mg, 1 times / day
Route: oral
Route: multiple
Dose: 32 mg, 1 times / day
Sources:
unhealthy, 42.8 years
n = 63
Health Status: unhealthy
Condition: chronic primary insomnia
Age Group: 42.8 years
Sex: M+F
Population Size: 63
Sources:
Other AEs: Somnolence, Malaise...
Other AEs:
Somnolence (12.7%)
Malaise (1.6%)
Dizziness (3.2%)
Nasopharyngitis (4.8%)
Sources:
40 mg 1 times / day multiple, oral
Overdose
Dose: 40 mg, 1 times / day
Route: oral
Route: multiple
Dose: 40 mg, 1 times / day
Sources:
unhealthy, 47 years
n = 1
Health Status: unhealthy
Condition: insomnia
Age Group: 47 years
Sex: F
Population Size: 1
Sources:
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Disc. AE: Somnolence, Dizziness...
AEs leading to
discontinuation/dose reduction:
Somnolence (0.8%)
Dizziness (0.5%)
Nausea (0.3%)
Fatigue (0.3%)
Headache (0.3%)
Insomnia (0.3%)
Sources:
160 mg single, oral
Highest studied dose
Dose: 160 mg
Route: oral
Route: single
Dose: 160 mg
Sources:
unknown
AEs

AEs

AESignificanceDosePopulation
Malaise 1.6%
32 mg 1 times / day multiple, oral
Highest studied dose
Dose: 32 mg, 1 times / day
Route: oral
Route: multiple
Dose: 32 mg, 1 times / day
Sources:
unhealthy, 42.8 years
n = 63
Health Status: unhealthy
Condition: chronic primary insomnia
Age Group: 42.8 years
Sex: M+F
Population Size: 63
Sources:
Somnolence 12.7%
32 mg 1 times / day multiple, oral
Highest studied dose
Dose: 32 mg, 1 times / day
Route: oral
Route: multiple
Dose: 32 mg, 1 times / day
Sources:
unhealthy, 42.8 years
n = 63
Health Status: unhealthy
Condition: chronic primary insomnia
Age Group: 42.8 years
Sex: M+F
Population Size: 63
Sources:
Dizziness 3.2%
32 mg 1 times / day multiple, oral
Highest studied dose
Dose: 32 mg, 1 times / day
Route: oral
Route: multiple
Dose: 32 mg, 1 times / day
Sources:
unhealthy, 42.8 years
n = 63
Health Status: unhealthy
Condition: chronic primary insomnia
Age Group: 42.8 years
Sex: M+F
Population Size: 63
Sources:
Nasopharyngitis 4.8%
32 mg 1 times / day multiple, oral
Highest studied dose
Dose: 32 mg, 1 times / day
Route: oral
Route: multiple
Dose: 32 mg, 1 times / day
Sources:
unhealthy, 42.8 years
n = 63
Health Status: unhealthy
Condition: chronic primary insomnia
Age Group: 42.8 years
Sex: M+F
Population Size: 63
Sources:
Fatigue 0.3%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Headache 0.3%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Insomnia 0.3%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Nausea 0.3%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Dizziness 0.5%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Somnolence 0.8%
Disc. AE
8 mg 1 times / day steady, oral
Recommended
Dose: 8 mg, 1 times / day
Route: oral
Route: steady
Dose: 8 mg, 1 times / day
Sources:
unhealthy, adult
n = 3594
Health Status: unhealthy
Condition: insomnia
Age Group: adult
Population Size: 3594
Sources:
Overview

OverviewOther

Other InhibitorOther SubstrateOther Inducer







Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no (co-administration study)
Comment: theophylline AUC increased 40% and Cmax increased 35%
Page: 11, 13
no
no (co-administration study)
Comment: dextromethorphan AUC and Cmax did not change
Page: 11, 13
no
no (co-administration study)
Comment: ramelteon decreased digoxin exposure by 3%
Page: 11, 60, 63
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
inconclusive
major
yes (co-administration study)
Comment: fluvoxamine increased ramelteon AUC 190-fold and Cmax 70-fold; rifampin decreased total expsoure to ramelteon by 80%
Page: 11, 13
minor
yes (co-administration study)
Comment: rifampin decreased total expsoure to ramelteon by 80%
Page: 11, 13
minor
yes (co-administration study)
Comment: ketaconazole increased ramelteon AUC by 84% and Cmax 36%; rifampin decreased total expsoure to ramelteon by 80%
Page: 11, 13
yes
yes (co-administration study)
Comment: fluconazole increased AUC by 150% and Cmax by 150%; rifampin decreased total expsoure to ramelteon by 80%
Page: 13.0
Tox targets

Tox targets

Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Relative abuse liability of hypnotic drugs: a conceptual framework and algorithm for differentiating among compounds.
2005
Sleep and aging: prevalence of disturbed sleep and treatment considerations in older adults.
2005
Ramelteon.
2005
Fresh from the pipeline: Ramelteon.
2005 Nov
Ramelteon (Rozerem) for insomnia.
2005 Nov 7
Gateways to clinical trials.
2005 Oct
New drugs and dosage forms.
2005 Sep 15
Depression and sleep: pathophysiology and treatment.
2006
Ramelteon: profile of a new sleep-promoting medication.
2006 Apr
Practical considerations of new drugs: new choices for old problems.
2006 Apr
Ramelteon (rozerem) a novel approach for insomnia treatment.
2006 Apr
Potential therapeutic use of melatonin in migraine and other headache disorders.
2006 Apr
Consultation corner. Are the new sleep aids right for you?
2006 Apr
New drugs 06, part II.
2006 Aug
Pharmacologic management of insomnia: past, present, and future.
2006 Dec
An efficacy, safety, and dose-response study of Ramelteon in patients with chronic primary insomnia.
2006 Jan
Searching for new options for treating insomnia: are melatonin and ramelteon beneficial?
2006 Jul
Ramelteon: a novel treatment for the treatment of insomnia.
2006 Jul
Effect of ramelteon (TAK-375), a selective MT1/MT2 receptor agonist, on motor performance in mice.
2006 Jul 24
Gateways to clinical trials.
2006 Jul-Aug
Acute and chronic effects of ramelteon in rhesus monkeys (Macaca mulatta): dependence liability studies.
2006 Jun
Effects of ramelteon on patient-reported sleep latency in older adults with chronic insomnia.
2006 Jun
A new sleeping pill.
2006 Oct
Ramelteon for the treatment of insomnia.
2006 Oct
Ramelteon: a novel hypnotic lacking abuse liability and sedative adverse effects.
2006 Oct
Update on the safety considerations in the management of insomnia with hypnotics: incorporating modified-release formulations into primary care.
2007
[Melatonin, melatonin receptor agonists and tryptophan as sleep aids].
2007
Drug Insight: the use of melatonergic agonists for the treatment of insomnia-focus on ramelteon.
2007 Apr
Age and gender effects on the pharmacokinetics and pharmacodynamics of ramelteon, a hypnotic agent acting via melatonin receptors MT1 and MT2.
2007 Apr
Treatment options for insomnia.
2007 Aug 15
New perspectives for the treatment of disorders of sleep and arousal.
2007 Jul
[New hypnotics: perspectives from sleep physiology].
2007 Jul-Aug
Hypnotic sedative drugs.
2007 Jun
The management of insomnia in the older adult.
2007 Jun
A 2-night, 3-period, crossover study of ramelteon's efficacy and safety in older adults with chronic insomnia.
2007 May
In search of novel and therapeutically significant melatoninergic ligands.
2007 Nov
Self-reported efficacy and tolerability of ramelteon 8 mg in older adults experiencing severe sleep-onset difficulty.
2007 Sep
Safety of ramelteon in individuals with mild to moderate obstructive sleep apnea.
2007 Sep
Melatonin receptor agonists: SAR and applications to the treatment of sleep-wake disorders.
2008
Melatonin therapy to improve nocturnal sleep in critically ill patients: encouraging results from a small randomised controlled trial.
2008
Melatonergic drugs in clinical practice.
2008
A review of ramelteon in the treatment of sleep disorders.
2008 Feb
Jet lag: therapeutic use of melatonin and possible application of melatonin analogs.
2008 Jan-Mar
Ramelteon: a melatonin receptor agonist for the treatment of insomnia.
2008 Jan-Mar
Ramelteon 8 mg/d versus placebo in patients with chronic insomnia: post hoc analysis of a 5-week trial using 50% or greater reduction in latency to persistent sleep as a measure of treatment effect.
2008 Jul
Stimulatory effects of a melatonin receptor agonist, ramelteon, on BDNF in mouse cerebellar granule cells.
2008 Jul 4
Sleep dysfunction in heart failure.
2008 Sep
Ramelteon: a novel approach in the treatment of insomnia.
2008 Sep
Melatonin receptor agonist ramelteon activates the extracellular signal-regulated kinase 1/2 in mouse cerebellar granule cells.
2008 Sep 9
The effect of melatonergic and non-melatonergic antidepressants on sleep: weighing the alternatives.
2009
Patents

Sample Use Guides

The recommended dose 8 mg taken within 30 minutes of going to bed. It is recommended that drug not be taken with or immediately after a high fat meal.
Route of Administration: Oral
In Vitro Use Guide
Curator's Comment: Ramelteon inhibited forskolin-stimulated cAMP production in the CHO cells that express the human MT1 or MT2 receptors.
Unknown
Name Type Language
RAMELTEON
HSDB   INN   JAN   MART.   MI   ORANGE BOOK   USAN   VANDF   WHO-DD  
INN   USAN  
Official Name English
RAMELTEON [JAN]
Common Name English
RAMELTEON [VANDF]
Common Name English
ROZEREM
Brand Name English
TAK375
Code English
(-)-N-(2-(((8S)-1,6,7,8-TETRAHYDRO-2H-INDENO(5,4-.BETA.)FURAN-8-YL)ETHYL)PROPANAMIDE
Common Name English
RAMELTEON [HSDB]
Common Name English
RAMELTEON [MART.]
Common Name English
RAMELTEON [ORANGE BOOK]
Common Name English
RAMELTEON [USAN]
Common Name English
TAK-375
Code English
Ramelteon [WHO-DD]
Common Name English
RAMELTEON [MI]
Common Name English
PROPANAMIDE, N-(2-((8S)-1,6,7,8-TETRAHYDRO-2H-INDENO(5,4-.BETA.)FURAN-8-YL)ETHYL)-
Common Name English
ramelteon [INN]
Common Name English
Classification Tree Code System Code
WHO-ATC N05CH02
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
LIVERTOX NBK548437
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
NDF-RT N0000000250
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
WHO-VATC QN05CH02
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
NDF-RT N0000175743
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
NCI_THESAURUS C47795
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
Code System Code Type Description
NCI_THESAURUS
C66504
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
LACTMED
Ramelteon
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
WIKIPEDIA
RAMELTEON
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
FDA UNII
901AS54I69
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
CAS
196597-26-9
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
USAN
PP-50
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
RXCUI
596205
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY RxNorm
HSDB
7787
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
ChEMBL
CHEMBL1218
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
DRUG CENTRAL
2355
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
EVMPD
SUB21315
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PRIMARY
MERCK INDEX
M9489
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY Merck Index
DAILYMED
901AS54I69
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
INN
8447
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
EPA CompTox
DTXSID6045951
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
MESH
C495910
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
PUBCHEM
208902
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
IUPHAR
1356
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY
DRUG BANK
DB00980
Created by admin on Fri Dec 16 18:57:16 UTC 2022 , Edited by admin on Fri Dec 16 18:57:16 UTC 2022
PRIMARY