Active substanceMelatoninMelatonin
Similar drugsTo uncover
  • Coxpal Neo
    pills inwards 
    PROFIT FARM, LLC     Russia
  • Melaxen
    pills inwards 
    Unipharm, Inc.     USA
  • Melaxen Balance
    pills inwards 
    Unipharm, Inc.     USA
  • Melaren®
    pills inwards 
    NIZHFARM, JSC     Russia
  • Melaritm®
    pills inwards 
  • Melatonin-SZ
    pills inwards 
    NORTH STAR, CJSC     Russia
  • Sonnovan®
    pills inwards 
    Bakter, OOO     Russia
  • Circadian
    pills inwards 
  • Dosage form: & nbspTfilm-covered abeys.
    Composition:

    1 tablet, film-coated, contains:

    active substance: melatonin 3 mg;

    Excipients: calcium hydrophosphate 112 mg, starch corn pregelatinized 3.5 mg, magnesium stearate 1.5 mg, microcrystalline cellulose 40 mg;

    composition of film shell: opadray 85FII White 48105 5 mg, including: 2.345 mg polyvinyl alcohol, macrogol (polyethylene glycol 4000) 1.18 mg talc 0.87 mg titanium dioxide 0.605 mg.

    Description:Round, biconvex tablets with a risk, covered with a film shell of white color. The cross section is almost white.
    Pharmacotherapeutic group:Adaptogenic agent
    ATX: & nbsp

    N.05.C.H.01   Melatonin

    N.05.C.H   Melatonin receptor agonists

    Pharmacodynamics:
    Synthetic analogue of the hormone of the pineal body (epiphysis); has an adaptogenic, sedative, hypnotic effect. Normalizes circadian rhythms. Increases the concentration of gamma-aminobutyric acid (GABA) and serotonin in the middle brain and hypothalamus, changes the activity of pyridoxal kinase involved in the synthesis of GABA, dopamine and serotonin. Regulates the sleep-wake cycle, diurnal changes in locomotor activity and body temperature, positively influences the intellectual and mnestic functions of the brain, on the emotional-personal sphere. Promotes the organization of biological rhythm and normalization of night sleep. It improves sleep quality, speeds up falling asleep, regulates neuroendocrine functions. Adapts the organism of meteosensitive people to changes in weather conditions.
    Pharmacokinetics:

    Absorption

    Melatonin is rapidly absorbed after ingestion in the gastrointestinal tract. In older people, the rate of absorption can be reduced by 50%. The kinetics of melatonin in the range 2-8 mg is linear. When administered orally at a dose of 3 mg Cmax in blood plasma and saliva is achieved after 20 minutes and 60 minutes, respectively. Time to reach the maximum concentration Tmax in the blood serum 60 minutes (normal range 20-90 minutes). After taking 3-6 mg of melatonin, the maximum concentration of Cmax in serum, as a rule, 10 times more endogenous melatonin in the serum at night. The concomitant intake of food delays the absorption of melatonin.

    Bioavailability

    Bioavailability of melatonin at oral intake ranges from 9 to 33% (approximately 15%).

    Distribution

    In studies in vitro The association of melatonin with plasma proteins is 60%. Basically melatonin binds to albumin, α1acid glycoprotein and high-density lipoproteins. Volume of distribution Vd about 35 liters. Rapidly distributed into saliva and passes through the blood-brain barrier, is determined in the placenta. Concentration in cerebrospinal fluid is 2.5 times lower than in plasma.

    Biotransformation

    Melatonin is metabolized predominantly in the liver. After oral administration melatonin undergoes significant transformation during primary passage through the liver, where its hydroxylation takes place and conjugation with sulfate and glucuronide to form 6-sulfatoxymelatonin; the level of presystemic metabolism can reach 85%.Experimental studies suggest that during the metabolism of melatonin, isozymes participate CYP1A1, CYP1A2 and, possibly, CYP2C19 of the cytochrome P450 system. The main metabolite of melatonin-6-sulfatoxymelatonin, is inactive.

    Allocation

    Melatonin is secreted from the body by the kidneys. Mean half-life (T1/2) of melatonin is 45 minutes. Excretion is carried out with urine, about 90% in the form of sulfate and glucuron conjugates of 6-hydroxymelatonin, and about 2% -10% is excreted unchanged.

    On the pharmacokinetic parameters affect age, taking caffeine, smoking, taking oral contraceptives. Critical patients experience accelerated absorption and impaired elimination.

    Elderly patients

    Metabolism of melatonin, as is known, slows down with age. At different doses of melatonin, higher values ​​of the area under the concentration-time curve (AUC) and CmOh are obtained in the elderly, which reflects a reduced metabolism of melatonin in this group of patients.

    Patients with impaired renal function

    With prolonged treatment, cumulation of melatonin was not observed. These data are consistent with a short half-life of melatonin in humans.

    Patients with impaired hepatic function

    The liver is the main organ involved in the metabolism of melatonin, so liver disease leads to an increase in the concentration of endogenous melatonin. In patients with cirrhosis of the liver, the plasma concentration of melatonin increased significantly during the day.

    Indications:In sleep disorders, incl. caused by a disturbance in the rhythm of "sleep-wakefulness", such as desynchronosis (sudden change of time zones).
    Contraindications:

    Hypersensitivity to the components of the drug, autoimmune diseases, liver failure, severe renal failure, children under 18 years.

    Pregnancy and lactation:

    The drug is contraindicated for use during pregnancy and during breastfeeding.

    Dosing and Administration:

    Inside.

    With sleep disturbance, desynchronosis - 1 tablet once a day for 30-40 minutes before bedtime.

    When used as an adaptogen when changing time zones - 1 day before the flight and in the next 2-5 days - 1 tablet 30-40 minutes before bedtime. The maximum daily dose is 6 mg.

    Elderly patients

    With age, there is a decrease in melatonin metabolism, which must be taken into account when choosing a dosing regimen for elderly patients. With this in mind, elderly patients can take the drug 60-90 minutes before bedtime.

    Renal insufficiency

    The effect of varying degrees of renal failure on the pharmacokinetics of melatonin has not been studied, therefore melatonin should be used with caution to such patients. Patients with severe renal failure use of the drug is not recommended.

    Side effects:

    Classification of the incidence of side effects in accordance with the recommendations of the World Health Organization: very often (≥ 1/10), often (from ≥ 1/100 to <1/10), infrequently (from ≥1 / 1000 to <1/100), rarely (from ≥1 / 10000 to <1/1000) , very rarely (<1/10000), including individual messages; frequency is unknown (according to available data, it is not possible to establish the frequency of occurrence).

    Infectious and parasitic diseases:

    rarely: herpes zoster.

    Violations of the blood and lymphatic system:

    rarely: leukopenia, thrombocytopenia.

    Immune system disorders:

    frequency unknown: hypersensitivity reactions.

    Disorders from the metabolism and nutrition:

    rarely: hypertriglyceridemia, hypokalemia, hyponatremia.

    Disorders of the psyche:

    infrequently: irritability, nervousness, anxiety, insomnia, unusual dreams, nightmares, anxiety;

    rarely: mood changes, aggression, agitation, tearfulness, stress symptoms, disorientation, early morning awakening, increased libido, decreased mood, depression.

    Disturbances from the nervous system:

    infrequently: migraine, headache, lethargy, psychomotor hyperactivity, dizziness, drowsiness;

    rarely: fainting, memory impairment, impaired concentration, delirium, restless legs syndrome, poor sleep quality, paresthesia.

    Disturbances on the part of the organ of sight:

    rarely: decreased visual acuity, blurred vision, increased lacrimation.

    Hearing disorders and labyrinthine disorders:

    rarely: vertigo, positional vertigo.

    Disorders from the cardiovascular system:

    infrequently: arterial hypertension;

    rarely: angina pectoris, palpitations, hot flashes.

    Disorders from the gastrointestinal tract:

    infrequently: abdominal pain, abdominal pain in the upper abdomen, dyspepsia, ulcerative stomatitis, dry mouth, nausea;

    rarely: gastroesophageal disease, gastrointestinal disturbance or disorder, bullous stomatitis, ulcerous glossitis, vomiting, increased peristalsis, bloating,hypersecretion of saliva, unpleasant odor from the mouth, abdominal discomfort, dyskinesia of the stomach, gastritis.

    Disturbances from the liver and bile ducts:

    infrequently: hyperbilirubinemia.

    Disturbances from the skin and subcutaneous tissues:

    infrequently: dermatitis, sweating at night, itching and generalized itching, rash, dry skin;

    rarely: eczema, erythema, hand dermatitis, psoriasis, generalized rash, itching rash, nail damage;

    frequency unknown: Quincke's edema, edema of the oral mucosa, edema of the tongue.

    Disturbances from musculoskeletal and connective tissue:

    infrequently: pain in the limbs;

    rarely: arthritis, muscle spasm, pain in the neck, nocturnal cramps.

    Disorders from the kidneys and urinary tract:

    infrequently: glycosuria, proteinuria;

    rarely: polyuria, hematuria, nocturia.

    Violations of the genitals and the breast:

    infrequently: menopausal symptoms;

    rarely: priapism, prostatitis;

    frequency unknown: galactorrhea.

    General disorders and disorders at the site of administration:

    infrequently: asthenia, chest pain;

    rarely: fatigue, pain, thirst.

    Laboratory and instrumental data:

    infrequent: deviation from the norm of laboratory indicators of liver function, weight gain;

    rarely: increased activity of "liver" transaminases, deviation from the norm of the content of electrolytes in the blood, deviation from the norm of the results of laboratory tests.

    Overdose:

    According to available literature, the use of melatonin in a daily dose of up to 300 mg did not cause clinically significant adverse reactions. There was hyperemia, abdominal cramps, diarrhea, headache and scotoma with melatonin at doses of 3000-6600 mg for several weeks. When using very high doses of melatonin (up to 1 g), involuntary loss of consciousness was observed. Overdose may develop drowsiness.

    Treatment: gastric lavage and the use of activated charcoal, symptomatic therapy. The clearance of the active substance is expected within 12 hours after ingestion.

    Interaction:

    Pharmacokinetic interaction

    - It is known that in concentrations significantly exceeding therapeutic, melatonin induces isoenzyme CYP3A in vitro. The clinical significance of this phenomenon is not fully understood. In case of development of signs of induction, consideration should be given to reducing the dose of concomitant medications.

    - In concentrations significantly exceeding therapeutic, melatonin does not induce isoenzymes of the group CYP1A in vitro. Consequently, the interaction of melatonin with other drugs due to the influence of melatonin on the isozymes of the group CYP1A, apparently, is insignificant.

    - Metabolism of melatonin is mainly mediated by isoenzymes CYP1A. Consequently, the interaction of melatonin with other drugs is possible due to the influence of melatonin on the isozymes of the group CYP1A.

    - Care should be taken with respect to patients taking fluvoxamine, which increases the concentration of melatonin (an increase in AUC by 17 times and Cmax 12 times) due to inhibition of its metabolism by cytochrome P450 (CYP) isoenzymes: CYP1A2 and CYP2C19. Such a combination should be avoided.

    - Use caution in patients taking 5- and 8-methoxypsoralen that increases the concentration of melatonin from inhibition of its metabolism.

    - Care should be taken with respect to patients taking cimetidine (inhibitor of isoenzymes CYP2D), as it increases the plasma melatonin content by inhibiting the latter.

    - Smoking can reduce the concentration of melatonin by inducing isoenzyme CYP1A2.

    - Caution should be exercised for patients taking estrogens (eg, contraceptives or hormone replacement therapy) that increase the concentration of melatonin by inhibiting their metabolism with the CYP1A1 and CYP1A2 isoenzymes.

    - Inhibitor inhibitors CYPA2, for example, quinolones, are capable of increasing the exposure of melatonin.

    - Inductors of isoenzyme CYP1A2, such as carbamazepine and rifampicin, are able to reduce the plasma concentration of melatonin.

    - In the current literature, there are many data concerning the effect of agonists / antagonists of adrenergic and opioid receptors, antidepressants, inhibitors of prostaglandins, benzodiazepines, tryptophan and alcohol on the secretion of endogenous melatonin. Studies of the mutual influence of these drugs on the dynamics or kinetics of melatonin were not carried out.

    Pharmacodynamic interaction

    - During the reception of melatonin should not drink alcohol, because it reduces the effectiveness of the drug.

    - Melatonin potentiates the sedative effect of benzodiazepine and nonbenzodiazepine hypnotics, such as zaleplon, zolpidem and zopiclone. In the course of the clinical study, clear signs of transient pharmacodynamic interaction between melatonin and zolpidem were observed an hour after their administration. Combined use can lead to progressive attention, memory and coordination disorder compared to zolpidem monotherapy.

    - During the research melatonin was administered jointly with thioridazine and imipramine, drugs that affect the central nervous system. In none of the cases was there a clinically significant pharmacokinetic interaction. Nevertheless, simultaneous use with melatonin led to an increase in the sense of calm and difficulty in performing certain tasks in comparison with monotherapy with imipramine, as well as an increase in the feeling of "turbidity in the head", in comparison with monotherapy with thioridazine.

    Special instructions:

    It is recommended that you avoid exposure to bright light during the Sonnovan® treatment period.

    It is necessary to inform women who want to become pregnant, about the presence of a weak contraceptive effect in the drug.

    There are no clinical data on the use of melatonin in patients with autoimmune diseases,in connection with which the use in this category of patients is not recommended.

    Effect on the ability to drive transp. cf. and fur:

    The Sonnovan® drug causes drowsiness, therefore, during the treatment period, one should refrain from driving motor vehicles and practicing potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

    Form release / dosage:Tablets, film-coated, 3 mg.
    Packaging:

    By 2, 7, 10 or 30 tablets in a contour mesh box made of polyvinylchloride film and aluminum foil printed lacquered.

    For 1, 2, 3 contour packs for 2, 7 or 10 tablets or 1 contour pack of 30 tablets together with the instructions for use are placed in a pack of cardboard.

    Storage conditions:

    At a temperature of no higher than 25 ° C, in the manufacturer's packaging.

    Keep out of the reach of children.
    Shelf life:

    2 years.

    Do not use after the expiration date.

    Terms of leave from pharmacies:Without recipe
    Registration number:LP-003425
    Date of registration:25.01.2016 / 04.10.2016
    Expiration Date:25.01.2021
    The owner of the registration certificate:Bakter, OOOBakter, OOO Russia
    Manufacturer: & nbsp
    Representation: & nbspCANONFARMA PRODUCTION CJSC CANONFARMA PRODUCTION CJSC Russia
    Information update date: & nbsp04.08.2016
    Illustrated instructions
      Instructions
      Up