Meloset (Melatonin)
Also sold as: Meloset, Circadin, Slenyto, Melzap, Zonest
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 0.5mg, 1mg, 2mg, 3mg, 5mg, 10mg +2
Indications
- Insomnia in patients ≥55 years (Circadin 2mg PR — approved indication in Europe; monotherapy)
- Jet lag (time zone shift — short course)
- Circadian rhythm sleep disorders (delayed sleep phase syndrome, non-24-hour sleep-wake rhythm disorder, especially in blind patients)
- Insomnia in autism spectrum disorder and ADHD (paediatric)
- Shift work sleep disorder
Adult Dosing
Insomnia ≥55 years (Circadin PR)
2 mg PO 1–2 hours before bedtime for up to 13 weeks (European approval)
Effectiveness is modest — reduces sleep latency by ~12 minutes vs placebo. Very safe profile vs benzodiazepines/z-drugs. No dependency or rebound.
Jet lag
0.5–5 mg PO at bedtime at destination (starting day of arrival)
Take for 2–5 days at destination. Going east (advance phase): also 2–3 mg on departure day morning
Delayed sleep phase (insomnia)
0.5–3 mg PO 5–6 hours before desired bedtime (chronobiotic use) — not at bedtime
Advance circadian phase. Timing is critical for chronobiotic effect.
Pediatric Dosing
Slenyto (licensed paediatric PR formulation): 1–5 mg for ASD/Smith-Magenis. Review at 1 year.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Any CrCl | No adjustment required — hepatically metabolised (CYP1A2) |
Hepatic Adjustment
Avoid in significant hepatic impairment — markedly increased bioavailability (hepatic first-pass effect reduced)
Pregnancy & Lactation
Pregnancy: Category C
Insufficient data in human pregnancy. Animal studies show no teratogenicity. Melatonin crosses placenta. Avoid unless essential — chronic insomnia in pregnancy: sleep hygiene first.
Lactation: Caution
Naturally present in breast milk (lowest in daytime, peaks at night). Supplemental melatonin: avoid in breastfeeding as neonatal effects unknown.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| CYP1A2 inhibitors (fluvoxamine, ciprofloxacin, caffeine) | Fluvoxamine dramatically increases melatonin levels (17× increase) — avoid combination | Major |
| CYP1A2 inducers (tobacco smoke, rifampicin, omeprazole) | Smoking reduces melatonin levels by ~75% — smokers may need higher doses; stopping smoking → levels rise | Moderate |
| Anticoagulants (warfarin) | High-dose melatonin may increase anticoagulant effect — monitor INR | Moderate |
| Antidiabetics | Melatonin may impair glucose tolerance and insulin secretion — monitor blood glucose in diabetics | Moderate |
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Side Effects
Common
- Drowsiness (next day at higher doses)
- Headache
- Dizziness
- Nausea
- Irritability
- Vivid dreams
Serious / Discontinue If
- Seizure threshold lowering (caution in epilepsy — monitor)
- Hypotension (at high doses)
- Hepatotoxicity (very rare, case reports)
Contraindications
- Severe hepatic impairment
- Autoimmune disorders (theoretical — melatonin can stimulate immune system; caution in autoimmune diseases)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Meloset 3mg | Aristo | 10 tab ₹85 |
| Zonest 1mg | Sun Pharma | 10 tab ₹65 |
| Melzap 3mg | Cipla | 10 tab ₹78 |
| Circadin 2mg PR | Mundipharma/Napp | 30 tab ₹285 (imported) |
Monitoring Required
- Sleep diary (latency, total sleep time, wakefulness)
- Blood glucose in diabetics
- Seizure frequency in epilepsy
- Review at 13 weeks (clinical benefit assessment)
Patient Counseling Points
- Take 1–2 hours before your desired bedtime — not later (allows time to work)
- Turn off blue-light screens (phone, TV) after taking melatonin — light suppresses its effect
- Very safe for short-term use — no dependency, no rebound insomnia on stopping
- Results are modest — typical benefit is falling asleep 10–15 minutes faster; sleep hygiene is equally important
- Jet lag: take at destination bedtime, starting on arrival day — can take up to 5 days to readjust
- Higher doses (> 5 mg) are not necessarily better — 0.5–3 mg is often sufficient and causes less next-day drowsiness
Stop Googling drug references mid-consultation
EasyClinic auto-flags Meloset interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Vikas Desai, MD (Psychiatry), Senior Consultant Psychiatrist
Last reviewed: 2026-04-01
References
- EMA Circadin Summary of Product Characteristics
- Cochrane — Melatonin for Insomnia
- BNF — Melatonin
- AASM Clinical Practice Guidelines Melatonin 2017
- NICE — Melatonin for Sleep Disorders in Children