Which of the following is not true about Ramelteon
|A||It acts on MT1 and MT2 receptor|
|B||Use in treatment of insomnia|
|C||It is CYP450 inhibitor|
|D||It has addiction liability|
(BG Katzung, Basic & Clinical Pharmacology’ 11th Edition’ 2010; pp-282)
a. Ramelteon is a new hypnotic and is a melatonin receptor agonist (MT1/MT2 agonist).
b. Physiological role of melatonin in body is to control circadian rhythm by acting on
suprachiasmatic nucleus .
c. in context of sleep, it induces sleep during night and signals to get awakened during the day time.
d. Ramelteon does the same by maintaining the circadian rhythm, therefore it is used in the treatment of those patients who is suffering from insomnia due to disturbance of circadian rhythm like shift workers, old age patients and in treatment of jet lag.
e. The drug has no action on GABA receptors and therefore has no abuse potential. and the withdrawal and rebound insomnia
f. The drug is distinctively superior in terms of efficacy to melatonin but is less effective as hypnotic than benzodiazepines.
g. It is metabolized by CYP450 and therefore can interact with many drugs metabolized by same enzyme.
h. The toxicity of this drug is not well defineD. drug may interfere with reproductive function. It has been shown to reduce levels of LH and FSH and increase prolactin levels.
(Mnemonics: RAMELTEON : R- Receptor, A- Agonist, MELT- Melatonin)