• Insomnia
• Sleep Disorders

How Does Ramelteon Work?

Published: April 29, 2025
Updated: April 29, 2025
4 mins

As the saying goes, “the body is not a machine.” Getting quality sleep gives your body a chance to recharge and perform to its full potential. Even if you’re getting the recommended eight hours of sleep, you may still feel groggy if you’re constantly having restless sleep. Those with insomnia may need additional guidance to improve sleep quality beyond going to sleep earlier every night.

If you have insomnia, a healthcare provider may start with cognitive behavioral therapy and suggest lifestyle changes to improve your sleep. Insomnia is a common sleep disorder that makes it more difficult to fall asleep or stay asleep. 

Medication is often the last consideration unless your symptoms continue to worsen. Ramelteon is one of the medications used to treat those with insomnia. Ramelteon is recommended for sleep insomnia, but may not be the right medication for other sleep disorders like sleep apnea.

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What is Ramelteon?

Ramelteon is a melatonin receptor agonist FDA-approved for insomnia treatment. You may see it available under the brand name Rozerem^®. Melatonin receptor agonists act similarly to the hormone melatonin, which affects the sleep-wake cycle in the body.

Over time, taking Ramelteon helps those with insomnia to remain asleep for at least seven to eight hours. Ramelteon is a medication taken once a day without food. The recommended dosage for ramelteon is eight milligrams (mg). However, a healthcare provider may recommend a different dosage based on your health history and individual symptoms.

How Effective is Ramelteon for Sleep?

Ramelteon can begin working within 30 minutes of taking the medication. Health experts recommend waiting until right before bedtime to take the medication. Otherwise, you may feel too drowsy throughout the day. Symptoms typically improve within seven to 10 days of taking the medication daily as prescribed.

What are the Advantages of Ramelteon? 

One of the main benefits of Ramelteon is that it often causes fewer side effects in people than hypnotic medications that also help with sleep. 

Many healthcare providers prescribe Ramelteon to elderly adults with insomnia because of the following benefits:

• Reduced risk of memory loss

• Less likely to cause withdrawal symptoms

• May improve brain health

While there is some research showing that ramelteon may help elderly adults with cognitive impairment, more research is still needed to know how effective the medication is for brain health.

What are the Common Side Effects of Ramelteon?

Ramelteon is known to cause drowsiness. You may experience the following side effects while taking Ramelteon:

• Nausea

• Headaches

• Dizziness

• Fatigue

What are the Severe Side Effects of Ramelteon?

While severe side effects are possible, it’s rare to experience them. One study found that only around 3% of participants experienced severe side effects.

One of the most severe potential side effects of ramelteon is driving, talking, and doing activities while sleeping but not remembering afterward. If you notice any drastic changes in your behavior or thinking, don’t hesitate to reach out to your healthcare provider.

You may experience the following severe side effects while taking Ramelteon:

• Hallucinations

• Suicidal thoughts

• Memory loss

• Hormonal fluctuations

Does Ramelteon Have Any Drug Interactions?

Be sure to discuss any other medications you’re taking with your healthcare provider before starting Ramelteon. Some medications may increase your risk of experiencing severe side effects. Try to avoid drinking alcohol excessively while taking ramelteon. Alcohol can also increase the risk of severe side effects and reduce the effectiveness of the medication.

The following medications may interact with Ramelteon:

• Fluvoxamine (Luvox)

• Fluconazole (Diflucan)

• Rifamycin (Aemcolo)

• Viloxazine (Qelbree)

• Alprazolam (Xanax)

• Lorazepam (Ativan)

• Carisoprodol (Soma)

• Antihistamines

Be sure to let a healthcare provider know if you are pregnant or plan on becoming pregnant before starting ramelteon. Taking ramelteon while pregnant may have harmful effects on the unborn child.

Who Should Not Take Ramelteon?

Before prescribing ramelteon, a healthcare provider will ask you about your health history. A healthcare provider may recommend an alternate medication if you have a history of the following conditions:

• COPD (chronic obstructive pulmonary disease)

• Sleep apnea

• Depression

• Liver disease

Before prescribing ramelteon, a healthcare professional may ask you if you have a history of suicidal ideation. Ramelteon may make it harder to navigate mental health challenges because of its effects on the brain.

What are Additional Treatment Options for Insomnia?

Chronic insomnia can affect how well your brain, heart, and other parts of your body function. As a result of a lack of sleep, you may find it more difficult to concentrate and get sick often.

Before starting medication, consider trying the following habits to improve sleep quality:

• Stick to a daily sleep schedule.

• Try to avoid naps.

• Eat dinner earlier to sleep longer.

• Practice mindfulness to manage stress.

• Avoid caffeine right before bed.

• Engage in calming activities before bed.

• Limit screen time right before going to sleep.

While taking melatonin supplements may help you fall asleep, health experts need more research to determine how effective it is for sleep disorders. Some healthcare providers may recommend additional practices like light therapy to improve sleep quality. Light therapy consists of sitting in front of an artificial light box for a set amount of time to help reset your sleep-wake cycle. 

How Can LifeMD Help?

It’s easy to find yourself prioritizing other things instead of sleep. Many people have busy schedules where sleep is not always a guaranteed part of a busy life. However, getting enough sleep will make you better equipped to take on responsibilities in your daily life. 

You don’t have to figure out how to incorporate more quality sleep into your life on your own. At LifeMD, a LifeMD-affiliated licensed healthcare provider can provide guidance on getting more quality sleep and prescribe FDA-approved medications to help you fall asleep faster.

Get started today by completing a short assessment to help a licensed healthcare provider determine your eligibility for ramelteon. If you qualify, your prescription sleep medication can be shipped directly to your door in a timely manner.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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