Ramelteon (Rozerem) 101: Everything You Need to Know

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 10/20/2020

Ramelteon is a prescription sleep medication that’s used to treat insomnia. In the United States, it’s commonly sold under the brand name Rozerem®

First approved by the FDA in 2005, ramelteon is one of only a few prescription sleeping pills approved by the FDA for long-term use to treat insomnia. Unlike many older sleeping pills, ramelteon hasn’t been shown to have potential for abuse or dependence.

As a treatment for insomnia, ramelteon works by binding to the body’s melatonin receptors and inducing drowsiness. 

Below, we’ve explained what ramelteon is and how it works in more detail. We’ve also looked at some of the science behind ramelteon, including studies that observe how effective ramelteon is as a treatment for difficulty sleeping. 

What Is Ramelteon?

Ramelteon is a hypnotic/sedative medication that’s used to treat insomnia. As with many other sleep aids, it’s only available as a prescription medication. Ramelteon comes in tablet form at a typical dose of 8mg per tablet.

If you have insomnia, your healthcare provider might suggest ramelteon as a treatment option, particularly if you have persistent difficulty falling asleep.  

How Ramelteon Works

Ramelteon belongs to a class of medications known as melatonin receptor agonists. It works by binding to your body’s MT1 and MT2 receptors, which play a major role in the signaling pathway of melatonin in the body. 

Melatonin is a neurotransmitter-like compound that’s responsible for regulating your sleep-wake cycle. Your body produces melatonin naturally in the pineal gland in response to changing levels of light.

Melatonin causes you to feel sleepy. As the concentration of melatonin in your body increases, you’re more likely to feel ready to go to sleep. 

As the sun starts to disappear in the evening and night, your body’s production of melatonin is ramped up. Typically, melatonin levels reach their peak in the early hours of the morning, when you’re most likely to feel sleepy. 

By binding to your body’s MT1 and MT2 receptors, ramelteon mimics the effects of melatonin, meaning you’ll gradually feel tired and ready to go to bed after using it.

Studies of ramelteon show that it works effectively as a sleeping pill. In a 2011 scientific review, researchers noted that ramelteon caused a reduction in sleep onset latency (the amount of time required to fall asleep) regardless of factors such as patient age or type of insomnia.

Another review from 2010 noted that ramelteon caused a moderate decrease in latency to sleep in people with transient and chronic insomnia.

In one study mentioned in this review, a standard dose of ramelteon taken 30 minutes before bedtime reduced time to sleep by 7.5 minutes. 

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Ramelteon Side Effects

Like other medications, ramelteon has the potential to cause certain side effects. However, ramelteon is less likely to cause many side effects than certain older sleeping pills that are commonly prescribed to treat insomnia.

For example, studies of ramelteon have noted that unlike older sleeping pills, ramelteon is less likely to cause next-day side effects such as drowsiness or a sleeping pill “hangover.”

Ramelteon has also not shown to have any abuse liability. As such, unlike older sleeping pills, it isn’t scheduled by the Drug Enforcement Administration (DEA). 

The most common side effects of ramelteon are dizziness, sleepiness, nausea and exacerbated insomnia. In clinical trials, these side effects affected between three and four percent of patients given ramelteon at a standard 8mg dosage. 

People using ramelteon or other prescription sleeping pills may experience abnormal thoughts or behavior. These include sleepwalking, waking up in the night to prepare food, talk to others, have sex or even “sleep-drive,” often with no memory of this event.

If you experience any abnormal thoughts or behaviors after using ramelteon, stop taking the medication immediately and talk to your healthcare provider as soon as possible. 

Like other medications, ramelteon may cause allergic reactions, including severe reactions that require medical attention. If you experience any signs of an allergic reaction, such as swelling of the face, tongue or throat, hives, vomiting or difficulty breathing, seek immediate medical help. 

Ramelteon can interact with other medications, including certain sleeping pills, muscle relaxers, anti-anxiety medications and other medications that increase drowsiness.

To avoid any potential drug interactions, inform your healthcare provider of all medications you use before discussing ramelteon. 

Is It Safe to Drink Alcohol with Ramelteon?

You should not drink alcohol immediately before or after taking ramelteon. Consuming alcoholic beverages with ramelteon can increase certain side effects of this medication, such as dizziness and drowsiness. 

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Learn More About Treating Insomnia

If you suffer from insomnia and believe ramelteon could be a good treatment option, it’s best to talk to your healthcare provider.

Based on your symptoms, they may prescribe ramelteon to help you fall asleep faster and enjoy a better, longer night’s sleep. 

Ramelteon is one of several medications used to treat insomnia. Others, such as doxepin, may also help you reduce the effects of sleep difficulties and benefit from better sleep health.

You can learn more about the most effective treatments for insomnia in our complete guide to prescription sleeping pills, which lists everything from older-generation sleeping pills to newer insomnia treatments. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.