3 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: melatonin, Fish Oil.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Moderate
Melatonin
+ Food
The following applies to the ingredients: Melatonin
MONITOR: Oral caffeine may significantly increase the bioavailability of melatonin. The proposed mechanism is inhibition of CYP450 1A2 first-pass metabolism. After administration of melatonin 6 mg and caffeine 200 mg orally (approximately equivalent to 1 large cup of coffee) to 12 healthy subjects, the mean peak plasma concentration (Cmax) of melatonin increased by 137% and the area under the concentration-time curve (AUC) increased by 120%. The metabolic inhibition was greater in nonsmokers (n=6) than in smokers (n=6). The greatest effect was seen in subjects with the *1F/*1F genotype (n=7), whose melatonin Cmax increased by 202%. The half-life did not change significantly. The clinical significance of this interaction is unknown.
According to some authorities, alcohol may reduce the effect of melatonin on sleep. The mechanism of this interaction is not fully understood.
In addition, CYP450 1A2 inducers like cigarette smoking may reduce exogenous melatonin plasma levels. In a small clinical trial (n=8), habitual smokers had their melatonin plasma levels measured two times, each after a single oral dose of 25 mg of melatonin. They had smoked prior to the first measurement but had not smoked for 7 days prior to the second. Cigarette smoking significantly reduced melatonin plasma exposure (AUC) as compared to melatonin levels after 7 days of smoking abstinence (7.34 +/- 1.85 versus 21.07 +/- 7.28 nmol/L*h, respectively).
MANAGEMENT: Caution and monitoring are recommended if melatonin is used with inhibitors of CYP450 1A2 like caffeine or inducers of CYP450 1A2 like cigarette smoking. Consumption of alcohol should be avoided when taking melatonin.
References
- Hartter S, Nordmark A, Rose DM, Bertilsson L, Tybring G, Laine K "Effects of caffeine intake on the pharmacokinetics of melatonin, a probe drug for CYP1A2 activity." Br J Clin Pharmacol 56 (2003): 679-682
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Ursing C, Bahr CV, Brismar K, Rojdmark S "Influence of cigarette smoking on melatonin levels in man" Eur J Clin Pharmacol 61 (2005): 197-201
Drug and Pregnancy Interactions
Major
Fish Oil
+ Pregnancy
The following applies to the ingredients: Omega-3 Polyunsaturated Fatty Acids (found in Fish Oil)
Use is recommended only if clearly needed.
AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned
Comments:
-There is insufficient data on use in pregnancy to identify drug-associate risks for major birth defects, miscarriage, or adverse fetal or maternal outcomes.
-Animal studies of dams given oral omega-3-acid ethyl esters from mating through lactation did not show adverse reproductive or developmental effects at 5 times the maximum recommended human dose (MRHD).
-Animal studies of oral dosing at clinically relevant doses during organogenesis did not show teratogenicity.
-There is no official RDA for omega-3 fatty acids during pregnancy, but the US Institute of Medicine and the Food and Nutrition Board suggest that 1400 mg per day should be adequate during lactation.
-Pregnant women may not consume adequate amounts of omega-3 fatty acids from their diet due to recommendations to limit fish consumption to no more than twice weekly (due to mercury content of fish).
Animal studies of oral administration from 2 weeks prior to mating through lactation showed no adverse effects at 5 times the recommended human dose (MRHD). A dose ranging study of oral administration from 2 weeks prior to mating to postpartum day 7 showed a 20% reduction in live births and a 40% reduction in pup survival to postnatal day 4 at or above 3000 mg/kg/day (7 times the MRHD). Oral doses up to 14 times the MRHD (a maternotoxic dose) administered during organogenesis showed no fetal adverse effects. Animals given oral doses up to 5 times the MRHD from gestation day 14 through lactation day 21 showed no adverse effects. Skeletal malformations and reduced fetal growth were seen at maternally toxic doses (4 times the MRHD) and embryolethality occurred at 7 times the MRHD in rabbits. There are no controlled data in human pregnancy. Adequate omega-3 fatty acid intake during pregnancy may reduce preterm birth, increase birth length, weight, and head circumference, improve cognitive and visual development, and reduce risk of allergies. The background birth defect and miscarriage risk for the indicated population is not known. In the US general population, the estimated major birth defect risk is 2 to 4% and the miscarriage risk is 15 to 20%.
AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Lovaza (omega-3 polyunsaturated fatty acids)." GlaxoSmithKline (2012):
- Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):
- "Product Information. Omega-3-Acid Ethyl Esters (omega-3 polyunsaturated fatty acids)." Apotex Corporation (2017):
- "Product Information. Omega-3 D-3 Wellness Pack (obsolete) (omega-3 polyunsaturated fatty acids)." TMIG Inc (2017):
Unknown
Melatonin
+ Pregnancy
The following applies to the ingredients: Melatonin
Interaction data not available for these drugs.
Details concerning possible warnings or interactions cannot be determined.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.
Drug and Breastfeeding Interactions
Minor
Fish Oil
+ Breastfeeding
The following applies to the ingredients: Omega-3 Polyunsaturated Fatty Acids (found in Fish Oil)
Safety has not been established; use is not recommended.
Excreted into human milk: Yes
Comments:
-There is no information regarding this drug on the effects on a breastfed infant, or effects on milk production.
-Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for this medication as well as any potential adverse effects from this drug or the underlying maternal condition.
-Higher omega-3 fatty acid levels have been seen in lactating patients receiving oral omega-3 fatty acid supplementation.
-Infant needs for docosahexaenoic acid (DHA) is approximately 70 to 80 mg per day.
-There is no official RDA for omega-3 fatty acids during lactation, but the US Institute of Medicine and the Food and Nutrition Board suggest that 1300 mg per day should be adequate during lactation.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):
- "Product Information. Omega-3-Acid Ethyl Esters (omega-3 polyunsaturated fatty acids)." Apotex Corporation (2017):
- "Product Information. Omega-3 D-3 Wellness Pack (obsolete) (omega-3 polyunsaturated fatty acids)." TMIG Inc (2017):
Unknown
Melatonin
+ Breastfeeding
The following applies to the ingredients: Melatonin
Interaction data not available for these drugs.
Details concerning possible warnings or interactions cannot be determined.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Consumer Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.