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TASIMELTEON

brandsClassTASIMELTEON commonly prescribed forHow TASIMELTEON worksHow long until TASIMELTEON worksNotable Side EffectsLife Threatening Side Effectsweight gainsedationWhat to do about TASIMELTEON side effectsusual dosage rangeDosage Formslong term usehabit formingRenal ImpairmentHepatic ImpairmentCardiac ImpairmentElderlyChildren and AdolescentsPregnancyBreast Feeding

THERAPEUTICS

brands

  • Hetlioz

Class

  • Melatonin 1 and 2 receptor agonist

TASIMELTEON commonly prescribed for

(Bold for FDA approved)

• Non-24-Hour Sleep-Wake Disorder (Non-24)
• Insomnia associated with shift work, jet lag, or circadian rhythm disturbances

How TASIMELTEON works

• Binds selectively to melatonin 1 and melatonin 2 receptors as a full agonist, with greater affinity for melatonin 2 receptors than for melatonin 1 receptors

How long until TASIMELTEON works

• Because of individual differences in circadian rhythms, daily use for several weeks or months may be necessary before efficacy is observed

SIDE EFFECTS

Notable Side Effects

• Headache, nightmares, or unusual dreams

• Increased alanine aminotransferase

• Upper respiratory infection, urinary infection

Life Threatening Side Effects

• None reported

weight gain

unusual

unusual

sedation

common

common

What to do about TASIMELTEON side effects

• Wait

• To avoid problems with memory, take tasimelteon only if planning to have a full night’s sleep

• Switch to a different hypnotic

DOSING AND USE

usual dosage range

• 20 mg at bedtime

Dosage Forms

• Capsule 20 mg

long term use

• Not restricted to short-term use

• Continued use is necessary to maintain circadian entrainment

• Has been studied and found safe in a small number of patients for up to 1 year

habit forming

• No

SPECIAL POPULATIONS

Renal Impairment

• Dose adjustment not necessary

Hepatic Impairment

• Dose adjustment not necessary for mild to moderate impairment

• Not recommended for patients with severe impairment

Cardiac Impairment

• Not studied

Elderly

• Exposure to tasimelteon is increased by approximately 2-fold

Children and Adolescents

• Safety and efficacy have not been established

Pregnancy

• Effective June 30, 2015, the FDA requires changes to the content and format of pregnancy and lactation information in prescription drug labels, including the elimination of the pregnancy letter categories; the Pregnancy and Lactation Labeling Rule (PLLR or final rule) applies only to prescription drugs and will be phased in gradually for drugs approved on or after June 30, 2001

• Controlled studies have not been conducted in pregnant women

• In animal studies, administration of tasimelteon during pregnancy resulted in developmental toxicity (embryofetal mortality, neurobehavioral impairment, decreased growth and development in offspring)

Breast Feeding

• Unknown if tasimelteon is secreted in human breast milk, but all psychotropics are assumed to be secreted in breast milk

• Use caution if patient is breast feeding

Based on data Published online by Cambridge University Press

Compiled by Dr. Jash Ajmera