Circadin® 2mg 21s

What is Circadin® used for​​​?

Circadin® contains the active ingredient Melatonin. Melatonin is used for short-term treatment of insomnia (difficulty sleeping). Melatonin may also be used for other conditions. Check with your healthcare professional if you are unsure why you are given Melatonin.

How does Melatonin work?

Melatonin is a naturally occurring hormone produced by the our body. Physiologically, melatonin secretion increases soon after the onset of darkness, peaks at 2-4 am and diminishes during the second half of the night. Melatonin is associated with the control of circadian rhythms and entrainment to the light-dark cycle. It is thus associated with a hypnotic effect and increased propensity for sleep.

What is the difference between Circadin® and over-the-counter(OTC) Melatonin products?

Circadin® is specially formulated such that it releases melatonin slowly throughout the night to keep you asleep (also known as a prolonged release tablet). OTC melatonin are formulated as immediate release tablets, and usually only stay in the body for much shorter durations.

What is the difference between Circadin® and prescription-only sleeping pills?

Most prescription sleeping pills fall into the category of Sedative-Hypnotics. Some examples include:

• Antidepressants - such as Fluoxetine (Prozac®) and Escitalopram (Lexapro®).
• Benzodiazepines - such as Alprazolam (Xanax®) and Lorazepam (Ativan®).
• Z-drugs - such as Zolpidem (Ambien®) and Zopiclone (Imovane®).

These sleeping pills carry the risk of tolerance and dependence (or, addiction), and are thus recommended only for short-term treatment (generally less than 2-4 weeks) at low doses.

Circadin®, however, has proven long-term safety data with no tolerance, rebound or withdrawal effects reported in clinical studies after 3 weeks, 26 weeks and 12 months of Circadin® usage.

Why is Circadin® a prescription-only medication?

Circadin® is the only melatonin product approved by HSA. Circadin® has been studied in multiple clinical trials, showing statistically significant and clinically meaningful efficacy in the treatment of insomnia.

In multiple clinical trials, Circadin® was clinically proven to improve sleep quality:

1. Circadin® significantly shorten time to onset of sleep by 9 minutes compared to placebo.
2. Circadin® significantly improved both quality of sleep and morning alertness by 47% as compared to 27% in the placebo group.

Long term safety profile of Circadin® is also proven: No tolerance, rebound or withdrawal effects were reported post 3 weeks, 26 weeks and 12 months of Circadin® usage.

Other OTC melatonin supplements and preparations are not considered pharmaceutical products and are not regulated by the health authorities. They have not been adequately tested in clinical controlled studies and there is no guarantee of their quality.

Dosage and how to use​

• Follow the instructions on your medication label and take this medication as prescribed by your doctor. 
• Melatonin should be taken with or after food.
• Melatonin should be taken shortly (1 – 2 hours) before going to bed.
• The tablet is prolonged-release (PR) and must be swallowed whole with water or other liquids; do not crush, chew or cut into half.

What should I do if I miss a dose?

If you are directed by your doctor to take the medication regularly and forget to take a dose, take it as soon as you remember, before going to sleep, or wait until it is time to take your next dose, then go on as before. Do not take two doses to make up for the missed dose.

What are the possible side effects of Melatonin?​

The mentioned side effects generally affect up to 10% of patients.

• Nausea or vomiting
  - Take Melatonin with or after food
  - Take simple meals and avoid rich or spicy foods
  
• Light-headedness (especially during a sudden change in posture)
  - Get up slowly from a sitting or lying down position
  
• Feeling tired or drowsy
  - Avoid driving or engaging in activities requiring concentration
  
• Headache
  - Speak to your doctor if it becomes bothersome

Most of the side effects listed here will improve with time. Speak to your doctor if they continue, get worse or are affecting your daily life.

What precautions should I take while on Melatonin?

Inform your healthcare professional if: 

• You are allergic to Circadin® or any of the other ingredients of Circadin®.
• You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side-effects with you. If you have further questions or concerns, do consult your doctor.
• You are taking any other medications including over-the-counter medications, supplements, traditional Chinese medicine and herbal remedies. Some of them may affect how this medication works or cause serious drug interactions.
• You are smoking. Smoking may decrease the amount of Melatonin that stays in your body.
• You have or have ever had:
  - Other drug allergies or lactose intolerance (congenital galactosaemia, glucose malabsorption syndrome or lactase deficiency)
  - Medical conditions such as: Lung, liver or kidney disease | Drug or alcohol abuse | Sleep apnea (temporary stopping of breathing during sleep) or Any autoimmune disease (where the body is ‘attacked’ by its own immune system)

What other medications and foods should I avoid when taking Circadin®?

Avoid drinking alcohol while taking Melatonin as it can reduce the effect of Melatonin on sleep.

Handling and storage

• Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 
• Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

References

https://www.healthhub.sg/a-z/medications/89/Melatonin