Melatonin

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist MRCPCH, CCT in Paediatrics (U.K.) Fellow in Paediatric Epilepsy & Neurology (London)

Brand names :

Tablet: Go 2 Sleep
Syrup: Tru Nap, Go 2 Sleep

Melatonin: The Sleep Inducing Chemical

What is Melatonin?

Melatonin is a natural hormone that is produced in our body, from the Pineal gland which is pea-sized and located in the brain. As the sun sets, the amount of natural light entering the eye is reduced, which stimulates the pineal gland to secrete Melatonin, which makes us feel sleepy and slows down many body activities, and prepares our body for actual sleep. This is a natural cycle of sleep and waking. Melatonin, synthetic preparation helps to augment (strengthen) the action of Melatonin produced

Melatonin as a medicine:
Sleep is an essential activity, during which the body recuperates or recharges itself; memory is formed, and any disturbance affects the learning process, normal growth, and development.
Melatonin is a medicine used to facilitate the onset of sleep. Sleep disorders are common in children with developmental delay, epilepsy, and cerebral palsy. In such children, Melatonin helps in reducing the time taken to sleep, however, it does not help in the case of light sleepers, who tend to wake up frequently.

Why is it important for my child to take this medicine?
Melatonin is advised only if a child has issues with sleep such as not being able to sleep or sleeping for very few hours. To help reset the sleep cycle, it is important to have good sleep hygiene. If you feel this has not solved the sleep issues, only then use of medications such as Melatonin would help.

How is Melatonin available?
Melatonin is available both as a Liquid medicine and as a Tablets by the names:
Make sure you know about licensed vs non-licensed medications before administering any medicine.

When should I give Melatonin?
Melatonin becomes effective only 30 to 45 minutes after administration. Hence, it is advised to be given 30 minutes before the time your child usually sleeps.

My child is sleeping, should I give melatonin?
No. However, in case the baby wakes up and you are not able to settle him/her to sleep in the usual expected manner, then you can administer Melatonin.

What if I forget to give it?
It is not a problem if your child is already sleeping. If not please give it once you recall.

What if my child vomits after administering Melatonin?
If your child vomits within 30 minutes of taking a dose of the medicine then you can give the dose again. But if your child vomits after 30 minutes of taking the dose, then do not give it again.

What is the dose I should give to my child?
Post your consultation with the doctor, your child will be prescribed a specific dose of Melatonin that is just right for him/her. Please follow the same.

NOTE: Always follow your doctor’s instructions and do not administer excess amount of the medicine.

How should I administer Melatonin?
Read about giving medicines the right way!
Liquid or syrup: Measure the right amount using an oral syringe or medicine spoon. You can get these from your nearby pharmacist.

NOTE: NEVER use a regular kitchen spoon since it will not give the correct quantity.

Tablets: These must be swallowed without breaking with either a glass of water, milk, or juice. If difficult to take, they can be crushed and mixed in water/juice or a small amount of yogurt/curd.
Read about the difference between generic vs branded medications here.

Are there any possible side effects?
We use medicines to help our children feel better, but sometimes they cause effects that we don’t want, which are what we call side effects. Melatonin is a safe medicine, in short term; they are not known to cause any specific side effects. When used for a long term, i.e., for years, it is reported to have caused headache, daytime sleepiness, irritability, stomach cramps, or altered mood.
If your child develops a rash, please stop administering the medications and SEEK IMMEDIATE Advice from a Doctor.
There could be other side effects that are possibly not listed above. If your child experiences anything unusual, that leaves you confused, please contact your doctor immediately.
Despite this list of side effects, Melatonin is an effective medicine.
Read more about side effects here.
Can other common medicines be given at the same time as Melatonin?
Medicines containing ibuprofen or paracetamol, antibiotics, or other over-the-counter medications can be administered unless specified otherwise by your doctor.
It is strongly advised to check with the doctor before you give any other medicines to your child (including any herbal or complementary medicines).
Some other medicines used to treat epilepsy may affect how well Melatonin works or may cause side effects. If you are worried about side effects, or if your child seems to be having more fits, contact your doctor.

Where and how should I store this medicine?
Make sure to store the medicine, away from heat and direct sunlight in a cupboard. Do not keep it in the fridge.
Strictly ensure that children cannot see or access the medicine.
Always store the medicine in the same container it came in.
For complete information please see the manufacturer’s information leaflet.
Overall, Melatonin is a highly effective medicine in sleep regulation. Since sleep is one of the primary functions to restore and rejuvenate our system, ensuring that your child gets proper sleep, especially in the growing years, also ensures better physical and overall health and growth for your child.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC) 4. Food and Drug Administration, USA https://www.fda.gov