Ramelteon and Fluconazole Interaction

Drug interaction information between Ramelteon and Fluconazole.

Ramelteon and Fluconazole have a documented moderate interaction in FDA labeling.

FDA drug labeling documents a moderate-severity interaction between Ramelteon and Fluconazole. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.

Drug A

Ramelteon

Melatonin Receptor Agonist

Drug B

Fluconazole

Azole Antifungal

How They Interact

Fluconazole stops the body from processing ramelteon normally, which leads to much higher levels of the drug in your system.

FDA Label Information

( 7.1 ) Fluconazole (strong CYP2C9 inhibitor): Increases systemic exposure of ramelteon; administer with caution. Fluconazole (strong CYP2C9 inhibitor) The AUC 0-inf and C max of ramelteon was increased by approximately 150% when ramelteon was coadministered with fluconazole. Ramelteon should be administered with caution in subjects taking strong CYP2C9 inhibitors such as fluconazole [see Clinical Pharmacology (12.5) ] .

Frequently Asked Questions

What SPL severity band is on file for Ramelteon + Fluconazole?

Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.

Which drug in this pair has the larger labeled-interaction portfolio?

Fluconazole has 67 labeled pairs on file vs Ramelteon's 7. In the moderate band specifically: Ramelteon has 2 (also Ketoconazole); Fluconazole has 7 (also Atorvastatin, Simvastatin, Carbamazepine, Amiodarone).

What mechanism field is on file for Ramelteon and Fluconazole?

Fluconazole stops the body from processing ramelteon normally, which leads to much higher levels of the drug in your system.

Fluconazole carries more major-labeled pairs than Ramelteon

SPL source-record counts only. This page's band is moderate · classes on file: Ramelteon (Melatonin Receptor Agonist); Fluconazole (Azole Antifungal).

Fluconazole has 3 major-labeled pairs vs Ramelteon's 0. This page itself is in the moderate band, not the major band.

Ramelteon

0 major · 2 moderate · 5 minor · 7 total

Fluconazole

3 major · 7 moderate · 57 minor · 67 total

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.