Rozerem (Ramelteon) and liver damage

[crOOk]

Hi guys!

I'm from Germany and this new non GABA sleep med named Ramelteon has not yet been approved for us. A good friend of my mother takes part in a clinical study and is amazed by the results. She wants me to get ahold of that stuff for her. I'm still a little sceptical.
I read this on a source board:

I had a Doc's appt a couple of days after Rozerem became available, and I asked my "very liberal" Doc for just some samples of it. He said he had plenty of samples, but would neither give them out NOR prescribe Rozerem, said something like "this stuff is so hard on the liver that we are afraid that it's going to be the next Rezulin. We are going to wait about 6 months before giving it out to see what it does." [Rezulin was the new diabetic wonder-drug that killed so many and was re-called, in case anyone wonders]. When a guy like my Doc, whom I know well and he is my friend and cares about my health, says something like this, then I listen. [...] So I'm going to hold off a while on Rozerem, per my learned Doc's advice. And I was really looking forward to trying it too...

Also it seems that Ramelteon is contraindicated if there is a liver impairment present in the patient.

Anyway, long story short, I could not find anything that supports the doctor's theory. I want to keep my mother's friend from using ramelteon though.

Any idea on it's mechanisms of action in the liver will be greatly appreciated, like which enzymes will be metabolizing it (and which enzyme levels she should therefore have checked by her doctor). Blah.

I hope you guys can help me out, it's all about the harm reduction, so get them grey cells of yours to work for me here and collect yourselves some good karma. Thank you!

crOOk

 

[crOOk]

FOund out that these enzymes are involved in the metabolization:
http://en.wikipedia.org/wiki/CYP2C9
http://en.wikipedia.org/wiki/CYP3A4
http://en.wikipedia.org/wiki/CYP1A2

More info is still appreciated.

crOOk

 

[BilZ0r]

Yeah, I'm not convinced it will work. Melatonin is not a "sleep hormone" generically across species at least. In nocturnal animals, melatonin is high during wakefulness. I find it hard to believe that evolutionarillly conserved sleep becomes highly regulated by a neurotransmitter that can do another task.