Melatonin

What is melatonin?

Melatonin is a naturally-occurring hormone made by the pineal gland in the brain. It is produced at night and helps the body to know when to wake up and when to be asleep.

What is melatonin used for?

Melatonin has been prescribed for children and young people who have problems with sleeping, when other methods have not worked. These other methods should not stop (good night-time routines etc), but should continue alongside the melatonin.

How is melatonin supplied?

Melatonin is first prescribed by a specialist and may be prescribed later by your own GP to enable you to obtain further supplies locally. Melatonin may have to be specially ordered by the pharmacy so hand in your prescription in advance before you run out of melatonin.

Modified-release tablet (Circadin): 2 mg
Tablets and capsules from 0.5 to 5 mg can be ordered specially from your pharmacist
Liquid medicine: 5 mg per 5 ml can also be ordered specially from your pharmacist

How should melatonin be taken?

The instructions for taking melatonin will be printed on the label on the box or bottle. The initial dose is 2 - 3 mg. Melatonin is best given 30 - 60 minutes before your child’s agreed bedtime. If this does not work the specialist may slowly increase the dose up to a maximum of 10 mg at night. Only one dose is given each night.

If the child wakes at night, then an extra dose of melatonin should not be given.

Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablets.
Capsules should be swallowed with a glass of water, milk or juice. Your child should not chew the capsules. You can open the capsules and mix the contents with a small amount of soft food such as yoghurt, honey or jam. Your child should swallow it all straight away, without chewing.
Liquid medicine. Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

Melatonin does not have a medicines’ licence for children, though it can be prescribed by specialists. Your doctor will have given careful consideration to prescribing and will have discussed the implications fully with you and your family.

Many medicines given to children are unlicensed and this does not mean they are unsafe. The Royal College of Paediatrics and Child Health, has produced a leaflet on unlicensed medicines for children, which is available on request. Your doctor or pharmacist can also answer any questions you may have on this.

How long will melatonin have to be taken for?

Your child should take melatonin as long as the doctor advises. Your doctor may increase the dose by 1 - 2 mg every 7 - 14 days if there is no improvement in the sleep pattern.

The maximum dose is 10 mg each night. If there is no improvement after 7 - 14 days on the maximum dose your doctor may discontinue treatment. Some children may be able to stop treatment after 6 months with an improved sleeping pattern. For some children however, withdrawal may not be successful and they require long term treatment.

Melatonin should not be stopped without checking with your doctor first. The need for continuing melatonin should be reviewed every 6 months by your doctor.