MelatoninInformation for parents and carers

Updated November 2017Leaflet review date: November 2018

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Contact usPharmacy DepartmentThe Cavell CentreEdith Cavell Healthcare CampusBretton Gate Peterborough PE3 9GZ

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Circadin tablets should normally be swallowed whole with a glass of water one to two hours beforebedtime. This is because they are modified (slow) release tablets which means that the Melatonin isreleased over a period of time. Depending on the dose prescribed, you may need to cut the tablets inhalf. Tablet-cutters are available from your chemist. Halving the tablets will not destroy their slow-release properties.

If your child has problems swallowing tablets or the specialist wants a more immediate effect, you willbe advised to crush the tablets and give with a spoonful of milk or yoghurt. Crushing Circadin tabletsmeans that they will work more quickly as the slow-release properties are destroyed. Crushed tabletsshould be given earlier - 30 minutes before bedtime.

Melatonin is generally well tolerated but long term side effects have not been evaluated. The mostcommon side effects reported are headache, nausea, dizziness and abnormal dreams. Rare side effects which should be reported to your doctor include an increased heart rate and changes in fitpattern in a child who has epilepsy.

Exposure to strong light in the morning and low lighting in the evening can help improve Melatoninproduction at night. Foods that are rich in Melatonin or help the body to boost Melatonin productioninclude:

ApplesBananasBarleyBeansBread (particularly wholemeal)Breakfast cereals with milkCheese (cottage, cheddar and parmesan)ChickenEggsFish (cod, canned salmon andsardines)

Ice creamMilkOats/oatcakes/porridgePasta with milk based saucesPotatoesSweetcornRice (particularly brown)Tomatoes Turkey

Melatonin is a natural hormone that regulates the sleep/wake cycle. When children have a disturbedsleep cycle, melatonin can help restore a more natural sleep pattern. Melatonin tablets work best incombination with good night-time routines. They are not intended to be a long-term treatment.

Melatonin is mainly used for children with cerebral palsy, Attention Deficit Hyperactivity Disorder(ADHD), autism, learning disabilities or visual impairment.

Only specialist paediatricians and psychiatrists can initiate treatment and prescribe for the first fewmonths of treatment. The prescribing may then be transferred to your GP. The specialist will reviewthe continued need for melatonin every six months. Attempts will be made to wean your child offmelatonin once a good sleep routine is established or if melatonin is no longer considered effective.

Melatonin is available as a modified-release tablet called Circadin. However, this is licensed for useonly in people aged over 55. This does not mean that it is unsafe to use Circadin in younger people,just that the manufacturer has not applied to the Medicines Healthcare Products Regulatory Agencyfor a licence. Many medicines are not licensed for use in children but are considered safe and effective. There is much evidence to support the use of melatonin in younger people.

The specialist will give you a prescription for Circadin which can be taken to your usual chemist. Repeat prescriptions for Circadin will continue to be supplied by the specialist until such time as it isconsidered appropriate for your GP to take over the prescribing.

If the modified-release tablets are not suitable for your child then the specialist may prescribe alternative forms. These are not easily available from your local chemist and will be supplied from thepharmacy at The Cavell Centre, Edith Cavell Healthcare Campus, Bretton, Peterborough. Supplies canbe collected from there or sent to you in the post.

What is Melatonin?

Who needs Melatonin?

Who can prescribe Melatonin?

What form of Melatonin will be supplied?

How will Melatonin be prescribed?

How does my child take Melatonin?

What side effects are there from Melatonin?

How can I boost Melatonin naturally?

Further information about MelatoninThe leaflet supplied with the Circadin tablets does not refer to its use in children. Further informationcan be obtained from the following websites:

www.choiceandmedication.org/cambridgeshire-and-peterborough/www.medicinesforchildren.org.uk