BNF:

4.1.1

Status:

Do Not Prescribe (DNP), Grey - after consultant/specialist recommendation, Grey - after consultant/specialist initiation

Decision Date:

October 2013

Comments

GREY after consultant/specialist initiation: 

• for use in children with neurodevelopment disorders and CAMHS patients (including off-label use). See Melatonin information sheet
• Melatonin MR 2mg tablets and Adaflex tablets are the preferred melatonin preparations. (Decision date - March/July/September 2022, June 2023)
• Circadin is a choice for those who require half a melatonin 2mg MR tablet whilst still retaining its modified release properties, or for those who may have medical reasons that make it difficult to switch (e.g. autism). (Decision date - June 2023)
• For the minority of cases where there are swallowing difficulties and it is not possible to use crushed tablets, generic melatonin 1mg/ml oral solution SF can be used in children 6 years and over at licensed doses
• N.B. For children under 6 years of age (off-label use) and unlicensed doses in children 6 years and over, consideration needs to be given to the excipients in different licensed liquid preparations. Appropriate product choice will be influenced by age and weight and product composition. See Specials guidance for further information. If prescribing a liquid in this age group is unavoidable, prescriptions should specify the brand or branded generic to be dispensed. N.B. Caution should be exercised if the patient is prescribed other liquid formulations containing the same excipients, as accumulation could result in exceeding the recommended limits.

GREY after consultant/specialist recommendation:

• Melatonin MR 2mg tablets for REM sleep for dementia with Lewy bodies and Parkinson's Disease dementia (off-label use). See managing behavioural problems in patients with dementia.  (Decision date - April 2023)

 GREY:

•  Melatonin MR 2mg tablets not recommended except in exceptional circumstances for its licensed indication in patients over 55. 

DO NOT PRESCRIBE (DNP):

 All melatonin preparations are DO NOT PRESCRIBE (DNP) for the following indications:

• For short-term treatment of jet-lag disorder in adults
• Melatonin for treating sleep disorders in adults who are blind. (Decision date - September 2021)

The following brand is also DNP: 

• Slenyto prolonged release tablets (Decision date - May 2019)

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