- Reference Number: HEY1239/2021
- Departments: Paediatrics, Pharmacy
- Last Updated: 25 June 2021
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Introduction
This leaflet is about the use of melatonin for particular sleep problems in childhood. It is used to help children who have problems getting to sleep at night. This leaflet has been written specifically for parents and carers about the use of this medicine in children. Please read this leaflet carefully and keep it somewhere safe so that you can read it again.
Name of drug: Melatonin. Brands include:
- Circadin® (modified-release tablets)
- Slenyto® (prolonged-release tablets)
- Melatonin is available in a range of branded products
Why is it important for my child to take this medicine?
Melatonin is mostly used for children with partial or complete blindness, cerebral palsy, attention deficit hyperactivity disorder, autism or learning disabilities. It is unlikely to be used for an otherwise healthy child who has sleep problems. Poor sleep can affect your child’s physical health, mood, behaviour and development. Melatonin may help your child to get into a regular sleep pattern.
When should I give melatonin?
It is best given between half an hour and 1 hour before your child’s agreed bedtime. Give the medicine at about the same time every day so that it becomes part of your child’s daily routine, which will help you to remember and help your child’s sleep pattern.
How much should I give?
Your doctor or nurse prescriber will work out the amount of melatonin (the dose) that is right for your child. The dose will be shown on the medicine label. You will probably start on a low dose, and the dose may be increased until sleep problems have improved, or up to an agreed maximum. It is important that your child receives the minimum they need to help them get to sleep. It is important that you follow the doctor or nurse’s instructions about how much to give.
How should I give the medicine?
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablets.
If your child cannot swallow tablets, prepare the tablet as follows
(see newtguidelines.com)
- Crush the tablet with a tablet crusher, or between two metal spoons
- Make sure all the powder is added to 15-30ml water and mix well.
- Draw up the solution into an oral syringe
- Administer the dose to your child
- Alternatively, the powder may be mixed with soft food
Do not crush tablets in plastic containers, other than commercially available tablet crushers as the medicine may stick to the plastic. Do not use boiling water to dissolve tablets as it may affect the way the medicine works. Do not leave oral medicines unattended in syringes. Do not administer any medicine you have not prepared yourself. Tablet crushers can be purchased from your local community pharmacy, for a few pounds. They are reusable and can be washed and dried after use.
If using two metal spoons, select two spoons of similar size sitting one spoon inside the one below. Make a small gap between the spoons, and place one tablet between these surfaces and gently squeeze the spoons together. The tablet should break up without shooting out. Please note that it is not necessary to crush to a very fine powder, as once the tablet is roughly crushed, it will offer “immediate release” as desired. Repeat if more than one tablet is required to provide the dose.
Information from the manufacturer states that crushing a tablet will not damage the active ingredient (melatonin). There are no safety concerns with crushing; however, it will affect the prolonged-release properties of the product. The tablet will keep its prolonged-release properties only if it is swallowed whole. The prolonged-release properties will be maintained to some extent it the tablets is halved or divided into 4 quarters. If it is crushed it will release melatonin similarly to an immediate release formulation e.g. liquid melatonin (see www.medicinesforchildren.org.uk)
When should the medicine start working?
Your child should start to feel sleepy about half an hour after taking the dose.
What if my child is sick (vomits)?
If it is less than 30 minutes after having a dose, give them the same dose again.
If it is more than 30 minutes after, you DO NOT need to give them another dose.
What if I forget to give it?
If you miss a dose, wait until the next normal dose. Do not give the missed dose.
What if I give too much?
If you think you may have given your child too much melatonin, contact NHS111. Have the medicine packet with you.
Are there any side effects? Ones you must do something about:
If your child has a fast heart rate (may have a fluttering feeling in their chest), contact your doctor or nurse before giving the next dose. If they seem unwell, take them to the hospital.
Other side effects: Your child’s temperature may fall a little after taking melatonin, this is a normal reaction.
Can I give other medicines at the same time as melatonin?
You can give your chid medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to. Check with your doctor, nurse or pharmacist before giving any other medicines to your child, including herbal or complementary medicines.
Is there anything else I need to know?
It is started by a specialist. We do not know what effects it may have on your child’s development if it is taken for a long time. Your doctor will review the need for it every 6 months.
Further information:
Should you require further advice on the issues contained in this information leaflet, please do not hesitate to contact the prescribing clinician.
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about your child
We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.
If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.
