Drug & supplement interaction

Breadfruit + Ramelteon

Ramelteon brand name: Rozerem.

Minor Interaction
The bottom line Minor

Breadfruit has a minor interaction with Ramelteon. Theoretically, breadfruit might inhibit cytochrome P450 3A4 (CYP3A4) and increase levels of drugs metabolized by these enzymes; until more is known, use with caution.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Breadfruit and Ramelteon

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Ramelteon

Ramelteon falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Breadfruit interacts with.

Theoretically, breadfruit might inhibit cytochrome P450 3A4 (CYP3A4) and increase levels of drugs metabolized by these enzymes; until more is known, use with caution. In vitro, the breadfruit constituent artocarpin can inhibit CYP3A4 enzymes. Also, animal research shows that breadfruit leaf extract can weakly inhibit CYP3A4 enzymes. However, it is unclear if this inhibitory activity causes a clinically meaningful effect on the metabolism of CYP3A4 substrates.
Some drugs metabolized by CYP3A4 include amitriptyline (Elavil), amiodarone (Cordarone), citalopram (Celexa), felodipine (Plendil), lansoprazole (Prevacid), ondansetron (Zofran), prednisone (Deltasone), sertraline (Zoloft), and many others.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Rozerem (ramelteon): your body clears it mainly through a liver enzyme called CYP3A4. In lab and animal studies, certain compounds in breadfruit leaves seem to slow that enzyme down a little. If that happened in people, ramelteon could hang around longer, which might mean more next-day grogginess, dizziness, or feeling unusually sleepy the following morning.

I want to be honest with you though, this is very much a theoretical concern. We only have test-tube and animal data, and even there the effect was weak. Eating breadfruit as a food is unlikely to cause any problem. Concentrated leaf teas or extracts are the bigger unknown, so if you're using those for a health reason, just give your pharmacist or doctor a heads-up first.

References
  1. Nwokocha CR, Owu DU, McLaren M, et al. Possible mechanisms of action of the aqueous extract of Artocarpus altilis (breadfruit) leaves in producing hypotension in normotensive Sprague-Dawley rats. Pharm Biol. 2012;50(9):1096-102.
  2. Qu W, Liu X. Identification of cytochrome P450 isoforms involved in the metabolism of artocarpin and assessment of its drug-drug interaction. Biomed Chromatogr. 2018;32(4). PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Breadfruit Also Interacts With Other Medications

Breadfruit has 438 moderate, 503 minor known drug interactions in our database — the Ramelteon one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Breadfruit

Covers the 2,830 medications we’ve checked against Breadfruit. Pick one to open its full report.

From our Q&A

Questions About Breadfruit or Ramelteon

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Breadfruit or Ramelteon, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ramelteon

This page covers Breadfruit only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ramelteon page lists 228 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 9 major · 173 moderate · 46 minor.

From our pharmacist’s overview on the Ramelteon page

“Ramelteon (Rozerem) is a prescription sleep aid, and its 228 interacting supplements call for real care, starting with the nine rated major. The frustrating part is that the things sleepless people typically reach for, kava, CBD, a glass of wine before bed, sit at the heart of the problem.”

Reviewed by 2 · Jul 18, 2026

Open the Ramelteon interaction page

How much people look this up

Where Breadfruit and Ramelteon Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Breadfruit
Top half

#469 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Ramelteon
Top 25%

#467 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Breadfruit

What is Breadfruit?

  • Source of nutrition and energy
  • High blood pressure
  • Diabetes and blood sugar support
  • Inflammation and joint discomfort
  • Skin conditions

Breadfruit is a starchy tropical fruit eaten as a staple food, and its leaves are used in traditional medicine for conditions like high blood pressure and diabetes. As a food it is nutritious and generally safe, but the medicinal use of leaf teas or extracts has very little human research to back it up. Talk with your pharmacist or doctor before using breadfruit products for a health condition.

Read the full Breadfruit monograph & all interactions
Medication

About Ramelteon

What Is Ramelteon Used For?

Brand name: Rozerem

Ramelteon tablets — sold as the brand Rozerem and as generic ramelteon — are used to treat insomnia when the main problem is trouble falling asleep at the start of the night. It is not indicated for difficulty staying asleep.

Clinical studies supporting its effectiveness ran up to six months in both adults and elderly patients.

See full Ramelteon drug information
Keep checking

Other Drugs & Breadfruit

Browse every other medication we’ve checked against Breadfruit — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
438Moderate
503Minor
1,888No known interaction
Moderate

438 interactions

Showing 60 of 438 moderate interactions — see all 438 on the Breadfruit page.

Minor

503 interactions

Showing 60 of 503 minor interactions — see all 503 on the Breadfruit page.

No interaction 1,888 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Breadfruit and Ramelteon Together: Common Questions

Can you take Breadfruit with Ramelteon?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Breadfruit and Ramelteon interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Ramelteon and Breadfruit?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.