Drug & supplement interaction

Colocynth + Ramelteon

Ramelteon brand name: Rozerem.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Colocynth and Ramelteon in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Colocynth and Ramelteon

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Ramelteon and Colocynth in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Colocynth safety at a glance

Colocynth overall Avoid Colocynth is a strong irritant and poison that can cause severe gut damage and death.
Pregnancy Avoid It may stimulate the uterus and is considered unsafe in pregnancy.
Breastfeeding Unsafe When used orally due to severe gastrointestinal toxicity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Ramelteon and Colocynth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Ramelteon

Interactions in our licensed database are recorded against drug classes, not just single drug names. Ramelteon is filed under 6 classifications — including cytochrome p450 2c9 (cyp2c9) substrates, cytochrome p450 1a2 (cyp1a2) substrates, cytochrome p450 1a2 (cyp1a2) substrates. Colocynth has documented interactions with 5 drug classes — the most serious being antidiabetes drugs (moderate), digoxin (lanoxin) (moderate) and diuretic drugs (moderate) — and none of Ramelteon’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Colocynth Does Interact With Other Medications

Colocynth has 185 moderate known drug interactions in our database — Ramelteon isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Colocynth

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

What to actually watch for

What Colocynth Itself Has Been Linked To

This is not an interaction — nothing below involves Ramelteon. It is the side-effect record for Colocynth on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Colocynth, this list is the first place to look. One entry is worth acting on rather than waiting out — marked below.

  • Seizures / Kidney problems Worth acting on Additional detail

    “Orally, colocynth is generally regarded as unsafe. Topically, colocynth seems to be well tolerated when used short-term.

    Most Common Adverse Effects:

    Orally: Diarrhea.

    Serious Adverse Effects (Rare):

    Orally: Bloody diarrhea, hemorrhagic cystitis, kidney damage, convulsions, paralysis, death.”

    Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.

  • Itching Additional detail

    “Topically, mild pruritus has been reported in one patient that used a sesame oil-based colocynth fruit extract in a small clinical study.”

    Colocynth · Natural Medicines adverse-effect record, reported in pruritus.

    1 source cited
    1. 98602. Heydari M, Homayouni K, Hashempur MH, Shams M. Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: A double-blind randomized placebo-controlled clinical trial. J Diabetes. 2016;8(2):246-52. DOI
  • Diarrhea Additional detail

    “Orally, ingestion of colocynth 0.6-1 grams can cause severe irritation of the gastric mucosa and bloody diarrhea (2,18). Cases of bloody diarrhea and intestinal cramps have been reported in case reports of individuals consuming the fresh fruit, the 'size of an orange' or unknown amounts of the extract. Colocynth ingestion can also cause acute toxic colitis.”

    Colocynth · Natural Medicines adverse-effect record, reported in diarrhea.

    5 sources cited
    1. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    2. 18. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
    3. 98601. Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI
    4. 10653. Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed
    5. 98604. Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

Everything above comes from the Natural Medicines adverse-effect record for Colocynth — expand a row for the licensed statement it rests on. We read the ADVERSE REACTIONS section of Ramelteon’s FDA label too, and the two lists don’t meaningfully overlap — which is why no Ramelteon column appears here.

Special populations

Colocynth in Pregnancy & Breastfeeding

Lactation Unsafe

When used orally due to severe gastrointestinal toxicity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

From our Q&A

Questions About Colocynth 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 Colocynth 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 Colocynth 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

One more smart check

Taking Colocynth as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Colocynth, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Colocynth. Even though Colocynth itself has no known interaction with Ramelteon, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Colocynth 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 Colocynth
Steady interest

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

29 days ago today
Medication Ramelteon
Top 25%

#689 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Colocynth reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Colocynth and Ramelteon records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Colocynth

What is Colocynth?

  • Constipation
  • Digestive complaints
  • Diabetes (traditional use)
  • Joint and nerve pain
  • Skin conditions

Colocynth is a bitter desert gourd used in traditional medicine mainly as a powerful laxative, but it is highly toxic and can cause severe, sometimes deadly poisoning even at small doses. There is not enough good human evidence to support its use, and most pharmacists would advise against taking it. If you are curious about it, talk to a doctor or pharmacist before using any product that contains it.

Citrullus colocynthis · Cucurbitaceae · Fruit (pulp), seeds, and root · Dried fruit pulp, powder, capsules, traditional and homeopathic preparations

An interaction check asks whether these two react with each other — it does not ask whether Colocynth is a good idea for someone in your situation. Here is what our Colocynth record says about it on its own.

Colocynth: dosing

There is no established safe dose of colocynth for general use, and most health authorities and pharmacists do not recommend taking it at all because of its toxicity. Never take raw colocynth fruit, pulp, or seeds.

From our Colocynth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Colocynth 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.

Most-Reported Side Effects for Ramelteon

From FAERS, the FDA’s public side-effect reporting system (7,348 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Initial insomnia 446 reports
Somnolence 418 reports
Insomnia 400 reports
Middle insomnia 390 reports
Nausea 337 reports
See full Ramelteon drug information
Keep checking

Other Drugs & Colocynth

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

0Major
185Moderate
0Minor
2,644No known interaction
Moderate

185 interactions

Showing 60 of 185 moderate interactions — see all 185 on the Colocynth page.

No interaction 2,644 drugs checked — show the list
Evidence & sources

Colocynth References

The 9 references that drive our Colocynth monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
  3. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  4. Osol and Farar. The Dispensatory of the United States of America. 25th ed. JB Lippincott Co., 1955.
  5. Goldfain D, Lavergne A, Galian A, et al. Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases. Gut 1989;30:1412-18.. PubMed
  6. Li Y, Zheng M, Zhai X, et al. Effect of Gymnema Sylvester, Citrullus colocynthis and Artemisa absinthum on blood glucose and lipid profile in diabetic human. Acta Pol Pharm. 2015;72(5):981-5.
  7. Khan SA, Shelleh HH, Bhat AR, Bhat KS. Colocynth toxicity. A possible cause of bloody diarrhea. Saudi Med J. 2003;24(8):904-6. DOI
  8. Heydari M, Homayouni K, Hashempur MH, Shams M. Topical Citrullus colocynthis (bitter apple) extract oil in painful diabetic neuropathy: A double-blind randomized placebo-controlled clinical trial. J Diabetes. 2016;8(2):246-52. DOI
  9. Huseini HF, Darvishzadeh F, Heshmat R, Jafariazar Z, Raza M, Larijani B. The clinical investigation of Citrullus colocynthis (L.) schrad fruit in treatment of Type II diabetic patients: a randomized, double blind, placebo-controlled clinical trial. Phytot

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Colocynth and Ramelteon Together: Common Questions

Is it safe to take Colocynth with Ramelteon?
We do not list a known interaction between Colocynth and Ramelteon. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
How was the Colocynth and Ramelteon combination checked?
Interactions in our licensed database are recorded against drug classes. Ramelteon is filed under 6 classifications, and Colocynth has documented interactions with 5 drug classes — none of Ramelteon's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Colocynth interact with any other medications?
Yes. Colocynth has 185 documented drug interactions in our database — Ramelteon is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Ramelteon interact with any supplements?
Yes. Ramelteon has documented interactions with 228 supplements in our database — Colocynth is not one of them. The Ramelteon interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Ramelteon and Colocynth?

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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.