Circadin

melatonin

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This is a summary of the European public assessment report (EPAR). It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the studies performed, to reach its recommendations on how to use the medicine.

If you need more information about your medical condition or your treatment, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist. If you want more information on the basis of the CHMP recommendations, read the scientific discussion (also part of the EPAR).

What is Circadin?

Circadin is a medicine that contains the active substance melatonin. It is available as white prolonged-release tablets (2 mg). ‘Prolonged-release’ means that melatonin is released slowly from the tablet over a few hours.

What is Circadin used for?

Circadin is used on its own for the short-term treatment of primary insomnia (poor quality of sleep) in patients aged 55 years or over. ‘Primary’ means that the insomnia does not have any identified cause, including any medical, mental or environmental cause.

The medicine can only be obtained with a prescription.

How is Circadin used?

The recommended dose of Circadin is one tablet a day, taken one to two hours before bedtime and after food. This dose can be continued for up to 13 weeks.

How does Circadin work?

The active substance in Circadin, melatonin, is a naturally occurring hormone, which is normally produced by a gland in the brain called the pineal gland. Melatonin is involved in coordinating the body’s sleep cycle by acting on cells in specific areas of the brain and helping to bring about sleep. Its levels in the blood normally increase after the onset of darkness and peak in the middle of the night. Older people may produce less melatonin, leading to the development of insomnia. By replacing the hormone, Circadin increases blood levels of melatonin, helping them to sleep. Because Circadin tablets release melatonin slowly over a few hours, they mimic the natural production of melatonin in the body.

How has Circadin been studied?

Circadin has been compared with placebo (a dummy treatment) in three main studies involving a total of 681 patients aged over 55 years with primary insomnia. The main measure of effectiveness was the number of patients who reported a significant improvement in their quality of sleep and ability to function normally on the following day, after three weeks of treatment. The patients assessed the severity of their symptoms using a standard questionnaire.

An additional study compared the effects of Circadin and placebo for up to six months.

What benefit has Circadin shown during the studies?

Circadin was more effective than placebo at improving quality of sleep and the patients’ ability to function normally on the following day. When the results of all three studies were looked at together, 32% of the patients taking Circadin (86 out of 265) reported a significant improvement in symptoms after three weeks, compared with 19% of those taking placebo (51 out of 272).

The additional study showed that Circadin was more effective than placebo for at least 13 weeks.

What is the risk associated with Circadin?

Side effects with Circadin are not common. However, the following side effects are seen in between 1 and 10 patients in 1,000: irritability, nervousness, restlessness, insomnia, abnormal dreams, anxiety, migraine, lethargy (lack of energy), psychomotor hyperactivity (restlessness with increased activity), dizziness, somnolence (sleepiness), hypertension (high blood pressure), abdominal pain (stomach ache), dyspepsia (heartburn), mouth ulcers, dry mouth, hyperbilirubinaemia (high blood levels of bilirubin, a breakdown product of red blood cells, which can cause yellowing of the skin and eyes), dermatitis (skin inflammation), night sweats, pruritus (itching), rash, dry skin, pain in the extremities (arms and legs), symptoms of the menopause, asthenia (weakness), chest pain, glycosuria (sugar in the urine), proteinuria (protein in the urine), abnormal liver function tests and increased weight. For the full list of all side effects reported with Circadin, see the package leaflet.

Circadin can cause drowsiness, so it should be used with caution if this could pose a risk to safety, including in people who need to drive or use machines. Patients should avoid alcohol before, during and after taking Circadin.

Circadin should not be used in people who may be hypersensitive (allergic) to melatonin or any of the other ingredients.

Why has Circadin been approved?

The CHMP decided that, although Circadin has only been shown to have a small effect in a relatively small number of patients, its benefits are greater than its risks. The Committee recommended that Circadin be given marketing authorisation.

Other information about Circadin

The European Commission granted a marketing authorisation valid throughout the European Union for Circadin to Neurim Pharmaceuticals EEC Limited on 29 June 2007.

Name Language First published Last updated
Circadin : EPAR - Summary for the public BG = bălgarski 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public ES = español 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public CS = čeština 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public DA = dansk 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public DE = Deutsch 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public ET = eesti keel 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public EL = elliniká 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public EN = English 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public FR = français 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public IT = italiano 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public LV = latviešu valoda 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public LT = lietuvių kalba 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public HU = magyar 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public MT = Malti 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public NL = Nederlands 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public PL = polski 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public PT = português 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public RO = română 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public SK = slovenčina 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public SL = slovenščina 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public FI = suomi 11/07/2007 10/06/2010
Circadin : EPAR - Summary for the public SV = svenska 11/07/2007 10/06/2010

This EPAR was last updated on 13/08/2015 .

Authorisation details

Product details

Product details for Circadin
NameCircadin
Agency product numberEMEA/H/C/000695
Active substance

melatonin

International non-proprietary name (INN) or common name

melatonin

Therapeutic area Sleep Initiation and Maintenance Disorders
Anatomical therapeutic chemical (ATC) code N05CH01

Publication details

Publication details for Circadin
Marketing-authorisation holder

RAD Neurim Pharmaceuticals EEC Limited

Revision25
Date of issue of marketing authorisation valid throughout the European Union29/06/2007

Contact address:

RAD Neurim Pharmaceuticals EEC Limited
One Forbury Square
The Forbury
Reading
Berkshire RG1 3EB
United Kingdom

Product information

Product information

21/05/2015  Circadin -EMEA/H/C/000695 -PSUSA/01963

Name Language First published Last updated
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015
Circadin : EPAR - Product Information SV = svenska 24/04/2009 13/08/2015

Contents

  • Annex I - Summary of product characteristics
  • Annex IIA - Manufacturing-authorisation holder responsible for batch release
  • Annex IIB - Conditions of the marketing authorisation
  • Annex IIIA - Labelling
  • Annex IIIB - Package leaflet

Please note that the size of the above document can exceed 50 pages.

You are therefore advised to be selective about which sections or pages you wish to print.


Name Language First published Last updated
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013
Circadin : EPAR - All Authorised presentations SV = svenska 11/07/2007 22/07/2013

Pharmacotherapeutic group

Psycholeptics

Therapeutic indication

Circadin is indicated as monotherapy for the short-term treatment of primary insomnia characterised by poor quality of sleep in patients who are aged 55 or over.

Assessment History

Changes since initial authorisation of medicine

Initial marketing-authorisation documents

Name Language First published Last updated
Circadin : EPAR - Procedural steps taken before authorisation SV = svenska 11/07/2007  
Circadin : EPAR - Scientific Discussion SV = svenska 11/07/2007  

Authorised

This medicine is approved for use in the European Union