What is calcium carbonate?

Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance.

Calcium carbonate is used to prevent or to treat a calcium deficiency.

There are many brands and forms of calcium carbonate available. Not all brands are listed on this leaflet.

Calcium carbonate may also be used for purposes not listed in this medication guide.

Calcium carbonate side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Calcium carbonate may cause serious side effects. Call your doctor at once if you have:

• little or no urinating;
• swelling, rapid weight gain; or
• high levels of calcium in your blood–nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or feeling tired.

Common side effects of calcium carbonate may include:

• upset stomach, gas; or
• constipation.

This is not a complete list of side effects and others may occur.

Warnings

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

Ask a doctor or pharmacist if it is safe for you to take calcium carbonate if you have ever had:

• kidney disease;
• kidney stones;
• cancer;
• a parathyroid gland disorder; or
• high levels of calcium in your blood.

Ask a doctor before using calcium carbonate if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

How should I take calcium carbonate?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Check the label of your calcium carbonate product to see if it should be taken with or without food.

Swallow the calcium carbonate regular tablet with a full glass of water.

The chewable tablet should be chewed before you swallow it.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Use the calcium carbonate powder as directed. Allow the powder to dissolve completely, then consume the mixture.

Calcium carbonate may be only part of a complete program of treatment that also includes dietary changes. Learn about the foods that contain calcium.

Your calcium carbonate dose may need to be adjusted as you make changes to your diet. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat. Do not freeze.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line.

What should I avoid while taking calcium carbonate?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking calcium carbonate.

What other drugs can affect calcium carbonate?

Calcium can make it harder for your body to absorb certain medicines. If you take other medications, take them at least 2 hours before or 4 or 6 hours after you take calcium carbonate.

Other drugs may interact with calcium carbonate, including prescription and over-the-counter medicines, vitamins, and herbal products. 

What is Klor-Con?

Klor-Con contains potassium chloride, a mineral that is found in many foods and is needed for several functions of your body, especially the beating of your heart.

Klor-Con is used to prevent or to treat low blood levels of potassium (hypokalemia). Potassium levels can be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrhea or vomiting.

Klor-Con is available as effervescent tablets, extended release tablets, extended release capsules (sprinkle), and powder for oral solution.

Warnings

You should not use Klor-Con if you have high levels of potassium in your blood (hyperkalemia), or if you also take a “potassium-sparing” diuretic.

To be sure Klor-Con is helping your condition, your blood may need to be tested often. Your heart rate and rhythm may also be checked using an electrocardiogram or ECG (sometimes called an EKG) to measure electrical activity of the heart. Do not miss any scheduled appointments.

Serious side effects of potassium include uneven heartbeat, muscle weakness or limp feeling, severe stomach pain, and numbness or tingling in your hands, feet, or mouth.

Do not stop taking Klor-Con without first talking to your doctor. If you stop taking potassium suddenly, your condition may become worse.

Do not crush, chew, break, or suck on an extended-release tablet or capsule. Swallow the pill whole. Breaking or crushing the pill may cause too much of the drug to be released at one time. Sucking on a potassium tablet can irritate your mouth or throat. Take Klor-Con with food or just after a meal.

Before taking this medicine

You should not use Klor-Con if you are allergic to potassium chloride, or if:

• you have high levels of potassium in your blood (hyperkalemia); or
• you take a “potassium-sparing” diuretic (water pill) such as amiloride, spironolactone, or triamterene.

To make sure Klor-Con is safe for you, tell your doctor if you have ever had:

• heart problems;
• high blood pressure;
• liver or kidney disease;
• a large tissue injury such as a severe burn;
• an electrolyte imbalance (such as low levels of calcium or magnesium in your blood);
• trouble swallowing;
• slow digestion;
• stomach bleeding, an ulcer, or a blockage in your stomach or intestines;
• an adrenal gland disorder;
• diabetes; or
• severe dehydration.

Tell your doctor if you are pregnant or breastfeeding.

How should I take Klor-Con?

Take Klor-Con exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take Klor-Con with food if the medicine upsets your stomach.

Always follow directions on the medicine label about giving this medicine to a child.

Take the tablet or capsule with a full glass of water.

Do not crush, chew, or suck on a potassium tablet or capsule. Sucking on the pill could irritate your mouth or throat.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Mix the oral solution with least 4 ounces of water before taking it.

You may need to follow a special diet while using Klor-Con. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition.

Call your doctor if you have trouble swallowing a Klor-Con capsule or tablet. You may be able to dissolve the tablet in water, or mix the medicine from a capsule with soft food. Carefully follow your doctor’s instructions.

You may need frequent medical tests. Your heart function may need to be checked using an electrocardiogram or ECG (sometimes called an EKG). Even if you have no symptoms, tests can help your doctor determine if this medicine is effective.

Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.

Store at room temperature away from moisture, heat, and light. Keep the medication in a closed container.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include stomach pain, vomiting, irregular heartbeats, chest pain, muscle weakness, loss of movement, numbness or tingling, or feeling light-headed.

What should I avoid while taking Klor-Con?

Do not use potassium supplements or other products that contain potassium, unless your doctor has told you to. Salt substitutes or low-salt foods often contain potassium. Read the label of any food or medicine to see if it contains potassium.

Klor-Con side effects

Get emergency medical help if you have signs of an allergic reaction to Klor-Con: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Klor-Con and call your doctor at once if you have:

• severe throat irritation;
• chest pain, trouble breathing;
• stomach bloating, severe vomiting, severe stomach pain;
• high potassium level – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• signs of stomach bleeding – bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common Klor-Con side effects may include:

• nausea, vomiting, diarrhea;
• gas, stomach pain; or
• the appearance of a Klor-Con tablet in your stool.

What is magnesium oxide?

Magnesium oxide is used as a supplement to maintain adequate magnesium in the body.

Magnesium oxide is also used to treat indigestion, upset stomach, or as a laxative to relieve occasional constipation.

Magnesium oxide may also be used for purposes not listed in this medication guide.

Magnesium oxide side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Stop using magnesium oxide and call your doctor at once if you:

• have rectal bleeding; or
• do not have a bowel movement after using magnesium oxide as a laxative.

Common side effects of magnesium oxide may include:

• nausea, vomiting;
• diarrhea; or
• stomach pain, loss of appetite.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA .

Warnings

Follow all directions on the label and package. Use exactly as directed.

Before taking this medicine

You should not take magnesium oxide if you are allergic to it.

Ask a doctor or pharmacist if magnesium oxide is safe to use if you have or have ever had:

• stomach pain, nausea, vomiting;
• a sudden change in bowel habits that has lasted longer than 2 weeks;
• if you are on a low-magnesium diet; or
• kidney disease.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

How should I take magnesium oxide?

Use exactly as directed on the label, or as prescribed by your doctor.

Take this medicine with a full glass of water.

When using this medicine as a laxative, it may be best to take your dose at bedtime.

Magnesium oxide may be taken with food if it upsets your stomach.

Stop using magnesium oxide and call your doctor if your symptoms do not improve after 7 days of treatment, or if they get worse.

Store at cool room temperature away from moisture and heat.

What happens if I miss a dose?

Magnesium oxide is used when needed. If you are on a dosing schedule, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include nausea, vomiting, weakness, breathing problems, slow reflexes, extreme drowsiness, loss of consciousness, and feeling dizzy or light-headed.

What should I avoid while taking magnesium oxide?

Avoid taking other medications at the same time you use an antacid. Some antacids can make it harder for your body to absorb other medicines you take by mouth.

What is magnesium sulfate?

Magnesium is a naturally occurring mineral that is important for many systems in the body especially the muscles and nerves. Magnesium sulfate also increases water in the intestines.

Magnesium sulfate is used as a laxative to relieve occasional constipation.

Magnesium sulfate (Epsom salt) can also be added to a bath for use as a soaking solution to help relieve minor sprains and bruises. Not all external uses for magnesium sulfate have been approved by the FDA. Epsom salt should not be used in place of medication prescribed for you by your doctor.

Magnesium sulfate may also be used for purposes not listed in this medication guide.

Magnesium sulfate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Common side effects may include diarrhea or upset stomach.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA .

Warnings

Never use a higher dose of magnesium sulfate than recommended on the package label, or as your doctor has directed. Using too much magnesium sulfate can cause serious, life-threatening side effects.

Do not use magnesium sulfate as a laxative without medical advice if you have: severe stomach pain, nausea, vomiting, a perforated bowel, a bowel obstruction, severe constipation, colitis, toxic megacolon, or a sudden change in bowel habits that has lasted 2 weeks or longer.

If you have rectal bleeding or if you do not have a bowel movement after using magnesium sulfate as a laxative, stop using the medication and call your doctor at once. These may be signs of a more serious condition.

Before taking this medicine

Do not use magnesium sulfate as a laxative without medical advice if you have:

• severe stomach pain;
• nausea or vomiting;
• a perforated bowel;
• a bowel obstruction or severe constipation;
• colitis or toxic megacolon; or
• a sudden change in bowel habits lasting 2 weeks or longer.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

• diabetes;
• kidney disease;
• an eating disorder (anorexia or bulimia);
• if you have already been using a laxative for longer than 1 week; or
• if you on a low-magnesium diet.

It is not known whether magnesium sulfate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether magnesium sulfate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take magnesium sulfate?

Use exactly as directed on the label, or as prescribed by your doctor.

Never use a higher dose of magnesium sulfate than recommended on the package label, or as your doctor has directed. Using too much magnesium sulfate can cause serious, life-threatening side effects.

Magnesium sulfate may be used orally (by mouth) or as a soak. Follow your doctor’s instructions or the directions on the package.

To take magnesium sulfate orally, dissolve one dose in 8 ounces of water. Stir this mixture and drink all of it right away. You may add a small amount of lemon juice to improve the taste of this mixture.

Magnesium sulfate taken orally should produce a bowel movement within 30 minutes to 6 hours.

Drink plenty of liquids while you are taking magnesium sulfate.

If you have rectal bleeding or if you do not have a bowel movement after using magnesium sulfate as a laxative, stop using the medication and call your doctor at once. These may be signs of a more serious condition.

To use magnesium sulfate as an epsom salt soak, dissolve in a large amount of water in a large bowl, a bucket, a foot tub, or a bath tub. Follow the directions on the product label about how much epsom salt to use per gallon of water.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since magnesium sulfate is used on an as needed basis, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . An overdose of magnesium sulfate can be fatal

Overdose symptoms may include nausea, vomiting, flushing (warmth, redness, or tingly feeling), feeling very hot, slow heart rate, extreme drowsiness, or fainting.

What should I avoid while taking magnesium sulfate?

Magnesium sulfate taken orally can make it harder for your body to absorb other medications you take by mouth, especially antibiotics. Avoid taking other medicines within 2 hours before or after you take magnesium sulfate as a laxative.

What other drugs will affect magnesium sulfate?

Other drugs may interact with magnesium sulfate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What is melatonin?

Melatonin is an oral, over-the-counter (OTC) dietary supplement available without a prescription in the U.S. It is often used to help with jet lag or trouble sleeping and comes as tablets, capsules, an oral liquid and chewable gummies.

Melatonin is also a natural hormone your body secretes in response to darkness to help maintain your wake-sleep cycle (also called “biological clock”). The wake-sleep cycle is the process of sleep and wakefulness; in humans this averages 8 hours of nighttime sleep and 16 hours of daytime activity.

Natural melatonin levels usually peak between 11PM and 3AM. Nighttime levels are roughly 10 times higher than in the daytime. Levels fall sharply before daylight, and are barely detectable in the daylight hours. The rise and fall in natural levels signal wake and sleep times, known as our circadian rhythm.

Shorter periods of natural melatonin production occur in the summer with longer days, and longer periods of production occur in the winter. Light at night (such as from smartphones or the TV) blocks production and can lead to sleep disturbances. Age also lowers nighttime melatonin release, which may contribute to the problem of insomnia and early awakening often seen in older adults.

What is melatonin used for?

Melatonin is most commonly used to treat:

• insomnia (trouble sleeping)
• jet lag due to travel
• sleep cycles in the blind (non 24-Hour Sleep Wake Disorder)
• shift-work sleep disorders in people with alternating work schedules

Melatonin dietary supplements may be promoted for many other uses, from eczema, to bowel disorders to cancer treatment, but adequate studies are lacking. It has been widely studied for treatment of jet lag and other sleep disorders.

How does melatonin work?

Natural melatonin is a hormone produced in the pineal gland in the brain. It is made from the amino acid tryptophan and then released into the blood and cerebrospinal fluid, crossing into the brain. It sends messages to areas in the brain and body to help control the sleep and wake cycles.

When taken as a dietary supplement, its function is to act like the natural sleep hormone. Drowsiness generally occurs within 30 minutes after taking a dose.

Taking supplemental melatonin for sleep before bedtime may not be the best strategy for all sleep disorders and may not work for everyone. Trouble with sleep may be a symptom of other medical disorders, like depression, anxiety or sleep apnea, so check with your doctor if your insomnia persists. Also check with a child’s doctor before use.

Is melatonin a hormone or a vitamin?

Melatonin is a natural hormone when produced in the body and is not a vitamin. Melatonin supplements you take by mouth – like pills, liquids or chewable gummies – are man-made products available without a prescription at the pharmacy, nutrition stores, and other retail shops.

Before taking this medicine

Do not use melatonin if you are allergic to it.

Before using this medication or giving it to your child, talk to your healthcare provider. This medication may not be recommended if you have certain medical conditions, such as:

• diabetes
• depression
• a bleeding or blood clotting disorder such as hemophilia
• taking a blood thinner like warfarin
• high or low blood pressure
• epilepsy or other seizure disorder
• if you are using any medicine to prevent organ transplant rejection
• an autoimmune condition
• using other sedatives or tranquilizers

It is not known whether this medication will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

High doses of this medicine may affect ovulation, making it difficult for you to get pregnant.

It is not known whether melatonin passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Do not give any herbal or dietary supplement to a child without medical advice from a qualified healthcare provider.

Melatonin dosage

Melatonin is considered an effective short-term treatment for jet lag and may aid with sleep during times when you would not normally be awake.

Effective starting doses of melatonin for jet lag range from 0.3 to 0.5 mg. One milligram tablets can be cut in half to achieve a 0.5 mg dose of melatonin if smaller doses are not available for purchase. Higher doses are commonly marketed in the U.S. (up to 10 mg), but higher doses may be associated with more side effects such as headache, next day drowsiness, or vivid dreams. Side effects of melatonin may occur more frequently or worsen in older adults.

Always start with the lowest dose. According to a Cochrane review, doses over 5 mg appear to be no more effective than lower doses. Higher doses may result in excessively high levels of physiologic melatonin.

Melatonin for jet lag

Jet lag is an air travel problem that causes trouble with falling and staying asleep, fatigue, trouble concentrating, constipation, and other symptoms. Jet lag is much more likely if you cross over several time zones, and can worsen the more time zones you cross.

Effective starting doses for jet lag range from 0.3 to 0.5 mg. Smaller doses may work for some while others may need a higher dose. It may be more difficult to fly east, when time is lost, rather than to fly west, when you gain it back. High doses, such as 20 mg pills are available for purchase on the Internet, but such high doses are not normally recommended or needed, and may greatly increase side effects.

• Eastbound: If you are traveling east, say from the US to Europe, take supplemental melatonin for sleep after dark, 30 minutes before bedtime in the new time zone or if you are on the plane. Then take it for the next 4 nights in the new time zone, after dark, 30 minutes before bedtime. If you are still feeling drowsy the day after using this medication, try a lower dose.
• Westbound: If you are heading west, for example, from the US to Australia, a dose is not needed for your first travel night, but you then may take it for the next 4 nights in the new time zone, after dark, 30 minutes before bedtime. Melatonin may not always be needed for westbound travel.

Given enough time (usually 3 to 5 days), jet lag will usually resolve on its own, but this is not always optimal when traveling.

Melatonin for sleep disorders

Primary Sleep Disorders (Insomnia):

• Dosage: Take 0.1 mg to 0.5 mg thirty minutes before bedtime. Studies suggest supplemental melatonin for primary sleep disorders may be effective in promoting but not maintaining sleep (early morning awakening). It is not usually recommended for long-term use. If insomnia continues, seek the advice of a healthcare provider.

Shift-Work Sleep Disorders

• Dosage: Take 1 to 3 mg thirty minutes prior to the desired onset of daytime sleep; melatonin may NOT lead to improved alertness during the nighttime work shift.

Delayed Sleep-Wake Phase Disorder

Delayed sleep-wake phase disorder (DSWPD) most often occurs in adolescents, possibly due to reduced production and melatonin deficiency at this age. Sleep onset is delayed by 3 to 6 hours compared with conventional bedtimes (10 to 11 pm). DSWPD can negatively affect school performance, daily activities, and lead to morning drowsiness which can be dangerous for teen drivers. Any sleep disorder in an adolescent should be evaluated by a physician.

• Dosage: No consensus is available for dosing in DSWPS. Some clinicians recommend 3 to 5 mg taken in the early evening, at least 1.5 hours before the desired bedtime. Bright light therapy and behavioral management may enhance results. Be aware drowsiness may occur after the melatonin dose, so avoid hazardous activities such as driving.

Non-24-Hour Sleep Wake Disorder (Non-24)

More than 70% of people who are totally blind have Non-24, a circadian rhythm disorder. For people who are totally blind, there are no light cues to help reset the biological clock. The sleep time and wake up time of people who have Non-24-Hour Sleep Wake Disorder shifts a little later every day. Sleep times go in and out of alignment compared to a normal sleep-wake phase. Extra minutes add up each day by day and disrupt the normal wake-sleep pattern.

Use of melatonin in Non-24 is to aid in stimulation to reset the biological clock with one long sleep time at night and one long awake time during the day.

• Dosage: Studies on people who are the blind suggest 0.5 mg/day, taken either at a fixed time before bed or one hour before bedtime.

Hetlioz, a prescription-only melatonin agonist is approved for use in Non-24-Hour Sleep Wake Disorder in adults and for the treatment of Nighttime Sleep Disturbances in Smith-Magenis Syndrome (SMS) in patients 3 years of age and older.

• Hetlioz (tasimelteon)

Rozerem (ramelteon), also a melatonin agonist, has been approved to treat insomnia characterized by difficulty with sleep onset in adults.

• Hetlioz (tasimelteon)Rozerem (ramelteon)

Fast-dissolving Tablets

Some melatonin tablets are available in fast-dissolving formulations in the U.S. To take the orally disintegrating tablet:

• Use dry hands to remove the tablet and place it in your mouth.
• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

Call your doctor if the condition you are treating with this medication does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

Melatonin for Children

Parents may consider using melatonin to help their child who has a trouble falling asleep. Only use this medication for your child under the care of a pediatrician or other medical sleep specialist. Insomnia or other sleeping disorders in children should always be evaluated by a medical professional.

Melatonin should not be used as a substitute for good sleep hygiene and consistent bedtime routines in children. According to Yale sleep specialist Dr. Craig Canapari, use of this medication results in less difficulty with falling asleep, earlier time of sleep onset, and more sleep at night.

Products containing lower-dose melatonin for kids do exist on the U.S. market. Long-term use of this medication has not been studied in clinical trials for children and possible side effects with prolonged use are not known. The use of melatonin in children with autism spectrum disorder or attention-deficit hyperactivity disorder should involve behavioral interventions and should be directed by a physician.

Delayed sleep phase disorder often occurs in teenagers and young adults, possibly due to alterations in endogenous production. Sleep onset is delayed by 3 to 6 hours compared with normal bedtime hours of 10 to 11 PM. Maintaining a consistent bedtime free of electronics for at least one hour prior to bedtime is especially important for insomnia in children and adolescents.

Melatonin Side Effects in Children

The most common melatonin side effect in children is morning drowsiness. Other common side effects in children include:

• Bedwetting
• Headache
• Dizziness
• Nausea
• Diarrhea
• Possible increased risk for seizures in children with severe neurological disorders.

Dietary melatonin supplements can still have drug interactions or health risks if you have certain medical conditions, upcoming surgery, or other health concerns.

What to avoid

• Avoid driving or operating machinery for at least 4 hours after taking melatonin, or until the drowsy effects are no longer present.
• Avoid using this medication with other prescription medications, over-the-counter drugs, or dietary supplements without asking your doctor, pharmacist or other healthcare provider.
• Avoid alcohol while taking this medication.
• Avoid coffee, tea, cola, energy drinks, or other products that contain caffeine, as it may counteract the effects of the melatonin.

What Happens if I Miss a Dose?

If you miss taking a dose there is no cause for concern, but melatonin may impair your thinking and reaction time. If you will be driving or doing any hazardous activity, skip your dose as melatonin can cause drowsiness.

Otherwise, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine or double your dose to make up the missed medication.

Can You Overdose?

Melatonin is thought to be very safe in the short-term with a low risk for overdose. If you suspect an overdose or serious adverse effects or allergic reactions, seek emergency medical attention from your health care provider or call the Poison Help Line .

Is Melatonin Safe?

Melatonin is a relatively safe supplement when used in the short-term, and melatonin side effects are uncommon. Its safety in the long-term has not been determined in randomized, controlled studies. In general this medication appears to be relatively nontoxic, even at higher doses such as 3 to 5 mg once a day.

Some people can have side effects from melatonin that may include:

• daytime drowsiness, dizziness, weakness, or confusion
• vivid dreams, nightmares
• feeling depressed, anxious, irritable
• headache
• loss of appetite, diarrhea, nausea, stomach pain
• blood pressure changes
• joint or back pain
• elevated risk for seizures

Higher external doses(>1 mg to 10 mg) can worsen side effects like daytime drowsiness, impaired physical or mental ability, low body temperature, and elevated prolactin levels.

Melatonin and Pregnancy

Most dietary supplements like melatonin have not been studied in pregnant women, during breastfeeding, or in children. Seek advice from your healthcare provider before using any dietary supplement if you are pregnant, nursing, or considering the use of this product in a child under 18 years of age.

Melatonin Drug Interactions

Some important drug interactions can occur with melatonin even though it is a dietary supplement. Always review for drug, food and disease interactions with your healthcare provider anytime you start, or even stop, a medication.

Always tell your doctor and pharmacist about all of the medications you take, including prescription drugs, over-the-counter medicines, vitamins and herbal supplements. Do not stop using any medications without first talking to your doctor.

Talk to your doctor before using melatonin if you take the blood thinner warfarin. Melatonin has been reported to increase the effects of warfarin in some patients. This is not a complete list of drug interactions that may occur with melatonin.

Is Melatonin Approved by the FDA?

Melatonin is not approved by the FDA for any use. It falls under the FDA’s Dietary Health and Education Act as a dietary supplement. Dietary supplements may include vitamins, minerals, amino acids, and herbs or botanicals, plus other substances used to supplement the diet. As with other dietary supplements, melatonin isn’t approved by the Food and Drug Administration (FDA) for safety or effectiveness.

Manufacturers must notify FDA about new ingredients prior to marketing. After the supplement is on the market, the FDA will monitor adverse event/s that are reported to them by the manufacturer, consumers or health care professionals. If a manufacturer makes an unproven health claim or if the supplement is found to be unsafe the FDA can remove the OTC from the market.

Avoid buying dietary supplements from the Internet and from online pharmacies whose authenticity you cannot verify. It is important to remember that an OTC label that says “natural” supplement does not always mean it’s “safe” for consumption. Formulations that are United States Pharmacopeial (USP) Convention Verified can be considered most reliable in this regard; the label “USP” is found on the outside of the bottle. For example, all Nature Made products are verified by the USP. The safest way to purchase drugs online is through pharmacies accredited by the Verification of Internet Pharmacy Practice Sites (VIPPS) programs.

Do Electronic Devices Alter Melatonin Levels?

Light at night blocks the production of melatonin, and this has been shown to cause sleep disturbances in people who use electronics that emit light at night. Researchers have found that light from electronic devices can block the release of natural hormone melatonin at night. The effect was most significant for younger children, with nighttime levels reduced by up to 37 percent in certain cases. This can also be problematic for children between ages 9 and 16.

Studies show that light after dark lowers melatonin levels which may lead to difficulty in initiating sleep. Electronic light-emitting devices such as the television, laptops, smartphones and tablets often find their way into the bedroom at night, or are used after dark. Children should not have electronics, including TVs, in their bedroom at bedtime and everyone should avoid use of light-emitting devices and screen time at least one hour before bedtime.

Melatonin Reviews and Studies

For Primary Sleep Disorders

Researchers have conducted many studies on melatonin supplements for various health conditions. Most studies have been conducted in sleep disorders, such as jet lag, shift work sleep disorders, delayed sleep phase disorder, and insomnia. Studies are often not consistent in their results and questions still remain about its usefulness, dosage, length of treatment and long-term safety for some sleep conditions.

Melatonin can be effective for jet lag for many people when dosed at the appropriate time. Studes measuring the effectiveness of melatonin for the treatment of insomnia show a slight reduction in the amount of time needed to fall asleep, but melatonin may not increase the overall quality of sleep. This medication does appear to be safe for short-term use for primary insomnia (less than three months).

For Other Conditions

Multiple areas for melatonin use have been investigated, but not all uses may be accepted or have adequate research to determine appropriate clinical use. These include:

• Cancer
• Boost the immune system
• Sunburn
• Irritable Bowel Syndrome (IBS)
• Fibromyalgia
• Systemic sclerosis
• Antioxidant and free radical scavenger
• Alzheimer’s disease
• Ocular diseases
• Sleep aid for children with autism spectrum disorder or attention deficit hyperactivity disorder (ADHD)
• Amyotrophic lateral sclerosis (ALS)
• Nighttime blood pressure control
• Seasonal affective disorder (SAD)

How Does Melatonin Come at the Store?

In the U.S., melatonin pills can be purchased without a prescription in the pharmacy, grocery, or health food store. Pill strengths range from 1 milligram (mg) to 10 mg, but you should always start with the lowest dose to judge its effects. Some experts suggest to start with 0.3 to 0.5 mg thirty minutes before bedtime, instead of the higher doses. Cut a 1-mg immediate release tablet in half to get a 0.5 mg dose if lower doses are not available; don’t do this with time release products. Also, don’t drink alcohol with the time-release preparation, as it can disrupt the time-release mechanism.

Does Food Contain Melatonin?

A study published in Food and Nutrition Research notes that certain food products do contain various amounts of melatonin as measured by immunological and chromatographic laboratory techniques. How consumption of these various foods might affect endogenous production sleep or was not evaluated:

• Tomatoes
• Walnuts
• Rice/barley cereal
• Strawberries, tart cherries
• Olive oil
• Wine, beer
• Cow’s milk

Research finds that melatonin synthesis depends upon availability of the essential amino acid tryptophan, a needed component of the diet. If intake of tryptophan is severely restricted, synthesis of melatonin is significantly reduced in humans.

In the Nurses’ Health Study, no link was found between the consumption of various nutrients, such as folate, vitamin B6 and zinc and increased urinary excretion.

Diets rich in vegetables, fruits and grain products will contain considerable levels of dietary melatonin. The overall effect of dietary consumption on nighttime levels of melatonin is very limited. Melatonin production is primarily driven by the effects of light and darkness and by age, declining as we get older.

How Much Does Melatonin Cost?

On average a 120-count bottle costs about $10.00, but prices can vary, depending upon the manufacturer and strengths purchased. Insurance usually will not pay for over-the-counter (OTC) products, although some plans may allow use of health savings account funds.

Bottom Line: Pros and Cons

Benefits:

• Widely available in the U.S. over-the-counter (OTC) without a prescription
• Short-term use (less than 3 months) is relatively safe with little evidence of toxicity
• Inexpensive product with generics or store brands available
• Lower dose and orally-dissolvable products for children are available
• Comes in a variety of dosage forms and doses

Downsides:

• Not approved for any uses by the FDA (over-the-counter dietary supplement)
• Quality of some products cannot always be assured
• Studies for less common uses are not consistent
• Doses tend to vary between patients; always ask a medical professional or your health care provider for dosing advice in children
• Effective lower doses (0.1 to 1 mg) are not always commercially available
• Higher doses (2 to 10 mg) used over a prolonged period may lead to rebound insomnia and are not well studied.

What is potassium chloride?

Potassium is a mineral that is found in many foods and is needed for several functions of your body, especially the beating of your heart.

Potassium chloride is used to prevent or to treat low blood levels of potassium (hypokalemia).

Potassium levels can be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrhea or vomiting.

Warnings

You should not use potassium chloride if you have high levels of potassium in your blood (hyperkalemia), or if you also take a “potassium-sparing” diuretic.

To be sure potassium chloride is helping your condition, your blood may need to be tested often. Your heart rate may also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electrical activity of the heart. This test will help your doctor determine how long to treat you with potassium. Do not miss any scheduled appointments.

Serious side effects of potassium include uneven heartbeat, muscle weakness or limp feeling, severe stomach pain, and numbness or tingling in your hands, feet, or mouth.

Do not stop taking this medicine without first talking to your doctor. If you stop taking this medicine suddenly, your condition may become worse.

Do not crush, chew, break, or suck on an extended-release tablet or capsule. Swallow the pill whole. Breaking or crushing the pill may cause too much of the drug to be released at one time. Sucking on a tablet can irritate your mouth or throat. Take potassium chloride with food or just after a meal.

Before taking this medicine

You should not use potassium chloride if you are allergic to it, or if:

• you have high levels of potassium in your blood (hyperkalemia); or
• you take a “potassium-sparing” diuretic (water pill) such as amiloride, spironolactone, or triamterene.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• kidney disease;
• cirrhosis or other liver disease;
• an adrenal gland disorder;
• a large tissue injury such as a severe burn;
• severe dehydration;
• diabetes;
• heart disease or high blood pressure;
• stomach or intestinal bleeding;
• a blockage in your stomach or intestines; or
• chronic diarrhea (such as ulcerative colitis, Crohn’s disease).

It is not known whether this medicine will harm an unborn baby. Your dose needs may be different during pregnancy. Tell your doctor if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

How should I take potassium chloride?

Take potassium chloride exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Take potassium chloride with a full glass of water. Take potassium chloride with food or just after a meal if this medicine upsets your stomach.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or suck on a tablet or capsule. Sucking on the pill could irritate your mouth or throat.

Call your doctor if you have trouble swallowing a potassium chloride capsule or tablet. You may be able to dissolve the tablet in water, or mix the medicine from a capsule with soft food. Carefully follow your doctor’s instructions.

Mix the powder form of this medicine with at least 4 ounces (one-half cup) of cold water or fruit juice before taking. Drink the mixture slowly, over 5 to 10 minutes in all. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

To be sure this medicine is helping your condition, you may need frequent blood tests. You may not notice any change in your symptoms, but your blood work will help your doctor determine how long to treat you with potassium chloride. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). Even if you have no symptoms, tests can help your doctor determine if this medicine is effective.

Your treatment may include a special diet. Follow the diet plan created for you by your doctor or nutrition counselor. Get familiar with the list of foods you should eat or avoid to help control your condition.

Potassium-rich foods include: squash, baked potatoes (skin on), spinach, lentils, broccoli, Brussels sprouts, zucchini, kidney or navy beans, raisins, watermelon, orange juice, bananas, cantaloupe, and low-fat milk or yogurt. Consume only the daily amounts recommended by your doctor or nutrition counselor.

Some tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.

Store at room temperature away from moisture and heat. Keep the medication in a closed container.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include irregular heartbeats, chest pain, or muscle weakness.

What to avoid

Avoid taking supplements or using other products that contain potassium without first asking your doctor. Salt substitutes or low-salt dietary products often contain potassium. If you take certain products together you may accidentally get too much potassium. Read the label of any other medicine you are using to see if it contains potassium.

Potassium chloride side effects

Get emergency medical help if you have signs of an allergic reaction to potassium chloride: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

• severe throat irritation;
• stomach bloating, severe vomiting, severe stomach pain;
• high potassium level – nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• signs of stomach bleeding – bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common potassium chloride side effects may include:

• nausea, vomiting, diarrhea;
• gas, stomach pain; or
• the appearance of a potassium chloride tablet in your stool.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect potassium chloride?

Tell your doctor about all your current medicines and any you start or stop using, especially:

• a diuretic or “water pill”; or
• heart or blood pressure medication.

This list is not complete. Other drugs may interact with potassium chloride, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.