agomelatine at a glance
Medicine class
Melatonergic antidepressant and serotonin 5-HT2C receptor antagonist
Licensed use
Major depressive episodes in adults
Administration
Film-coated tablets taken by mouth, with or without food
What is agomelatine used for?
Licensed for:
Treatment of major depressive episodes in adults.
How does agomelatine work?
Agomelatine activates MT1 and MT2 melatonin receptors and blocks serotonin 5-HT2C receptors. These actions can influence circadian rhythms and increase noradrenaline and dopamine release in the frontal cortex; it does not block serotonin reuptake.
agomelatine preparations and strengths
Tablet
Route: Oral
Strengths: 25 mg
How to take agomelatine
Follow the prescription label. Swallow the film-coated tablet with water; it may be taken with or without food. Do not change or stop treatment without discussing it with the prescriber.
Dizziness or sleepiness can occur; check how agomelatine affects you before driving or using machinery.
Blood tests remain important even if you feel well.
agomelatine side effects
Common or expected effects
- Headache
- Nausea, vomiting, diarrhoea, constipation or abdominal pain
- Dizziness or sleepiness
- Difficulty sleeping or abnormal dreams
- Anxiety
- Tiredness or back pain
- Weight gain
- Raised liver enzymes on blood tests
Get urgent medical advice
- Signs of liver injury, including jaundice, dark urine, pale stools, upper-right abdominal pain or persistent unexplained fatigue
- Swelling of the face, lips, tongue or throat, particularly with breathing or swallowing difficulty
- Suicidal thoughts or behaviour, or marked worsening of depression
- New manic or hypomanic symptoms, such as unusually elevated mood, overactivity or reduced need for sleep
- Hallucinations or severe confusion
agomelatine in pregnancy
Human pregnancy information is limited, so product information advises avoiding agomelatine as a precaution. It may occasionally be considered when it is the most suitable treatment; anyone planning a pregnancy or becoming pregnant should obtain an early review rather than stopping it without advice.
agomelatine while breastfeeding
It is not known whether agomelatine passes into human breast milk, and a risk to the infant cannot be excluded. A prescriber or specialist should weigh the benefits of breastfeeding and effective maternal treatment when deciding whether breastfeeding or agomelatine should be stopped.
agomelatine interactions
Check all prescribed, over-the-counter and herbal products with a pharmacist or prescriber. Important examples include:
Fluvoxamine
Strongly inhibits agomelatine metabolism and must not be used with it because exposure can rise substantially.
Ciprofloxacin
Strongly inhibits CYP1A2 and is contraindicated with agomelatine.
Common questions about agomelatine
Answers are fully visible for fast scanning and source review.
Why does agomelatine require liver blood tests?
It can raise liver enzymes and, rarely, cause hepatitis or liver failure. Testing helps detect injury before it becomes severe.
Can agomelatine be taken with food?
Yes. Food does not meaningfully alter its absorption, so the tablet may be taken with or without food.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.