Melatonin - Sleep disorders in Children and Young People with ADHD

The Area Prescribing Committee recommends the use of melatonin in children and adolescents with persistent sleep disorders (see approved formulations  and indications below).

The recommended products are:

Melatonin 2mg MR tablets (prescribed generically) are recommended 1st line (off-label use)
Licensed, immediate release tablets (available in strengths of 1mg-5mg)
Crushed immediate release tablets (available in strengths of 1mg-5mg) for children unable to swallow tablets
Melatonin 1mg/ml oral solution sugar free (the licensed liquid is also alcohol free) is reserved ONLY for those children who have a feeding tube in situ, or who have significant feeding difficulties, and the use of the whole or crushed tablets are unsuitable. Refer to Treatment Pathway below.

Prescribers are advised to check excipients of the oral solutions, as some may not be suitable for under 5s and to also check licensed indications.  It is possible that that the licensed liquid may be prescribed for an off-label indication, but this is considered preferable to using an unlicensed liquid.

NON-FORMULARY 
- All other solid dose formulations of melatonin are not supported for use
- other liquid formulations
- Melatonin for use in jet lag
- The Slenyto® brand (1mg and 5 mg prolonged release tablets) has been assigned a BLACK status for all indications - see link for further information https://surreyccg.res-systems.net/PAD/Search/DrugConditionProfile/6243

Primary care prescribers should ensure that patient medication records include any medicine for which prescribing remains the responsibility of secondary or tertiary care. This will ensure that GP records, which are accessed by other healthcare providers, are a true and accurate reflection of the patient's medication