Patient/caregiver was educated on how to take Melatonin as follows:

1. Take this medication as ordered by your physician. Do not change the dose and frequency on this medication without consulting your doctor. Take the medication dose for the duration prescribed without fail.
2. Take the medication dose at the same time, every day, to avoid forgetting the intake of medication. Taking the medication at regularly spaced intervals help maintain appropriate blood levels of melatonin needed to derive the beneficial effect of sleep induction at a defined time.
3. This medication can induce some nausea and vomiting, when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid these unpleasant gastrointestinal symptoms.
4. Melatonin, in higher doses, can induce some day time drowsiness and headache the following morning. Starting melatonin on a low dose and gradually increasing it to the desired dose, if needed, can help avoid this discomfort. If the drowsiness becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by melatonin.
5. Do not take melatonin with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the drowsiness and confusion caused by melatonin. A number of OTC cough medications, antihistamines, and antianxiety medications, can potentiate the drowsiness caused by melatonin and so, must be avoided taking along with melatonin.
6. Take the melatonin regular tablet as a whole, using a glass of water. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You can also crush the regular tablet and sprinkle the powder on a spoon of apple sauce or jello or pudding, to facilitate an easy swallow.
7. Take the melatonin regular capsule as a whole, using a glass of water. If you encounter difficulty swallowing the whole capsule, you may open the capsule and sprinkle the powder on a spoon of apple sauce or jello or pudding, to facilitate an easy swallow.
8. Melatonin is also available as an orally disintegrating tablet, which absorbs moisture from the atmosphere around rapidly and can start to dissolve. So, remove only one dose from the package at a time, just when it is time for intake of the dose. Make sure the hands are dry before getting the tablet out of the package. This orally disintegrating tablet must be placed on the tongue, allow it to dissolve in the mouth for one minute, before swallowing the remnants in the mouth with saliva or using some water.
9. If you are prescribed melatonin extended-release tablets, try to swallow the tablet as a whole, with a glass of water. These tablets are bi-layered controlled release tablets, the initial layer helping to fall asleep soon and the second layer of the tablets over time during the night, helping to continue the sleep phase without interruption and stay asleep longer. These tablets must not be cut or crushed or chewed in the mouth, doing which can result in rapid release and absorption of the medication into the blood stream, thus resulting in toxicity and compromised therapeutic benefit.
10. Individuals experiencing difficulty falling sleep must take the melatonin supplement 30 minutes before the scheduled sleep time, to help promote falling sleep. Shift workers experiencing difficulty falling asleep during the daytime must take the melatonin supplement 30 minutes before the scheduled sleep time, to help promote falling sleep.
11. Individuals taking melatonin supplement for jetlag must take the supplement 30 minutes before sleep time at the new destination and continue taking it for another 3-4 days, 30 minutes before sleep time. Individuals traveling westbound are less likely to experience jetlag, as they tend to gain time compared to individuals traveling eastbound who lose time. So, westbound travel might not require melatonin supplement.
12. Adolescents experiencing delayed onset of sleep in the night by a few hours, can compromise academic performance in the school the following morning. These adolescents can also present with daytime drowsiness, compromising safety during activities, such as, driving. Melatonin supplements, administered in such individuals, 4 – 6 hours before a defined sleep time, can help establish a regular sleep time and set the normal sleep pattern in place.
13. Notify your doctor regarding any continuing difficulty falling sleep, difficulty staying sleep, and any daytime drowsiness, so that, your dosage on the medication could be revised.
14. Melatonin can take some time to fairly adjust to your body and reach a therapeutic level in your blood, before offering the desired beneficial effects without any unwanted side-effects. Your physician might have to work a little around your dose, to reach a dose ideal for you. Do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
15. Your physician could change the dose of melatonin, based on the relief obtained or side-effects developed. So, maintain compliance with follow-up physician appointments, to update on the relief from symptoms. Be accommodative to the plan of dose changes, if need be, until you show an optimum response.
16. Continue taking melatonin as ordered, even if you experience relief from insomnia and difficulty falling sleep. Abrupt discontinuation on melatonin intake can result in recurrence of sleep problems. Discontinuing the medication should only be on your physician’s recommendation and must be slow and gradual, using tapering doses.
17. Melatonin interacts with a lot of other medications, thus influencing their function. If you are being newly started on melatonin, discuss with your physician regarding all your current medications and their safety with melatonin. Also, notify your physician regarding any current melatonin intake, if you are being started on any new medications and discuss their safety with melatonin.
18. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.