Combination Melatonin
Mechanism of Action
Endogenous hormone produced by pineal gland at night; exogenous melatonin shifts and reinforces circadian rhythm phase. Also direct hypnotic effect at higher doses.
Indications
Combination formulation. Circadian rhythm disorders (primary indication in lunar residents), jet lag equivalent from long transit, insomnia with circadian component. One of the most important medications for lunar resident wellbeing.
Dosing
Standard (Earth)
See Combination prescribing information. Circadian phase shifting: 0.5-3 mg, timed 2 hours before desired sleep time. Hypnotic effect: 1-5 mg at bedtime.
Lunar Protocol
Low-dose (0.5-1 mg) for circadian entrainment — more effective than high dose for phase shifting. Timing critical: administer at consistent clock time corresponding to habitat "dusk" lighting. 14-day lunar day cycle requires protocol adaptation. Combine with circadian lighting protocol for maximum effect. Long-term use appears safe — no evidence of tolerance or dependence.
Storage
Standard
Room temperature, protect from light.
Lunar (Radiation + Temperature)
Very stable. Radiation shielded (light sensitive compound). 2-year expiry. Maintain large supply — this is a first-line intervention for circadian problems affecting most residents. Immediate-release tablets preferred for circadian use; extended-release for maintenance insomnia.
Supply Chain & Lunar Pharmacy Notes
Available OTC. Inexpensive. Stock generously — high usage expected. Universal prophylactic use in first month of lunar residence may improve adaptation outcomes.
Drug Interactions
CNS depressants (additive sedation). Anticoagulants (may increase INR). Fluvoxamine (dramatically increases melatonin levels).
Contraindications
Autoimmune conditions (theoretical concern). Pregnancy (insufficient data).
Side Effects
Daytime drowsiness if poorly timed. Vivid dreams. Generally excellent tolerability.
Lunar Alternatives
Ramelteon (melatonin receptor agonist, prescription), zolpidem (hypnotic, but habit-forming), cognitive behavioral therapy for insomnia (CBT-I, first-line non-pharmacological).