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Melatonin Paediatric Product Selection Guide
Principles of using this guide:
• IR/MR formulations: MR formulations are not normally required to aid sleep. IR formulations to help with sleep onset are usually preferred. Specialist must specify if an MR formulation is required.
• Switching MR to IR /IR to MR requires discussion with relevant specialist.
• Products may have different licensed indications, but all are covered within the Amber status (may be used outside the terms of the product licence but not to an extent that a GP would not normally be expected to accept clinical responsibility).
• Preferred products may occasionally not be available due to supply chain issues. In these instances, other options can be used. Refer to SPS – Specialist Pharmacy Service
• Products to be administered via enteral tube will be advised by specialist.
1. Preferred First Line Options (all indications)
| First line choice | Where there are no swallowing difficulties | Where there are swallowing difficulties | Cost per 30 days based on DT June 2025 |
| If Immediate Release formulation required. |
Adaflex® 1mg, 2mg,3mg, 4mg, 5mg (Immediate release) tablets. Please prescribe by brand |
Trial of Adaflex® (crushed and mixed with water) before progressing to Table 2. |
1mg=£10.89 2mg=£10.89 3mg=£10.89* 4mg= £10.89 5mg=£10.89 |
| If Modified Release formulation required (MR must be specified by specialist) |
Melatonin M/R 2mg tablets. Prescribe generically |
Progress to Table 2. | 2mg=£2.71 4mg=£5.42 6mg=£8.13 |
2. Products which are recommended for Limited Use Only
| Products which are recommended for Limited Use Only |
Rationale | Cost per 30 days based on DT June 2025 |
| Licensed melatonin 1mg/ml sugar free oral solution
On dispensing community pharmacists MUST consider the product’s excipient content e.g. propylene glycol as some |
Use ONLY if: • Adaflex® (crushed and mixed with water) is not tolerated. |
1mg =£3.75 2mg =£7.50 3mg =£11.26 4mg =£15.01 5mg =£18.76 6mg =£22.51 |
| Slenyto® M/R 1mg, 5mg tablets. | Slenyto® is more expensive than Melatonin MR 2mg tablets Use a trial of Slenyto® ONLY if: • M/R is considered essential and patient cannot tolerate swallowing melatonin M/R 2mg tablets |
1mg=£16.48 2mg =£32.96 3mg =£49.44 4mg =£65.92 5mg=£82.40 6mg =£98.88 |
3. Products that are not recommended for use
| • Melatonin capsules (as much more expensive than tablets). • Colonis liquid in children under 5 years (as contains propylene glycol). • Ceyesto® liquid in children under 6 years (as contains propylene glycol and benzyl alcohol) • Melatonin 2mg/ml oral solution (as not licensed for use in children and contains propylene glycol) • Unlicensed melatonin formulations |
4. Additional references
This advice does not override or replace the individual responsibility of health professionals to make appropriate decisions in the circumstances of their individual patients, in consultation with the patient and/or guardian or carer. Product information is correct at the time of publishing
Version 1.2 (June 2025)
Date prepared – June 2025
Review date- June 2028