What is the recommended dosing for Circ (circadian rhythm medication) in a patient with unknown demographics and medical history?

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Circadian Rhythm Medication Dosing

I cannot provide specific dosing recommendations because "Circ" is not a recognized medication name in the available evidence or standard pharmacological references.

Clarification Needed

The term "Circ" does not correspond to any approved circadian rhythm medication in current clinical practice. If you are referring to a medication for circadian rhythm sleep-wake disorders, the most likely candidates based on the available evidence are:

Tasimelteon (Hetlioz)

For Non-24-Hour Sleep-Wake Disorder, the FDA-approved dosing is 20 mg taken orally one hour before bedtime at the same time every night, without food. 1

  • Administration timing is critical: Take at the same time every night to maintain circadian alignment 1
  • Take without food to ensure proper absorption 1
  • If a dose is missed: Skip that dose and resume the next scheduled dose—do not double up 1
  • Onset of effect: Drug effect may not occur for weeks to months due to individual differences in circadian rhythms 1

Important Clinical Considerations

Avoid combining tasimelteon with strong CYP1A2 inhibitors (e.g., fluvoxamine) due to potentially large increases in drug exposure and adverse reactions. 1

Avoid combining with strong CYP3A4 inducers (e.g., rifampin) as they significantly decrease tasimelteon exposure and reduce efficacy. 1

Beta-adrenergic receptor antagonists (e.g., metoprolol, acebutolol) may reduce tasimelteon efficacy when administered at night, as they inhibit melatonin production via beta-1 receptor blockade. 1

Common Adverse Effects

  • Headache (17% vs 7% placebo) 1
  • Elevated alanine aminotransferase (10% vs 5% placebo) 1
  • Nightmares/abnormal dreams (10% vs 0% placebo) 1
  • Somnolence warning: Limit activity to preparing for bed after taking tasimelteon, as it can impair mental alertness 1

Alternative Interpretation

If "Circ" refers to a different medication or abbreviation used in your institution, please provide the complete medication name for accurate dosing guidance. The American Academy of Sleep Medicine guidelines address circadian rhythm disorders with light therapy, melatonin, and behavioral interventions, but "Circ" as a standalone medication name does not appear in published guidelines 2, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Circadian Rhythm Sleep-Wake Disorders: a Contemporary Review of Neurobiology, Treatment, and Dysregulation in Neurodegenerative Disease.

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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