Melatonin Use in Primary Care: Clinical Evidence, Safety Considerations, and Practical Guidance for Family Physicians

Melatonin is one of the most widely used over-the-counter sleep aids in the United States. Patients frequently self-initiate therapy, often without clinician guidance regarding appropriate dosing, indications, safety, or potential drug interactions. This narrative review summarizes current clinical evidence regarding melatonin’s pharmacology, efficacy across age groups, safety profile, adverse effects, drug interactions, long-term use, cardiovascular considerations, and the role of behavioral therapies for insomnia. Practical recommendations are provided to assist family physicians in counseling patients and making evidence-informed decisions regarding melatonin use.