NZ Clears Melatonin for Over‑the‑Counter Sale: Pros, Cons & My Take

On 18 June 2025, New Zealand’s MedSafe approved the sale of melatonin, an over-the-counter (OTC) sleep aid, without a prescription for adults, similar to how Australia and the USA regulate it. Currently, only limited formulations (2 mg modified-release) were available under prescription for adults 55+.

✅ Pros of OTC Melatonin

1. Better access & convenience – Allows adults to address sleep issues like insomnia or jet lag without needing doctor visits or prescriptions. Associate Health Minister David Seymour emphasised that Kiwis were already buying it overseas, so this simply brings access closer to home rnz.co.nz1news.co.nz.
2. Evidence of benefit for some – Studies indicate melatonin can reduce sleep-onset latency and improve subjective sleep quality, particularly in older adults bpac.org.nzbpac.org.nz. Meta-analyses support its use for jet lag and delayed sleep phase syndrome en.wikipedia.org.
3. Safe short-term profile – Side effects are generally mild and uncommon at low doses, common reports include next-day grogginess, headaches, nausea—but overdose risk is low; doses up to 300 mg resulted in minimal serious effects en.wikipedia.orgpmc.ncbi.nlm.nih.gov.

⚠️ Cons & Cautions

1. Not a cure-all – Effectiveness tends to be limited (e.g., only ~6-minute reduction in sleep onset on average, per one review) en.wikipedia.org. Evidence is weaker in adults under 55, shift workers, and non-specific insomnia nzherald.co.nzbpac.org.nz.
2. Risk of dependence on quick fixes – With easier access, there’s a risk people skip proven behavioural sleep strategies. Experts warn melatonin should only follow failed attempts at sleep hygiene or cognitive-behavioural approaches theguardian.compinnaclepractices.co.nz.
3. Quality control varies – Over-the-counter supplements elsewhere often show significant variability in active content or contamination. There is also a concern relating to the purity of supplements. The actual concentration is often unknown in regions like the US, where melatonin is not regulated. A study conducted in 2017 found that out of 31 melatonin supplements, the actual content varied between 83% less and 478% more than what was on the label.
4. Possible side effects & interactions – Though rare, issues like dizziness, mood changes, impaired glucose tolerance (especially if taken after a meal), and drug interactions (e.g. warfarin) are possible en.wikipedia.org.

Behavioral First: A Better Foundation

Sleep experts and pediatricians agree that sleep hygiene, cognitive behavioural therapy for insomnia (CBT‑I), and good routines should be the first-line interventions. For children and neurodivergent populations, behavioral methods often succeed without medication, enabling sustainable sleep habits theguardian.comresearchgate.net. Melatonin is best viewed as an adjunct only after these strategies have been trialed.

My View

Should people take it?
Jury is still out on this one, but thoughtfully and temporarily perhaps. For adults struggling with onset insomnia or jet lag, and who have already tried good sleep hygiene, OTC melatonin can be a low-risk option. It’s an aid, not a band‑aid.

Should it replace professional advice?
Absolutely not. Anyone with persistent sleep issues should be guided by a qualified pharmacist, GP, or sleep therapist to rule out underlying causes (e.g. sleep apnea, mental health conditions) and to structure behavioural interventions like CBT‑I.

My recommendation:

1. Start with behavioral techniques: consistent sleep/wake times, bedtime routines, screen avoidance, caffeine restriction.
2. Trial OTC melatonin only if sleep problems persist after 2–4 weeks of proper routines.
3. Use the lowest effective dose (e.g., 1–3 mg extended-release), taken ~30–60 minutes before bedtime and ideally 2 hours after eating.
4. Seek medical advice if you’re pregnant, breastfeeding, on medications, or have chronic health conditions.

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📌 Bottom Line

Melatonin is a HORMONE. All hormones work in feedback loops. When hormone levels are high – hormone production is inhibited. Taking melatonin will reduce your body’s natural production of melatonin. What’s the long term consequences of this? Who knows – it’s unlikely to be good though. [Dave Liow 28/4/23]

If you are struggling with sleep, let’s take a look at what is going on first. I have a sleep assessment available and sleep is also a compinent of my 6 week group coaching programme so you get plenty of tips on how to maximise your sleep there too.