What is modafinil, and how does it work (mechanism of action)?
Modafinil is an oral drug that is used for
improving wakefulness in patients with excessive sleepiness. It is similar to
armodafinil (Nuvigil). Like amphetamines, modafinil promotes wakefulness by
stimulatIng the brain. The exact mechanism of action of modafinil is unknown. It
may work by increasing the amount of dopamine (a chemical neurotransmitter that
nerves use to communicate with each other) in the brain by reducing the reuptake
of dopamine into nerves. Modafinil was approved by the FDA in December 1998.
What brand names are available for modafinil?
Provigil
Is modafinil available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for modafinil?
Yes
What are the side effects of modafinil?
The most common side effects of modafinil include:
- headache,
- upper respiratory tract infection,
- nausea,
- nervousness,
- anxiety, and
- insomnia.
What are the uses for modafinil?
Modafinil is used to promote wakefulness in patients
with excessive sleepiness associated with narcolepsy,
obstructive sleep apnea
(in addition to treatment of the underlying obstruction), and shift work sleep
disorder. Narcolepsy is a chronic disease of the brain and spinal cord
characterized most commonly by a recurrent, uncontrollable desire to sleep.
Shift work sleep disorder is a condition in which the normal rhythm of sleep is
disturbed, often as a result of working at night. Sleep apnea is a condition
where sleep is constantly interrupted at night because of pauses in breathing or
shallow breathing usually due to obstruction of the upper airway.
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What is the dosage for modafinil?
The recommended dose is 200 mg once daily not to exceed 400
mg. It should be administered in the morning for treating narcolepsy or
obstructive sleep apnea, and one hour prior to work in those with shift work
disorder. It can be taken with or without food. The 400 mg dose may not be more
effective than the 200 mg dose.
Which drugs or supplements interact with modafinil?
Modafinil can decrease or increase the activity of
enzymes in the liver that metabolize (eliminate) other drugs. This can result in
decreased levels of some drugs that reduce their effectiveness and increased
levels of other drugs that leads to their toxicity. Modafinil treatment should
be carefully monitored if taken with any of these drugs. Drugs which may have
reduced effectiveness if taken with modafinil include cyclosporine (Sandimmune),
theophylline, and
hormonal contraceptives such as progestin-only or estrogen and
progesterone containing drugs (for example, Micronor, Ortho-Novum 1/50).
Alternative hormonal contraceptives or an additional non-drug form of
contraception should be considered during treatment with modafinil, and
treatment should continue for one month after modafinil therapy ends (since the
effects of modafinil on contraceptive hormones may continue for several weeks).
The effects of modafinil on hormonal contraceptives occurs if the hormones are
taken by mouth, patch, or implant.
Drugs that may show increased effects or
toxicity if taken with modafinil include warfarin (Coumadin), diazepam (Valium),
propranolol (Inderal), imipramine (Tofranil), desipramine (Norpramin), phenytoin
(Dilantin) and mephenytoin (Mesantoin).
Some other drugs that may increase the
effectiveness and/or toxicity of modafinil. These drugs include carbamazepine (Tegretol),
phenobarbital, and rifampin (Rifadin).
Other drugs, such as ketoconazole (Nizoral)
and itraconazole (Sporanox) may reduce the effectiveness of modafinil.
Methylphenidate may delay the action of modafinil.
The effect of alcohol on modafinil has not been adequately evaluated. Alcohol probably should be avoided
while taking modafinil.
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Is modafinil safe to take if I’m pregnant or breastfeeding?
There are no adequate studies that assess effects of
modafinil in pregnant women. Intrauterine growth retardation and spontaneous
abortion have been reported.
It is not known if modafinil is excreted in human milk.
What else should I know about modafinil?
What preparations of modafinil are available?
Tablets: 100 and 200 mg.
How should I keep modafinil stored?
Modafinil should be stored at room temperature, 15 C – 30 C (59 F – 86 F).