armodafinil (Nuvigil)

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GENERIC NAME: armodafinil


DRUG CLASS AND MECHANISM: Armodafinil is an oral drug that is used to promote wakefulness. It is similar to modafinil (Provigil). Like amphetamines, armodafinil promotes wakefulness by stimuatIng the brain; however, the exact mechanism of action of armodafinil is unknown. Armodafinil 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. The FDA approved armodafinil in June 2007.



PREPARATIONS: Tablets: 50, 150, 250 mg.

STORAGE: Armodafinil should be stored at room temperature, 20-30 C (68-77 F).

PRESCRIBED FOR: Armodafinil is prescribed for improving wakefulness associated with obstructive sleep apnea/hypoapnea syndrome, narcolepsy, and shift work sleep disorder.

DOSING: The recommended dose is 150 or 250 mg every morning or 150 mg daily one hour prior to the work shift.

DRUG INTERACTIONS: Armodafinil 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 as well as increased levels of other drugs that increase their toxicity. Armodafinil treatment should be carefully monitored if taken with any of these drugs.

Drugs which may have reduced effectiveness if taken with armodafinil include cyclosporine (Sandimmune), ethinyl estradiol (Estrace, Climara, Estraderm, Menostar) (present in many birth control pills), midazolam (Versed), and triazolam (Halcion).

Drugs that may show increased effects or toxicity if taken with armodafinil include omeprazole (Prilosec), warfarin (Coumadin), diazepam (Valium), propranolol (Inderal), imipramine (Tofranil), desipramine (Norpramin), clomipramine (Anafranil), phenytoin (Dilantin) and mephenytoin (Mesantoin).

Carbamazepine (Tegretol), phenobarbital, and rifampin (Rifadin) may reduce the action of armodafinil by increasing armodafinil's elimination by the liver. Ketoconazole (Nizoral), itraconazole (Sporanox) and erythromycin may increase the effectiveness of armodafinil by reducing the elimination of armodafinil by the liver.

PREGNANCY: There are no adequate studies in pregnant women. Use of armodafinil during pregnancy has been asociated with decreased fetal development and spontaneous abortion.

NURSING MOTHERS: It is not known whether ararmodafinil is secreted in breast milk.

SIDE EFFECTS: Headache is the most common side effect of ararmodafinil. Other side effects include anxiety, dizziness, diarrhea, dry mouth, insomnia, nausea, fatigue, and rash. Rare side effects include angioedema, difficulty swallowing, bronchospasms, and reversible psychosis.

Reference: FDA Prescribing Information for Nuvigil

Last Editorial Review: 7/27/2010 4:29:10 PM

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