armodafinil (Nuvigil)

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: armodafinil

BRAND NAME: Nuvigil

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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

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

Report Problems to the Food and Drug Administration You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.