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- What is modafinil, and how does it work (mechanism of action)?
- What brand names are available for modafinil?
- Is modafinil available as a generic drug?
- Do I need a prescription for modafinil?
- What are the uses for modafinil?
- What are the side effects of modafinil?
- What is the dosage for modafinil?
- Which drugs or supplements interact with modafinil?
- Is modafinil safe to take if I'm pregnant or breastfeeding?
- What else should I know about modafinil?
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 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.
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.
Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More
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.
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).
Reference: FDA Prescribing Information
Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More
Summary
Modafinil (Provigil) is a drug prescribed for the treatment of excessive sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. Side effects, drug interactions, dosing, and pregnancy safety information should be reviewed prior to taking this drug.
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Drug Interactions
Drug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.Hypersomnia
Hypersomnia is a condition where a person has excessive daytime sleepiness and trouble staying awake during the day. Treatment for hypersomnia includes medication, CPAP machines, and lifestyle changes.Kleine-Levin Syndrome
Kleine-Levin syndrome is a rare sleep condition, primarily affecting adolescent males. Symptoms of Kleine-Levin syndrome include recurring but reversible periods "episodes" of excessive sleep. There is no definitive treatment for Kleine-Levin syndrome. Medication can be prescribed to treat sleepiness and episodes.MS (Multiple Sclerosis) Symptoms and Treatments
Multiple sclerosis (MS) symptoms vary from person to person, and can last for days to months without periods of remission. Symptoms of MS include problems with the:
- Bowel
- Bladder
- Eyes (vision)
- Muscles
- Speech
- Swallowing
- Brain and nervous system
- Sexual problems
Treatment options vary depending on the type and severity of symptoms. Medications may be prescribed to manage MS symptoms.
Narcolepsy
Causes of narcolepsy, a chronic disease of the central nervous system, have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include:- excessive daytime sleepiness,
- cataplexy,
- hypnagogic hallucinations,
- sleep paralysis,
- disturbed nocturnal sleep, and
- automatic behavior.
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Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
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When sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can have problem sleepiness without realizing it. Symptoms of problem sleepiness include: consistently don't get enough sleep, or poor quality sleep, fall asleep while driving, struggle to stay awake when inactive (like watching TV or reading), have difficulty paying attention or concentrating at work, school, or home, have poor performance problems at work or school, have difficulty remembering things, have slowed responses, have difficulty controlling your emotions, and/or if you have to take naps on most days.Seasonal Affective Disorder (SAD)
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep, and overeating.Sleep
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:
- Irritability
- Tiredness
- Feeling sleepy during the day
- Concentration or memory problems
Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
Sleep Apnea
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.Sleep Disorders
Learn about the different types of sleep disorders such as insomnia and sleep apnea. Explore the symptoms, causes, tests and treatments of sleep disorders.Take the Sleep Quiz
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