Modafinil

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Induces
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Modafinil, Modasomil; Belgium: Provigil; Cyprus: Modiodal; Czech Republic: Modafinil, Vigil; Denmark: Modiodal; France: Modiodal; Germany: Modafinil, Vigil; Greece: Modiodal; Hungary: Vigil; Ireland: Modafinil, Provigil; Italy: Provigil; Luxembourg: Provigil; Netherlands: Modiodal; Poland: Modafinil, Vigil; Portugal: Modafinil, Modiodal; Slovakia: Modafinil, Vigil; Spain: Modiodal; Sweden: Modafinil, Modiodal; UK: Provigil.

North America

Canada: Alertec, Modafinil; USA: Modafinil, Provigil.

Latin America

Argentina: Forcilin, Intensit, Nopral, Vigicer.

Asia

Japan: Modiodal.

Drug combinations

Chemistry

Modafinil: C~15~H~15~NO~2~S. Mw: 273.35. Acetamide, 2-[(diphenylmethyl)sulfinyl]-. CAS-68693-11-8 (1994).

Pharmacologic Category

Anorexigenic Agents and Respiratory and Cerebral Stimulants, Miscellaneous. (ATC-Code: N06BA07).

Mechanism of action

May exert its stimulant effects by decreasing GABA-mediated neurotransmission (not yet fully evaluated). Also suggested that intact central α-adrenergic system is required for activity of modafinil. Drug increases high-frequency α-waves while decreasing both δ- and θ-wave activity; these effects are consistent with generalized increases in mental alertness.

Therapeutic use

Improve wakefulness in excessive daytime sleepiness associated with narcolepsy and shift work sleep disorder. Adjunctive therapy for obstructive sleep apnea/hypopnea syndrome.

Pregnancy and lactiation implications

Embryotoxic effects observed in some, but not all animal studies. There are no adequate, well-controlled studies in pregnant women. Use only when potential risk of drug therapy is outweighed by benefits of drug. Excretion in breast milk unknown (use caution during lactation).

Unlabeled use

Attention-deficit hyperactivity disorder. Treatment of fatigue in MS and other disorders.

Contraindications

Hypersensitivity to modafinil, armodafinil, or any component of the formulation.

Warnings and precautions

May impair ability to engage in potentially hazardous activities (some patients may not return to normal level of wakefulness). Serious and life-threatening rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis reported. Rare cases of multiorgan hypersensitivity reactions in association with modafinil use and lone cases of angioedema and anaphylactoid reactions with armodafinil reported. Use not recommended in history of angina, cardiac ischemia, recent history of myocardial infarction, left ventricular hypertrophy, or patients with mitral valve prolapse who have developed mitral valve prolapse syndrome with previous CNS stimulant use. Use with caution in hepatic or renal impairment, or in pre-existing psychosis or bipolar disorder (may induce mixed/manic episode). May exacerbate symptoms of behavior and thought disorder in psychotic patients. Use with caution in Tourette’s syndrome (stimulants may unmask tics).

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