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(ar-mo-daf-i-nil) ,


(trade name)


Therapeutic: central nervous system stimulants
Pregnancy Category: C


To improve wakefulness in patients with excessive daytime drowsiness due to narcolepsy, obstructive sleep apnea/hypopnea syndrome and shift work disorder.


Produces CNS stimulation.

Therapeutic effects

Improved wakefulness.


Absorption: Readily absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized (partially by the CYP3A4 enzyme system; <10% excreted in urine).
Half-life: 15 hr.

Time/action profile (blood levels)

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Contraindicated in: Hypersensitivity to modafinil or armodafinil.
Use Cautiously in: Concurrent alcohol ingestion; History of drug abuse, especially history of stimulant abuse; Severe hepatic impairment (↓ dose recommended); Recent MI or unstable angina; Geriatric: Blood levels may by ↑ due to ↓ clearance (lower dose may be necessary); Obstetric / Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • suicidal ideation (life-threatening)
  • dizziness (most frequent)
  • headache (most frequent)
  • insomnia (most frequent)
  • aggression
  • anxiety
  • delusions
  • hallucinations
  • mania


  • ↑ BP


  • nausea (most frequent)
  • dry mouth


  • Stevens-Johnson SYndrome (life-threatening)
  • rash


  • multi-organ hypersensitivity (life-threatening)
  • allergic reactions including anaphylactoid reactions and angioedema (life-threatening)


Drug-Drug interaction

Since armodafinil is partially metabolized by the CPY3A4 enzyme system, concurrent use of drugs that induce the CYP3A system, including carbamazepine, phenobarbital, and rifampin may ↓ levels and effectiveness. Concurrent use of drugs that inhibit the CYP3A system, including ketoconazole and erythromycin may ↑ levels and effectiveness.Armodafinil also induces the CYP3A system and may ↓ effectiveness of hormonal contraceptives (additional or alternative methods recommended, cyclosporine (dose adjustment may be necessary, midazolam and triazolam (excess sedation may occur, dose ↓ may be necessary).Armodafinil also inhibits the CYP2C19 system and may ↑ effects of phenytoin, diazepam, propranolol, omeprazole, and clomipramine (dose ↓ and monitoring for toxicity recommended).Use cautiously with MAO inhibitors and other CNS stimulants.


Oral (Adults) Obstructive sleep apnea/hypopnea syndrome and narcolepsy—150–250 mg once daily in the morning; Shift work sleep disorder—150 mg once daily one hour before start of work.

Availability (generic available)

Tablets: 50 mg, 150 mg, 250 mg

Nursing implications

Nursing assessment

  • Observe and document wakefulness and frequency of narcoleptic episodes.
  • If concurrent CPAP is used, assess CPAP adherence periodically during therapy.
  • Assess for psychiatric symptoms (mania, delusions, hallucinations, suicidal ideation, aggression) periodically during therapy; may require discontinuation.
  • Monitor BP periodically during therapy.

Potential Nursing Diagnoses

Disturbed thought process (Indications)
Deficient knowledge, related to disease process and medication regimen (Patient/Family Teaching)


  • Oral: Administer as a single dose in the morning.
    • If used for shift work disorder, take daily dose 1 hr prior to start of work shift.

Patient/Family Teaching

  • Instruct patient to take medication as directed. Advise patients that level of wakefulness may not return to normal. If used as an adjunct to CPAP, encourage patient to continue to use CPAP and other modalities. Inform patient that armodafinil does not take the place of getting enough sleep. Instruct patient to read Patient Information Leaflet prior to therapy.
  • Advise patient that sharing this medication with others, even those with the same symptoms, is dangerous and illegal.
  • Medication may impair judgment. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Instruct patient to notify health care professional immediately if rash, hives, mouth sores, blisters, peeling skin, swelling of face, eyes, lips, tongue, or throat, trouble swallowing or breathing, hoarse voice, or other allergic reactions occur. Patients should also notify health care professional if depression, anxiety, hallucinations, mania, thoughts of suicide or other mental problems (mania, delusions, hallucinations, suicidal ideation, aggression), or heart problems, including chest pain, occur.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications. Advise patient to avoid alcohol use during therapy.
  • Advise patient to use nonhormonal methods of contraception during and for 1 mo following discontinuation of therapy. Instruct patient to notify health care professional promptly if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Decrease in narcoleptic symptoms and an enhanced ability to stay awake. Evaluate effects of therapy periodically to determine long term usefulness.
Drug Guide, © 2015 Farlex and Partners
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References in periodicals archive ?
Concomitant use of esketamine and psychostimulants (ie, amphetamines, methylphenidates, modafinil, and armodafinil) may increase blood pressure.
The long-term tolerability and efficacy of armodafinil in patients with excessive sleepiness associated with treated obstructive sleep apnea, shift work disorder, or narcolepsy: an open-label extension study.
Armodafinil (Nuvigil), used for excessive sleepiness associated with narcolepsy and other sleep disorders, is being studied in the Nuvigil Pregnancy Registry (866-404-4106).
There are few recommendations for the pharmacological management of EDS in PD, as few multicenter clinical trials have been conducted in this area.[66],[67] A Movement Disorder Society evidence-based medicine review concluded that there was insufficient data to recommend any specific drug for the long-term treatment of EDS in PD patients.[68] Limited data exist for the use of wakefulness-promoting agents such as modafinil and armodafinil or stimulants such as methylphenidate or dextroamphetamines.
The MCCB scores of other drugs such as AL-108, Armodafinil, MK0777 and Pregnenolone showed no significant differences between the drug-treated group and the control group.
The researchers found that armodafinil did not improve the driving performance of those with ?obstructive sleep apnea?
Armodafinil. Because armodafinil has a longer half-life than modafinil, we may predict its better effect at treating patients with excessive daytime sleepiness [48].
Ketter, "Efficacy and safety of adjunctive armodafinil in adults with major depressive episodes associated with bipolar I disorder," Journal of Clinical Psychiatry, pp.
Mustian, PhD, MPH, and colleagues recently published a meta-analysis comparing the four most common CRF treatments: exercise (aerobic and/or anaerobic), psychological (cognitive behavioral or psychoeducational), combined exercise and psychological, and pharmaceutical (methylphenidate, modafinil, armodafinil, or paroxetine).
A few other recent launches include: Clindamycin Palmitate Hydrochloride, a generic version of Cleocin solution; Doxycycline Hyclate delayed-release tablets, a generic version of Doxteric; Armodafinil tablets, a generic version of Nuvigil; and Frovatriptan Succinate tablets, a generic version of Frova tablets.
Modafinil ve armodafinil: Gun icinde ve gece vardiyasi esnasinda uyanikligi, dikkati ve bilissel kapasiteyi artirmak icin 300 mg/gun dozunda modafinil ve 150 mg/gun dozunda armodafinil ile amfetamin gibi cesitli santral sinir sistemi uyaricilari vardiyadan bir saat once olacak sekilde kullanilabilir (36,37).
He is proposing that the Food and Drug Administration produce the non-narcotic wakefulness-promoting agents modafinil and armodafinil as part of 'harm reduction' measures.