modafinil


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modafinil

 [mo-daf´ĭ-nil″]
a central nervous system stimulant used in the treatment of narcolepsy.

modafinil

Alertec (CA), Apo-Mofafinil (CA), Provigil

Pharmacologic class: Nonamphetamine CNS stimulant

Therapeutic class: Analeptic

Controlled substance schedule IV

Pregnancy risk category C

Action

Unknown. Thought to stimulate CNS by decreasing the release of gamma-aminobutyric acid (a CNS depressant), thereby increasing mental alertness.

Availability

Tablets: 100 mg, 200 mg

Indications and dosages

Narcolepsy

Adults: 200 mg/day P.O. as a single dose in morning

Dosage adjustment

• Severe hepatic impairment

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:

• recent myocardial infarction, unstable angina, severe hepatic impairment, hyperthyroidism, hypertension, glaucoma, anxiety

• history of left ventricular hypertrophy, ischemic ECG changes, chest pain, arrhythmias, or mitral valve prolapse with previous CNS stimulant use

• history of psychosis

• drug abuse

• pregnant or breastfeeding patients

• children (safety and efficacy not established).

Administration

• Give without food (food delays drug absorption).

Adverse reactions

CNS: headache, dizziness, nervousness, insomnia, depression, anxiety, amnesia, tremor, emotional lability

CV: hypertension, chest pain, vasodilation, hypotension, syncope, arrhythmias

EENT: abnormal vision, amblyopia, epistaxis, rhinitis, pharyngitis

GI: nausea, vomiting, diarrhea, dry mouth, anorexia

GU: abnormal urine, urinary retention, albuminuria, abnormal ejaculation

Hematologic: eosinophilia

Metabolic: hyperglycemia

Musculoskeletal: joint disorders, neck pain and rigidity

Respiratory: lung disorder, dyspnea, asthma

Skin: dry skin

Other: fever, chills, herpes simplex infection

Interactions

Drug-drug. Carbamazepine, phenobarbital, rifampin, other CYP3A4 inducers: decreased modafinil blood level

Cyclosporine, theophylline: decreased blood levels of these drugs

Diazepam, phenytoin, propranolol, tricyclic antidepressants, warfarin: increased blood levels of these drugs

Hormonal contraceptives: decreased contraceptive efficacy

Itraconazole, ketoconazole, other CYP3A4 inhibitors: increased modafinil blood level

Methylphenidate: delayed modafinil absorption

Drug-diagnostic tests. Aspartate aminotransferase, eosinophils, gamma-glutamyl transferase, glucose: increased levels

Hepatic enzymes: abnormal levels

Patient monitoring

• Monitor respiratory and cardiovascular status, including vital signs and ECG.

• Monitor neurologic status, including mood, motor function, cognition, and emotional lability.

• Monitor blood glucose level in diabetic patient.

• Monitor patient carefully if he is also receiving MAO inhibitors. (However, interaction studies with MAO inhibitors haven't been done.)

Patient teaching

• Tell patient he may take with or without food, but that food may delay drug absorption up to 1 hour.

Advise patient to immediately report chest pain, irregular heart beats, light-headedness, or fainting.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, motor function, and alertness.

• Instruct female patient to use reliable nonhormonal contraception during and for 1 month after therapy.

• Tell diabetic patient to monitor blood glucose level closely and stay alert for hyperglycemia.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

modafinil

(mə-dăf′ə-nĭl)
n.
A nonamphetamine stimulant drug that causes long-lasting wakefulness, used to treat patients with narcolepsy and other disorders.

modafinil

Provigil® Neurology A nonamphetamine antinarcoleptic used as a 1st-line treatment of excess daytime sleepiness in narcolepsy. See Narcolepsy.

modafinil

A non-amphetamine (amfetamine) nervous system stimulant used to treat NARCOLEPSY and sleep apnoea. Modafinil is an ampakine that boosts the activity of the neurotransmitter glutamate. It is being widely used by people with reasons to wish to remain awake and alert. A brand name is Provigil.
References in periodicals archive ?
The app tells me that I can now buy 30 pills of the modafinil for $40.34 at a grocery store pharmacy that is 2.7 miles from my office or for $305.50 at Walgreens, 3.6 miles away.
In head-to-head trials, clinicians' ratings favored amphetamines over modafinil, atomoxetine, and methylphenidate in children, adolescents, and adults.
However, multiple case reports have been published which have demonstrated modafinil induced mania at various dosages in patients with bipolar disorder [9-13].
La apertura de la muestra B era el primer paso para iniciar su defensa, pues dias antes la Federacion Internacional de Esgrima (FIE) le comunico que en su muestra de orina A, tomada en el Campeonato Panamericano de Panama, se encontro modafinil, una sustancia prohibida por la Agencia Mundial Antidopaje (WADA).
Stimulants: This includes your standard caffeine, nicotine and more recently the new and soon to be discussed Modafinil. They all increase alertness, increase wakefulness and increase functional IQ but without major side effects, which can be felt without agents.
17% Stop sertraline and start modafinil, 200 mg/d, and encourage Ms.
The remaining trials focused on caffeine and two drugs, modafinil and armodafinil, that are prescribed for sleepiness during night shifts.
Modafinil, marketed as Provigil in the US, is a prescription-only drug used to improve wakefulness in those who suffer from sleep disorders like narcolepsy.
The two drugs most beneficial as adjunctive therapy for these patients are modafinil (Provigil) and armodafinil (Nuvigil).
WASHINGTON -- The Food and Drug Administration has decided that Teva Pharmaceuticals USA is sole first-to-file company for both Orange Book patents listed for Provigil (modafinil) and that the company's Abbreviated New Drug Application (ANDA) is entitled to 180-day exclusivity.
The Commission determined that the two groups have a similar generic drug based on the same active ingredient as Provigil, namely modafinil, and that competition on the generic drug markets where modafinil is sold could be hampered.
The EC asked Teva to sell Cephalon's marketing authorisation of generic modafinil in France and allow further rights to the buyer in the European economic area, the firms said.