Modafinil (Oral)

Modafinil is a stimulant used to treat certain sleep disorders, such as narcolepsy, shift work sleep disorder (SWSD), and obstructive sleep apnea/hypopnea syndrome (OSAHS).

Overview

People with sleep disorders such as these often do not get a restful sleep at night, and therefore can have difficulty staying awake the next day. Modafinil is used to help these people stay alert during the day.

Modafinil is a stimulant drug with effects that can last up to 8 hours. Therefore it should only be taken early in the day, otherwise it might interfere with your ability to get to sleep at night.

People who have heart, kidney, liver or mental health problems will usually not be given modafinil, because it may make these conditions worse. It is also not usually given to people with a history of alcohol or drug abuse, because it can be habit-forming.

This medication may make some medications stop working properly. This includes birth control medications such as pills, injections, and implants. You should use a different form of birth control such as condoms while you are using modafinil.

Modafinil is commonly sold under the brand name Provigil.

Conditions Treated

* Narcolepsy
* Obstructive sleep apnea/hypopnea syndrome (OSAHS)
* Shift work sleep disorder (SWSD)
* Sleep disorders

Type Of Medicine

* Stimulant

Side Effects

As well as its desired effect, modafinil may also cause some undesired side effects. Consult your doctor if you experience any of the following:

* Back pain
* Belching
* Black or tarry stools
* Constipation
* Clumsiness or disorientation
* Diarrhea
* Difficulty urinating
* Dizziness
* Dry mouth
* Dry skin
* Feeling of movement, either of yourself or the environment
* Feinting
* Headaches
* Heartburn or indigestion
* Memory problems
* Muscle pain
* Nasal congestion
* Nausea
* Reduced appetite
* Runny nose
* Sore throat
* Shaking, trembling, or tremors
* Thirst or increased urination
* Tingling or prickling skin
* Ulcers or white spots in the mouth
* Uncontrolled movement in the face, including the mouth and tongue
* Upset stomach
* Vision changes

This medication can cause skin problems that can become quite serious, especially if they become infected or are not treated early. Consult your doctor if you notice any peeling, blistering or sores on the skin.

Modafinil can cause symptoms similar to certain mental health disorders. If you notice any of the side effects listed below, or any other mental problem, stop taking the medication straight away and consult your doctor for further advice:

* Anxiety or nervousness
* Depression, low mood, or emotional instability
* Mania
* Suicidal thoughts

Modafinil can also sometimes cause drowsiness, and symptoms such as:

* Confusion
* Difficulty thinking
* Disorientation
* Dizziness
* Lack of coordination
* Vision problems

You should not drive, operate heavy machinery, or perform any tasks that require concentration when you start taking modafinil, until you are sure that it is safe for you to do so.

This is not an exhaustive list of side effects and modafinil may trigger adverse effects that are not listed here. While you are taking the medication, pay attention to how you feel and how the medication is affecting you. Sometimes side effects are harmless and will disappear on their own after your body becomes accustomed to the drug. However, in other cases, you may need further medical attention. If you notice any unusual side effects, consult your doctor for advice.

Overdose

Modafinil can be dangerous when taken in high doses and it is possible to overdose on this drug. If you notice any of the symptoms of an overdose, seek emergency medical assistance immediately. These include:

* Agitation or excitement
* Very fast or pounding heartbeat
* High blood pressure
* Trouble sleeping

Allergic reaction

Although allergic reactions to modafinil are rare, they can occur. Some people are also allergic to the non-active filler ingredients contained in some medications. Tell your doctor about any medications or other substances that you are allergic to before you start taking this drug.

Modafinil can cause a severe type of allergic reaction called anaphylaxis. You should seek emergency medical assistance if you experience any of the symptoms listed below:

* Breathing problems, including hoarseness, shallow breathing, and wheezing
* Redness, itching, rashes, or hives on the skin
* Severe dizziness, drowsiness, or fatigue
* Swelling anywhere on the body, but especially on the face, tongue, throat or hands

Modafinil, in very rare cases, can also cause allergic reactions that affect body organs, such as the liver, kidneys, or the heart. Contact your doctor without delay if you experience any of the symptoms on the list below:

* Bruising or bleeding, especially if unexpected or unusual
* Chills
* Dark color to the urine
* Fever
* Headaches, especially if they are severe
* Pain in the stomach
* Pain, tightness or other discomfort in the chest
* Tiredness, fatigue or weakness, especially if severe or unexpected
* Yellow coloration to the skin or the eyes

Dosage

Your doctor will prescribe a dose and schedule for taking modafinil that is unique to you, based on the symptoms you are experiencing and other factors such as your body weight and previous experience with similar drugs. Take this medication exactly as your doctor prescribes - do not take it more often or in greater quantities. However, as a general guideline, below are the typical doses of modafinil that are given for different conditions.

For obstructive sleep/hypopnea syndrome or narcolepsy:

* Adults: 200 milligrams (mg) in the morning as a starting dose, which may be increased at a later time according to your response to the medication.
* Children under 17 years: your doctor will determine an appropriate dose.

For shift work sleep disorder:

* Adults: 200 milligrams (mg) around an hour before your shift. Again, your doctor may increase this initial dose depending on your response to it.
* Children under 17 years: your doctor will determine an appropriate dose.

If your prescribed dose does not appear to be having an effect, do not increase the dose yourself. Instead, consult your doctor. They may want to increase your dose of modafinil, or they may want to discuss other options with you.

If you suffer from sleep apnea and you are using a continuous positive airway pressure (CPAP) machine when you go to sleep at night, you should keep using this while you are taking modafinil

It is best to take your dose of modafinil at the same time each day.

If you forget to take one of your doses and it is before 12:00 noon (or at least 10 hours before your usual bedtime if you are a shift worker), take the dose as soon as you remember. If it is after 12:00 noon (or less than 10 hours before your usual bedtime), simply skip the missed dose. The medication stays in your system for a long time, and if you take it too late in the day, you may have trouble getting to sleep that night.

If you miss a dose, do not double your dose the next day to compensate. There is no additional benefit to doing so, and it may interfere with your sleep patterns, or have other negative side effects. Furthermore, modafinil can be habit forming if taken in larger than prescribed amounts.

At the end of your course of treatment with modafinil, you will probably be advised to reduce the dose gradually over a period of time, rather than stopping abruptly. This is because you may experience withdrawal symptoms such as headaches, fatigue, or agitation if you stop taking modafinil abruptly. Do not stop taking your medication unless advised to do so by your doctor.

Interactions

Before you take this drug, you should talk to your doctor about any other medications that you are taking, as well as any vitamin or herbal supplements. Your risk of experiencing adverse side effects may be increased if you take modafinil at the same time as other medications, and modafinil may stop some other medications from working properly. The medications listed below are of particular concern:

* Any medication given for high blood pressure
* Any medication given for liver problems. Certain liver medications can affect the enzymes that would normally remove modafinil from your body, and this can lead to dangerously high levels of modafinil in your system.
* Beta blockers
* Blood thinners such as warfarin

Modafinil can also interfere with how some other drugs are removed from your body, in some cases making these drugs pass through your body more quickly, and in other cases making them stay for longer in your body. These include:

* Certain antidepressants, including clomipramine, desipramine, and selective serotonin reuptake inhibitors
* Cyclosporine
* Diazepam
* Phenytoin
* Propranolol
* Theophylline
* Triazolam

If you are taking any of the above medications, tell your doctor before you begin to take modafinil. In some cases, you may be advised not to take modafinil. In other cases, you may be able to take it, but the dosage of your other medications will be altered, and your doctor will probably want to see you for more frequent check-ups.

Modafinil may stop birth control medications from working properly. This includes birth control pills, injections, implants, patches, intrauterine devices (IUDs, often referred to as 'Å“coil', or vaginal rings. You should employ other forms of birth control while you are taking modafinil, such as condoms, diaphragms, contraceptive jellies, or contraceptive foams.

You should limit your consumption of alcohol during the course of your treatment with modafinil.

Limit your intake of stimulants wherever possible when you are taking modafinil. This includes caffeinated beverages like coffee and cola, some herbal supplements such as ma huang, and some ingredients that are often found in cough and cold remedies, such as ephedra or pseudoephedrine. Street drugs such as amphetamine or methamphetamine should be strictly avoided while you are taking modafinil. Because modafinil itself is a stimulant, the combined effect may cause adverse side effects. It can also be very harmful for you to take a large amount of stimulants. If you have any concerns about this, discuss them with your doctor.

Warnings

Modafinil is generally well-tolerated and is considered safe when taken as your doctor prescribes. However, modafinil can make the symptoms of certain other medical conditions worse. You should discuss your medical history with your doctor before you are prescribed modafinil, to ensure that it is safe for you to take. The following conditions are of particular concern:

* Alcohol or drug abuse. Modafinil may be habit-forming if taken for long periods of time or in high doses, and this is more likely to occur in people with a history of drug or alcohol abuse.
* Angina (chest pain)
* Depression or other emotional or mood disorders
* Heart problems, especially heart disease, heart attack, left ventricular hypertrophy or mitral valve prolapse.
* High blood pressure (hypertension)
* Liver problems including liver disease
* Mania
* Psychosis or schizophrenia

You should also let your doctor know if you have previously had any of these conditions, even if you do not suffer from them at the present time.

In some cases, your doctor may advise you not to take modafinil because the potential side effects could be very harmful to you. In other cases, you may still be prescribed the medication, but your doctor might want to see you more often for checkups, to make sure it is not affecting you in a negative way. If you have another medical condition and the symptoms get worse while you are taking modafinil, contact your doctor right away.

Modafinil can become habit-forming, especially when taken for a long period of time, or if taken in high doses. Consult your doctor if you feel a strong need or desire to keep taking the medication, or to take more of the medication than you have been prescribed to take.

This medication should not be used as a replacement for a good, restful sleep. It should not be used for occasional sleepiness that has not been diagnosed as a sleep disorder. You should continue to manage your sleep condition and work towards using modafinil on as few occasions as possible, for example by ensuring you sleep in a cool, completely dark room. Ask your doctor if you have any questions about getting a good night's sleep.

It is not known whether modafinil is safe for pregnant women to take. Consult your doctor if you are pregnant or plan to become pregnant while you are taking modafinil.

It is also not known whether modafinil can pass to infants via breast milk. If you are breastfeeding, consult your doctor before you take modafinil.

Storage

If modafinil is not stored correctly, the potency or the safety of the medication may be affected. You should observe the following guidelines when you are storing this medication.

Avoid heat: Heat can damage this medication. Store your modafinil tablets away from any sources of heat, such as radiators, heaters, or the stove. Do not store your tablets in the glove compartment of your car, as this location can often become too hot to be suitable for storing medications.

Avoid cold: This medication should be stored at room temperature. Do not refrigerate the tablets, and do not store them in the freezer.

Avoid moisture: Store your tablets in a dry location. Do not store them in the medicine cabinet in your bathroom, as the moisture as well as the heat from the shower may damage them. Also, if your medication came in a bottle containing cotton wool, take this out of the bottle as it can transfer moisture to the tablets.

Avoid sunlight: Keep your medication away from sources of direct sunlight, such as near windows or on the dashboard of your vehicle.

Keep away from children: This medication is potentially harmful if taken by infants and children, so you should store it out of their sight and reach. You should also keep your modafinil tablets in a child-proof container.

Check for damage: Before you take your medication, check it for signs that it has become damage. These signs include chips or cracks in the tablets, changes in color, crumbling tablets, or soft tablets. Do not take any damaged medication as it may be dangerous.

Expiry date: Check the expiry date on the medication before you take it. Do not take any medication that has passed its expiry date.

Observe safe disposal: If your medication has become damaged, or if it has passed its expiry date, ask your doctor or pharmacist for advice on how to dispose of it. Do not throw it away in the trash. Usually you will be advised to take the damaged medication to a local take-back scheme. Your pharmacist will have more details on this.

Summary

Modafinil is a stimulant that promotes wakefulness. It is given to people with sleep disorders so that they can stay awake and alert during the day.

Because modafinil is a stimulant, it should only be taken early in the day. If you take it less than 10 hours before your normal bedtime, you may have trouble getting to sleep.

This medication is not recommended for people with heart, liver, kidney or mental health problems. It can also be habit-forming, especially when taken in high doses, or for long periods of time. For this reason, it is also not recommended for use in people with drug or alcohol abuse problems, or who have a history of these disorders.

Modafinil can make hormonal birth control methods less effective. This includes pills, injections and tablets. You should use alternative forms of birth control while you are taking this medication.