The recommended dose is mg PO once daily as a single dose in the morning. For elderly patients, consideration of a lower initial dose is recommended, with careful monitoring. For geriatric patients, consideration should be given to the use of lower initial doses and close monitoring. For the geriatric patient, consider use of lower initial doses with close monitoring. For obstructive sleep apnea, modafinil is indicated to improve wakefulness in patients with excessive sleepiness and not as treatment for the underlying obstruction. If continuous positive airway pressure CPAP is the treatment of choice for a patient, a maximal effort to treat with CPAP for an adequate period of time should be made prior to initiating modafinil for excessive sleepiness. Initiate at mg PO once daily in the morning.

Common side effects include headache, anxiety, trouble sleeping, and nausea. Modafinil was approved for medical use in the United States in Modafinil is a eugeroic used for treatment of narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea. For obstructive sleep apnea, it is recommended that continuous positive airway pressure be appropriately used before considering starting modafinil to help with daytime sleepiness. Armed forces of several countries, including the United States, the United Kingdom, India and France, have expressed interest in modafinil as an alternative to amphetamine —the drug traditionally employed in combat situations or lengthy missions where troops face sleep deprivation.

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Modafinil is a racemic compound. Modafinil has wake-promoting actions like sympathomimetic agents including amphetamine and methylphenidate, although the pharmacologic profile is not identical to that of sympathomimetic amines. Modafinil is not a direct- or indirect-acting dopamine receptor agonist and is inactive in several in vivo preclinical models capable of detecting enhanced dopaminergic activity. In a preclinical model, the wakefulness induced by amphetamine, but not modafinil, is antagonized by the dopamine receptor antagonist haloperidol. Modafinil does not appear to be a direct or indirect alpha 1 -adrenergic agonist. Although modafinil-induced wakefulness can be attenuated by the alpha 1 -adrenergic receptor antagonist, prazosin, in assay systems known to be responsive to alpha -adrenergic agonists, modafinil has no activity. Unlike sympathomimetic agents, modafinil does not reduce cataplexy in narcoleptic canines and has minimal effects on cardiovascular and hemodynamic parameters. In addition to its wakefulness-promoting effects and increased locomotor activity in animals, in humans, PROVIGIL produces psychoactive and euphoric effects, alterations in mood, perception, thinking, and feelings typical of other CNS stimulants. Modafinil is reinforcing, as evidenced by its self-administration in monkeys previously trained to self-administer cocaine; modafinil was also partially discriminated as stimulant-like. At steady state, total exposure to the l -isomer is approximately three times that for the d -isomer.

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This includes narcolepsy, sleep apnea, and shift work sleep disorder. Strength: MG. Color: White. Shape: Oblong. Shape: Oval. Shape: Round.

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Indicated to improve wakefulness in adults with excessive sleepiness associated with shift work disorder SWD. Risk of skin reactions eg SJS, toxic necrolysis, and drug rash with eosinophilia and systemic symptoms ; discontinue if rash or other hypersensitivity reactions occur. Not recommended in patients with angina, cardiac ischemia, recent history of myocardial infarction, left ventricular hypertrophy, or mitral valve prolapse. Use with caution in severe hepatic impairment, elderly, history of: depression, psychosis may exacerbate psychiatric symptoms, or mania. May reduce effectiveness of steroidal contraceptives 1 month after discontinuation of drug therapy. Unknown; not sympathomimetic; may increase dopamine levels in the brain by binding to the dopamine transporter and inhibiting dopamine reuptake.

Aka: Modafinil, Provigil. Patients should address specific medical concerns with their physicians. Mental Health. Pharmacology Chapter. Obstetrics Neuropsychiatric Medications in Pregnancy. Mechanism Stimulant.

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Indicated to improve wakefulness in adults with excessive sleepiness associated with shift work disorder SWD. Prior Authorization Drugs that require prior authorization.

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Modafinil is indicated in adults for the treatment of excessive provigil 200 mg tablet associated with narcolepsy with or without cataplexy. Excessive sleepiness is defined as difficulty maintaining wakefulness and an increased likelihood of falling asleep in inappropriate situations. Treatment should be initiated by or under the supervision of a physician with appropriate knowledge of indicated disorders see section 4. The recommended starting daily dose is mg. The total daily dose may be taken as a single dose, one in the morning or as two doses in the morning and at one noon, according to physician assessment of the patient and the patient's response. Doses of up to mg in one or two divided doses can be used in patients with insufficient response to the initial mg modafinil dose.

Provigil may be used alone or with provigil 200 mg tablet medications. Modafinil is a racemic compound. It is sparingly to slightly soluble in methanol and acetone. Consideration should be given to the use of lower doses and close monitoring in geriatric patients see Use in Specific Populations. NDC — Bottles of North Wales, PA

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