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NERVOUS SYSTEM › PSYCHOANALEPTICS › PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS › Centrally acting sympathomimetics
modafinil
N06BA07
Forms & Strengths
- Oral tablets: 100 mg
- Oral tablets: 200 mg
Adult Dosing
- Narcolepsy: 200 mg orally once daily in the morning
- Obstructive sleep apnea: 200 mg orally once daily in the morning
- Shift work sleep disorder: 200 mg orally once daily approximately 1 hour before work shift
- Severe hepatic impairment: Reduce dose by 50%
Pediatric Dosing
- Not recommended in pediatric patients under 17 years of age due to risk of serious rash and neuropsychiatric adverse events
Indications
- Improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy
- Obstructive sleep apnea (as adjunct to standard treatment)
- Shift work sleep disorder
Mechanism of Action
- Wake-promoting agent with unclear exact mechanism
- Binds to the dopamine transporter and inhibits dopamine reuptake, increasing extracellular dopamine levels
- May also affect GABA, glutamate, orexin, and histamine neurotransmitter systems
Contraindications
- Known hypersensitivity to modafinil or armodafinil
- History of rash associated with modafinil or armodafinil use
Adverse Reactions
- Headache
- Nausea
- Nervousness
- Rhinorrhea
- Insomnia
- Anxiety
- Dizziness
- Serious skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
Drug Interactions
- CYP3A4/5 inducer: Can decrease concentrations of oral contraceptives, cyclosporine, and midazolam
- CYP2C19 inhibitor: Can increase concentrations of warfarin, omeprazole, and phenytoin
- CYP2C19 inducers (e.g., rifampin) or inhibitors (e.g., ketoconazole) may alter modafinil clearance
- May decrease efficacy of hormonal contraceptives; alternative or barrier methods recommended
Curated Content: Needs Vetting Before Put to Clinical Use