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Modafinil acts as a wakefulness-promoting agent. It is primarily used to treat conditions such as narcolepsy which causes excessive daytime sleepiness. Modafinil drug is also used for Obstructive Sleep Apnea, a condition that involves repeated airway blockages during sleep. Additionally, it can treat work sleep disorder, a circadian rhythm disorder causing insomnia and excessive sleepiness. Unlike traditional stimulants, Modafinil presents a lower potential for abuse and dependence, which makes it a great option for enhancing alertness and cognitive function.
Mechanism Of Action Of Modafinil:
Although the exact mechanism of action is unclear, in studies it is found that it influences in several ways.
Dopamine and norepinephrine reuptake: It inhibits the reuptake of dopamine and norepinephrine in the hypothalamus region of our brain.
Orexinergic neurons: It increases the levels of dopamine and norepinephrine by activating orexinergic neurons in the brain.
Histaminergic system: It reduces the inhibitory input of GABAergic neurons and indirectly activates the histaminergic system.
It also decreases GABA-medicated neurotransmission, which has stimulant effects on the person. As it gets absorbed quickly after taking it orally, it starts metabolizing in the liver and is eliminated from the body with a half-life of about 15 hours.
All these modulations promote wakefulness and enhance cognitive functions without causing the jitteriness commonly associated with other stimulants.
Drug Composition:
The chemical name for modafinil is 2-[(diphenylmethyl)sulfinyl]acetamide.
It usually comes in two variants i.e. Modafinil 100 mg and Modafinil 200 mg.
Each 100 mg tablet contains:
Active Ingredient: Modafinil
Inactive Ingredients: Includes 113.500 mg lactose monohydrate, microcrystalline cellulose, magnesium stearate, Croscarmellose sodium, and Povidone (K-30).
Each 200 mg tablet contains:
Active Ingredient: Modafinil
Inactive Ingredients: Includes 227.000 mg lactose monohydrate, microcrystalline cellulose, magnesium stearate, Croscarmellose sodium, and Povidone (K-30).
Modafinil Uses:
Modafinil is indicated for:
- Narcolepsy: A chronic sleep disorder characterized by excessive daytime sleepiness.
- Obstructive Sleep Apnea: To improve wakefulness in patients who experience excessive sleepiness despite treatment.
- Shift Work Sleep Disorder: For individuals who work non-traditional hours and experience sleep disruptions.
Recommended Dosage For Modafinil:
Narcolepsy: The typical starting dose is 200 mg of Modafinil for ADHD once daily in the morning.
Obstructive Sleep Apnea: The dose starts with 200 mg per day and could go up to 400 mg, however, no consistent evidence for additional benefit at 400 mg/day dose has been found.
Shift Work Sleep Disorder: Take 200 mg about one hour before the start of the work shift.
This is for adults and teenagers older than 16 years of age. Your doctor may increase your dose as needed
Modafinil Overdose & Missed Dose:
If you ever miss a dose by accident, take it as soon as you remember, unless it’s close to the next scheduled dose. Do not double up on doses just to catch up. Also avoid taking the missed dose near to your bedtime, doing so might disrupt your sleep cycle. Take your next dose at the regular scheduled interval.
An overdose may lead to symptoms such as severe headache, dizziness, nausea, passing out, agitation or excitement, fast and pounding heartbeat, increased blood pressure, hallucinations, diarrhea, trouble sleeping, or trouble breathing. Call 911 and seek immediate medical attention if an overdose is suspected and try to stick to your prescribed dose for better results, it can help to avoid all such complicated situations.
Potential Side Effects of Modafinil Drug:
Common Side Effects
- Fever
- Dark urine
- Jaundice
- Headache
- Nausea
- diarrhea
- Dizziness
- Insomnia
- Dry mouth
- Nervousness
- Trouble sleeping
- Trouble swallowing
- Swelling in legs
- Shortness of breath
Serious Side Effects
Seek immediate medical attention for serious reactions such as:
- Fast, irregular heartbeat
- Hallucinations
- Increased blood pressure
- Sore throat, fever, or chills
- Tremors
- vomiting
- Severe allergic reactions (e.g., rash, itching)
- Chest pain or palpitations
- Mental health changes (e.g., anxiety, depression)
- Uncontrolled movements of the face, mouth, or tongue
- Unusual bleeding or bruising
- Unusual tiredness or weakness
Modafinil Interactions:
Modafinil drug class can interact with various medications in various ways. It’s essential to inform your physician about all medications being taken. Notable interactions include:
-
- Oral Contraceptives: Modafinil may reduce the effectiveness of hormonal birth control such as pills, patches, or rings. Which could lead to unwanted pregnancy.
- Antidepressants: Some may have altered effects when combined with Modafinil.
- Abilify (aripiprazole): Modafinil decreases blood levels, making aripiprazole less effective.
- Anticonvulsants: These may require dosage adjustments.
- Caffeine: Increases the side effects of this medication.
- Hypertension: As CNS stimulants increase blood pressure and heart rate, the use might contradict medications related to hypertension.
- MAO Inhibitors: Increases the risk of side effects from Modafinil and MAOIs.
- Some Antifungals: Increase the risk of side effects.
- Certain HIV drugs: Can make Modafinil less effective.
- Macrolides (Antibiotics): Increases the risk of side effects from Modafinil.
-
- Blood Thinners: Modafinil can affect the workings of blood thinner like warfarin
- Corticosteroids: When combined with corticosteroids like prednisone, it can worsen the side effects of the steroids.
- Proton Pump Inhibitors (PPIs): If you use PPIs like omeprazole for acid reflux, modafinil can reduce its effectiveness.
Warnings and Precautions:
While using this medication, there are several important warnings you should be aware of.
- Monitor for any unusual skin reactions, as this medication has caused serious skin reactions in the past. Be alert for potential allergic reactions such as rash, itching, or swelling, as these can sometimes lead to serious consequences. If you have a history of heart problems, consult your doctor before using this medication, as there are some serious cardiovascular risks associated with it.
- Be cautious about the potential for its misuse and psychological dependency, especially if you take doses higher than the prescribed amount over a prolonged period.
- If you have any kind of liver-related issues, you may need to lower your dose to avoid adverse effects, as this medication can pose risks for those with renal and hepatic impairments. Also, be aware that mood changes such as increased anxiety, agitation, or depressive symptoms have been reported in the past while using Modafinil. Finally, if you have a history of seizures, this medication may increase your risk.
so it is essential to discuss all these warning signs with your doctor thoroughly.
Precautions While Using Modafinil:
Before taking a Modafinil tablet make sure it is safe for you, talk to your doctor if you have:
- A history of heart-related issues such as an enlarged heart, heart attack, irregular heartbeat, etc.
- Monitor your heart rhythm closely if you have a history of arrhythmias.
- Do not stop consuming Modafinil suddenly, as this could lead to withdrawal symptoms.
- Avoid the use of Modafinil during pregnancy unless directed by your physician; it may affect fetal development.
- Make sure if you are allergic to Modafinil or armodafinil
- Angina (chest pain)
- Problems related to the liver, like Cirrhosis
- Kidney related disease
- If you are having surgery, including dental surgery.
- A history of mental health disorders such as depression, mania, or psychosis.
- History of alcoholism or drug addiction
- Avoid driving or any task that requires alertness in the beginning period of modafinil use.
- Tell your doctor about all the prescribed/non-prescribed medications, vitamins, nutrition supplements, and herbal products you are using or planning to use while using modafinil.
Storage and Disposal Of Modafinil Tablet:
Storage Guidelines
Room Temperature: Store it at room temperature, and avoid extreme temperatures to maintain the medication’s effectiveness.
Moisture and Heat: Keep it away from direct moisture and heat sources. It can compromise the integrity of the tablets.
Child safety: Always store Modafinil out of reach of children to prevent accidental ingestion.
Original Container: It is best practice to keep the medication in its original container, as it is designed to keep it safe from unwanted heat and moisture.
Expiration Date: Check the expiration date of the medication regularly. If it is past this date, it is important to dispose of it safely.
Disposal Methods
Safely dispose of unused or expired Modafinil by mixing it with an undesirable substance and sealing it in a container. Utilize drug take-back programs when available.
Alternatives
If you are looking for alternatives to Modafinil for similar conditions, options include:
- Armodafinil: A closely related compound that promotes wakefulness.
- Amphetamines: Traditional stimulants used for ADHD and narcolepsy.
- Caffeine: A small dose of Caffeine can be as effective as Modafinil in maintaining alertness.
- Adderall: A CNS stimulant with a similar mechanism but comes with a higher risk of abuse.
- Lumryz: A CNS depressant used for treating excessive daytime sleepiness (EDS) in adults with narcolepsy.
- Sunosi: Not a stimulant, used for improving wakefulness in adults with narcolepsy or OSA.
Frequently Asked Questions (FAQ)
How long does Modafinil last?
Modafinil usually lasts for 12 to 15 hours after administration.
How to get a Modafinil prescription?
Consult with a Healthcare provider and discuss symptoms and medical history.
Modafinil Vs Adderall, Which one is the better choice?
While both are CNS stimulants, they both vary in their potential for abuse. The risk of abuse in Adderall is quite higher than in Modafinil.
What is the best time to take Modafinil?
Take it in the morning for Narcolepsy and OSAHS, and before one hour of your work shift for shift work sleep disorder.