Modafinil

The recommended adult dose of modafinil for narcolepsy is between 200 mg and 400 mg daily. The total daily dose is usually divided between a morning and noon dose. Doses are usually started at 200 mg per day, and then gradually increased by the doctor as needed to a maximum of 400 mg daily.

For adults with obstructive sleep apnea, the usual adult daily dose of modafinil is 200 mg taken as a single dose in the morning.

Adults with shift work disorder should take 200 mg once daily, approximately 1 hour before the start of the work shift.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way you are using the medication without talking to your doctor.

It is important to take Modafinil exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Avoid taking the medication in the late afternoon or evening, as it may prevent falling asleep at your normal bedtime. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Modafinil at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dryness of the mouth; it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause sleep disturbances or insomnia; it may cause nausea or, rarely, vomiting; it may cause nervousness or anxiety. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each white, round, biconvex tablet, engraved "MOD" over "100" on one side, contains modafinil 100 mg. Nonmedicinal ingredients: methylcellulose, croscarmellose sodium, magnesium stearate, and colloidal silicon dioxide.

Do not take Modafinil if you:

• are allergic to modafinil or any ingredients of the medication
• are in an agitated state
• have severe anxiety

There may be an interaction between modafinil and any of the following:

• alcohol
• alpha blockers (e.g., Alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• anti-cancer medications (e.g., Cabazitaxel, Docetaxel; Doxorubicin; Etoposide, Ifosfamide, Irinotecan, Vincristine)
• antipsychotics (e.g., Aripiprazole, Clozapine, Haloperidol, Quetiapine), Aprepitant
• Atomoxetine
• "azole" antifungals (e.g., itraconazole, ketoconazole, posaconazole, Voriconazole)
• benzodiazepines (e.g., Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam)
• birth control pills
• Bisoprolol
• Bosentan
• fast acting bronchodilators (e.g., salbutamol, terbutaline)
• long acting bronchodilators (e.g., formoterol, salmeterol)
• Buprenorphine
• Buspirone
• caffeine
• Calcitriol
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• Carbamazepine
• chloroquine
• conivaptan
• Cyclosporine
• Dantrolene
• Dapsone
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• Deferasirox
• Dexamethasone
• dipivefrin
• Disopyramide
• Enzalutamide
• Epinephrine
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Everolimus
• Fentanyl
• "gliptin" Diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• Guanfacine
• Hepatitis C antivirals (e.g., daclatasvir, dasabuvir, ledipasvir, paritaprevir, ombitasvir, sofosbuvir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Hydrocodone
• lidocaine
• Linezolid
• Losartan
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• maraviroc
• Mefloquine
• Methadone
• Methylphenidate
• mifepristone
• Mirtazapine
• Moclobemide
• Montelukast
• Nabilone
• nefazodone
• nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
• Ondansetron
• Oxcarbazepine
• Oxycodone
• Perampanel
• Phenobarbital
• Phenytoin
• praziquantel
• Primaquine
• primidone
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• protein kinase inhibitors (e.g., Dasatinib, imatinib, Nilotinib, Pazopanib)
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinidine
• quinine
• Repaglinide
• rifabutin
• rifampin
• rilpivirine
• Rivaroxaban
• Romidepsin
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• Sildenafil
• siltuximab
• Sirolimus
• "statin" anti-cholesterol medications (e.g., Atorvastatin, Lovastatin, Simvastatin)
• Tacrolimus
• Tamoxifen
• Tetracycline
• Theophylline (e.g., Aminophylline, Oxtriphylline, theophylline)
• Ticagrelor
• Ticlopidine
• Tocilizumab
• Tofacitinib
• Tolterodine
• Tolvaptan
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Imipramine)
• Trimethoprim
• Venlafaxine
• Zolpidem
• zonisamide
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Modafinil. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Modafinil.

HEALTH CANADA ADVISORY

June 20, 2019

Health Canada has issued information concerning the use of modafinil. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Birth Control: Birth control pills, patches and other forms of estrogen and estrogen/progestin birth control may be less effective when you are also taking modafinil. Alternative methods of birth control should be used while you are taking modafinil and for at least 1 month after stopping treatment with modafinil.

Drowsiness/reduced alertness: Some people experience ongoing drowsiness or dizziness while taking modafinil. It may also cause overconfidence and over-stimulation, causing poor judgement. Do not drive, operate machinery, or perform other hazardous tasks until you have determined how Modafinil affects you.

Heart disease: Modafinil may cause an irregular heartbeat or increased blood pressure. The safety of using modafinil has not been established for people with heart problems. If you have a heart condition or history of heart problems, discuss with your doctor how Modafinil may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Modafinil, and whether any special monitoring is needed.

Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of modafinil. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Liver function: People with severe liver disease should take lower doses of modafinil because of an increased risk of accumulation of the medication in the body and side effects. If you have liver disease or decreased liver function, discuss with your doctor how Modafinil may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Modafinil, and whether any special monitoring is needed.

Mental illness: Modafinil may reactivate certain mental disorders or cause confusion and agitation. If you have a history of mental disorders such as depression, psychosis, or mania, discuss with your doctor how Modafinil may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Modafinil, and whether any special monitoring is needed. If you experience symptoms of agitation, depression or hallucination, or notice them in a family member who is taking Modafinil, contact your doctor immediately. Your doctor will monitor you closely for these side effects while you are taking Modafinil.

Normal fatigue states: Modafinil should not be used to treat normal fatigue states (e.g., fatigue due to lack of sleep rather than narcolepsy), as it can lead to overconfidence in abilities without actually increasing performance. This could make it more dangerous to perform certain activities.

Seizure disorder: If you have a seizure disorder or a history of seizures, discuss with your doctor how Modafinil may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Modafinil, and whether any special monitoring is needed.

Skin rash: Modafinil may cause skin rash. Rarely, people taking modafinil experience a severe skin reaction that can be life-threatening. This usually occurs within the first 5 weeks of taking the medication, but it can develop at any time while you are taking modafinil. If you experience a rash that gets worse, or develops into blisters, sores on the lips or eyes or covers a large area of the body, contact your doctor immediately.

Pregnancy: Modafinil should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Modafinil, contact your doctor immediately.

Breast-feeding: It is not known if modafinil passes into breast milk. If you are a breast-feeding mother and are taking Modafinil, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Serious reactions have been associated with the use of modafinil by children. The risks and benefits of modafinil have not been established for children. It is not recommended that children be given modafinil.

Seniors: Seniors may be more sensitive to the effects of modafinil. They should use lower starting doses.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. This medication may be taken with or without food.