MODAFINIL: DRUG INFORMATION
8 September 2020
What is Modafinil?
Modafinil is a newer psychostimulant
It is popular with night-shift workers, who want to improve their alertness and keep them awake.
This drug will decrease sleepiness and fatigue.
It will increase the attention span.
This drug will improve accuracy.
What is the approved indication of Modafinil?
Day time sleepiness due to narcolepsy
Sleep apnoea syndrome
Shift- work disorder (SWD)
What is the other indication of Modafinil?
Reduce → Euphoria produced by cocaine
Suppress→ Cocaine withdrawal symptoms
Prevent→ Relapse of cocaine dependence
What category does Modafinil belong to?
How does Modafinil work?
Modafinil inhibits noradrenaline (NA) and Dopamine (DA) uptake and also alters the junctional concentration of glutamate and GABA. The exact mechanism of action is unknown.
What is the pharmacokinetics of Modafinil?
Mode of administration: Oral route
Absorption: maximum plasma concentrations→ 2-4 hours
Metabolism: Liver (Largely: through amide hydrolysis ), (Lesser: Cytochrome P450 -mediated oxidative pathways)
Elimination half-life: 15 hours.
Whether the drug will cause dependence?
Dependence on this drug is possible on long-term use.
Can Modafinil be used in pregnancy/ Breast feeding?
Modafinil should be avoided in pregnancy and breastfeeding.
Mention the cautions of modafinil?
Monitor Blood Pressure(BP) and Heart Rate(HR) in hypertensive patients
Check ECG before initiation
History of Depression/Mania
History of Psychosis
History of Alcohol and drug abuse
Discontinue the treatment → if psychiatric symptoms develop
Discontinue the treatment → if rash develop
What are the adverse drug reactions of modafinil?
Gastrointestinal disturbances (such as Nausea, Diarrhoea, Constipation, Dyspepsia)
Multi-organ hypersensitivity reaction
Toxic Epidermal Necrolysis
Mention the contra-indications of Modafinil?
Moderate to severe uncontrolled hypertension
History of Left ventricular hypertrophy (LVH)
Signs of CNS-stimulant induced mitral valve prolapse
Mention the drug interactions of modafinil?
Phenytoin (Antiepileptics): Modafinil possibly increases the plasma concentration of phenytoin.
Bosutinib (Cytotoxics): Modafinil possibly decreases the plasma concentration of bosutinib.
Oestrogen: Modafinil accelerates the metabolism of oestrogen; therefore leads to reduced contraceptive effect.
Ciclosporin: Modafinil decreases the plasma concentration of ciclosporin.
Mention the dose of Modafinil?
· Day time sleepiness due to narcolepsy/Sleep apnoea syndrome: 100-200 mg morning and afternoon.
· Night shift work: 200 mg → 1 hour before starting night shift.