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?

Psychostimulant

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)
Dry mouth
Appetite changes
Headache
Abdominal pain
Tachycardia
Palpitation
Anxiety
Dizziness
Drowsiness
Confusion
Depression
Asthenia
Paraesthesia
Visual disturbances

Less commonly:

Flatulence
Vomiting
Mouth ulcers
Glossitis
Dysphagia
Taste disturbances
Weight Changes
Tremor
Emotional lability
Decreased libido
Agitation
Aggression
Hyperglycaemia
Hypertension
Thirst
Urinary frequency
Menstrual disturbances
Acne
Sweating
Pruritus

Rarely:

Hallucinations
Mania
Psychosis
Multi-organ hypersensitivity reaction
Stevens-johnson Syndrome
Toxic Epidermal Necrolysis

Mention the contra-indications of Modafinil?

Moderate to severe uncontrolled hypertension
Arrhythmia
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.

Sandhoshini Meena

MODAFINIL: DRUG INFORMATION

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