What is Provigil?
Provigil, also known as modafinil, is a prescription medicine that works on the central nervous system to prevent excessive sleepiness in various types of sleep disorders. It promotes wakefulness and alertness in individuals and belongs to a class of medications called stimulants.
It is believed that Provigil works by altering the effects of chemical messengers called neurotransmitters, which are involved in sleep in humans. Examples of these neurotransmitters are Gamma-aminobutyric acid (GABA), serotonin (5-HT), and norepinephrine.
The drug is used to arrest the symptoms that are associated with uncontrolled sleepiness as seen in narcolepsy, shift work sleep disorder, or obstructive sleep apnea.
Provigil comes as white to off-white round or oblong tablets. There is an inscription of Provigil on one side and the dosage strength of 100mg or 200mg on the other side.
Because the drug is a controlled substance, uncontrolled use of Provigil can lead to drug abuse and drug dependence. It is therefore imperative you avoid self-medication and take it only when prescribed by your doctor. Long-term use of Provigil promotes psychological and physical dependence, even though it is rarely seen.
Uses of Provigil
The drug is indicated in the following:
- Obstructive sleep apnea
- Shift work sleep disorder
It is used as an off-label prescription for:
- treatment of fatigue symptoms that are associated with multiple sclerosis (MS)
- adjuvant to antidepressants in the treatment of symptoms of depression
- ADHD (Attention deficit-hyperactivity disorder), though not the first line of treatment of this condition and not approved for use in children
Dosage and Drug Administration
The drug should not be crushed but should be taken by mouth with or without food. It is administered once a day, usually in the morning. Children, less than 17 years of age, should not ingest Provigil.
Narcolepsy: In people (adults) who are suffering excessive sleepiness in Narcolepsy, the dose is 200mg. This is to be taken in the morning. Though some people are known to tolerate higher doses like 400mg single dose, there is no evidence to prove that doses higher than 200mg/day are more effective.
Obstructive sleep apnea: for improvement of wakefulness in adults who have obstructive sleep apnea, 200mg of Provigil taken once in the morning is recommended. For patients with liver impairment, a dosage modification of what is given to adults with a healthy liver is necessary. Also, half of the 200mg, that is 100mg, is recommended in patients with liver impairment.
Shift Work Disorder: in this condition, the dose is still 200mg. However, the drug should be taken one hour before the start of the shift. Half of this dose is required as a modified dose in people who do not have an optimal liver function.
Precautions to Observe Before or While Using Provigil
People who have a history of allergies to the active ingredient, modafinil, or allergies to Nuvigil should not consume Provigil. To be certain that you can use the drug, do inform your physician if you experience any of the following:
- Angina pectoris ( chest pain that is associated with a decrease in the rate of blood flowing to the heart)
- Renal ( kidney) disorders
- History of psychosis or mental disorders
- Cirrhosis of the liver or other liver diseases
- Drug addiction history including a history of alcohol consumption
- History of heart attack, high blood pressure, or any other form of cardiomyopathies
The effects of Provigil on unborn babies have not been clearly defined. It is best to inform a health professional if you become pregnant or planning to get pregnant.
Also, whether the drug can pass through breast milk to harm nursing babies is unknown. Lactating women should inform their doctors before the start of therapy.
Again, Provigil is known to frustrate the efforts of birth control pills and contraceptives. It means that you can get pregnant when using Provigil even if you are on hormonal contraceptives.
The FDA has not approved the drug for use in people who are below 17 years of age.
Side Effects of Provigil
The following adverse effects have been observed in people using the drug:
- Mouth sores and difficulty in swallowing
- Suicidal tendencies, thoughts, and actions
- Chest pains
- Loss of appetite
- Irregular heartbeat
- Difficulty in sleeping or falling asleep ( insomnia)
- Stuffy nose
- Feeling of nervousness
- Stomach upsets
- Cardiac palpitations and trouble breathing
- Serious allergic reactions
- Dry mouth
- Severe rash
- I inability to operate heavy machines
- Yellowing of the eyes and skin, also known as jaundice
- Darkening of urine
- Being hyperactive
- Being more talkative than usual
- Unusual aggressive behaviors
- Back pain
Provigil interacts with different drugs, beverages, and chemical substances. It is seriously contraindicated while using the following:
- Selegiline transdermal
The drug has serious interactions with
Provigil has minor interactions with:
- American ginseng
- Topical cocaine
- Yerba mate
There should be close monitoring while using Provigil with any of the following:
- Green tea
- Shepherd’s purse
- Warfarin and Topiramate
Missed Dose and Overdose
Do well to inform your doctor if you forgot to take Provigil when you are meant to. It is better to skip the already missed dose if you don’t plan to stay awake for a longer period of time than expected.
Also, you’re allowed to skip the missed dose if it is close to your bedtime. It is not advisable to overdose in order to make up for missed doses.
In the event of an overdose or suspected poisoning with Provigil, seek immediate medical assistance or call the poison control center helpline in your area.
Provigil just like other prescription medicine should be kept out of the reach of children and pets. It should be kept in its containing bottle or box. Also, you should store it at room temperature, away from excessive sunlight and direct heat.