Modafinil: Clinical Uses, Action Mechanism, Dosage, Side Effects, Precautions and FAQs

By Christine RamirezOct 01, 20213069

Available under the brand name Provigil, modafinil is one of the wake-promoting agents approve by the U.S. Food and Drug Administration (FDA) for the treatment of narcolepsy and shift work sleep disorder (SWSD). It is also used as adjunctive treatment of obstructive sleep apnea (OSA).

Modafinil is a promising drug and has shown large potential for many uses in mental health and psychiatry. It is difficult to treat daytime sleepiness, as determining the exact nature of the sleep disorder is vital. And modafinil could play a key role in treating excessive sleepiness caused by narcolepsy and OSA.

Modafinil Uses

Modafinil is a smart drug specifically prescribed to narcolepsy patients, but it has largely been used among healthy individuals for cognitive enhancement. Off-label, modafinil uses include attention-deficit hyperactivity disorder (ADHD) and dementia. Modafinil for ADHD is used off-label, which means the FDA has not approved the drug for ADHD. However, the FDA has approved modafinil use in patients with:

• Narcolepsy
• Shift Work Sleep Disorder
• Obstructive Sleep Apnea

Modafinil Mechanism of Action

Although the exact modafinil mechanism of action is unknown, the drug is presumed to work in a localized manner, using neurotransmitters such as hypocretin, epinephrine, histamine, gamma-aminobutyric acid, orexin, and glutamate. The drug is a well-tolerated nootropic with a low propensity for abuse, which is why it has frequently been used for off-label indications.

Clinically, modafinil has been proven as an effective smart drug for patients with narcolepsy, a neurological disorder characterized by excessive daytime sleepiness. Modafinil has a specific action on orexin, a neurotransmitter that is associated with wakefulness-promoting and sleep-inhibiting peptides. The drug is presumed to improve the secretion of orexin, which in turn, helps keeps one alert and awake.

Modafinil Dosage

Modafinil dosage may vary from patient to patient and the condition it is advised for. Typically, the recommended dose of modafinil is 200 mg taken once a day as a single dose. Modafinil dosage up to 400 mg a day, take as one dose, has been well-tolerated in most patients.

For narcolepsy and OSA, modafinil 200 mg is advised once a day as a single dose, preferably in the morning. For SWSD, the dosage is Modafinil 200 mg orally once a day as a single dose, approximately an hour before starting the work/night shift.

As far as the modafinil dosage in older patients is concerned, doctors often prescribe it in lower doses, maybe modafinil 100 mg once a day. The drug is advised in much lower potencies in patients with severe liver impairment, such as modafinil 100mg once a day.

Modafinil Side Effects

Nausea, headache, restlessness, nervousness, dizziness, or difficulty sleeping are a few probable modafinil side effects. If any of these side effects aggravate, check with your doctor or pharmacist right away. Remember, most people using this smart drug may not experience serious side effects.

You should immediately seek medical attention if you experience serious side such as fast/irregular heartbeat, any kind of changes in mood changes, such as confusion, agitation or depression, hallucinations. Seek medical help if you have experience sudden chest pain or breathlessness after taking a modafinil tablet.

Modafinil Precautions

Before using this smart drug, tell your doctor if you have any drug allergies or any medical conditions, such as cardiovascular disease, liver dysfunction, kidney problems, mental health issues, or drug addiction. More importantly, tell your doctor if you have been using any other medication so drug interactions can be avoided.

Modafinil does keep you awake, but you still may not be able to do things safely, such as driving or operating machinery. Also, the drug makes you a bit dizzy. Do not drive, operate machinery or do things that need your mental alertness while you are under the influence of this nootropic. Remember, a combination of modafinil and alcohol can make you more drowsy so avoid any type of alcoholic beverages during treatment.

Modafinil FAQs

Is modafinil available over the counter?

Are you curious to know whether you can buy modafinil over the counter? While the drug may available without a prescription in some countries such as India and Mexico, in the United States, you cannot buy modafinil over the counter because it is a Schedule IV Drug, which means it is a controlled substance. You need to provide a prescription to buy modafinil online or offline in the United States.

Can I get a modafinil prescription online?

It is unclear whether you can get a modafinil prescription online in the United States. However, some nations do offer modafinil prescription online, such as European Union countries, as they have dedicated websites for online consultations, especially in the United Kingdom. In Mexico and India, you can buy modafinil without prescription. In fact, in Mexico, it is available as an OTC smart drug under the name Modiodal.

Does modafinil cause weight loss?

Modafinil weight loss has been reported in some patients. A 2005 study found that using modafinil caused 10 lbs. weight loss over a period of six weeks, according to the National Institutes of Health. The treatment with this smart drug resulted in a significant weight loss in one patient. However, at the time, researchers said it was only seen in a few patients so more trials were necessary to learn about modafinil weight loss.

Does modafinil cause depression?

There is no evidence that modafinil causes depression or any other mood/mental health issues. Instead, a 2013 study concluded that taking modafinil along with antidepressant drugs reduces the severity of depression, according to Science Daily. This nootropic appears to have a promising effect on depression if taken in association with antidepressants.

Is modafinil for studying and learning?

Well, modafinil is one of the effective smart drugs so it does help with cognitive enhancement, making it an effective nootropic for studying and learning.  In fact, a study has found that modafinil actually works for some people when it comes to studying, as the drug boosts concentration, focus, motivation, and alertness. However, there are a few ethical concerns over the use of modafinil for studying.

Is modafinil generic available?

The FDA approved the brand Provigil on December 24, 1998, which is manufactured by an American biopharmaceutical company, Cephalon, Inc. Since the patent has expired, modafinil generic is available, but it does not necessarily mean that generics are commercially available in the United States. Some of the generic versions of this smart drug include Modvigil, Modalert, Modawake, among others.

Is modafinil a stimulant?

Yes, modafinil is a central nervous stimulant drug. It is also called a eugeroic drug, which means it promotes wakefulness and alertness. The FDA approved modafinil stimulant for uncontrollable daytime sleepiness in patients with narcolepsy, OSA, and SWSD. Once again, remember, modafinil is a controlled substance but it has been found to be less dangerous than other stimulants, that’s because the drug has less potential to cause dependence. 

Is there an association between modafinil and birth control?

According to NHS UK, modafinil has been found to interact with certain types of birth control methods, making them less effective and increasing the chances of getting pregnant. The drug is not advised to pregnant women as it can cause birth defects in an unborn child. It is important to use the right contraceptive when taking modafinil.

Does modafinil cause fatigue?

There have been reports of modafinil causing fatigue. A study found that some patients who took modafinil 400 mg per day experienced asthenia (mild to moderate fatigue), headache, and nervousness. Some patients who took the drug in 200 mg potency experience anxiety. So, yes, modafinil, in higher potencies, may cause fatigue. For more information on the side effects of this nootropic, check with your doctor.

Is it safe to buy modafinil online?

First, you must talk to your doctor if you want to use this smart drug off-label. If your doctor gives you a green signal, you can buy modafinil online, but make sure you get it from a regulated source. It is important to note that in the United States, you cannot buy modafinil online without prescription, as it is a controlled substance because it has some potential to cause addiction.

Modafinil and coffee: is it a good mix?

Both modafinil and coffee are stimulants so they have similar benefits when it comes to cognitive enhancement. But is modafinil and coffee a good mix? Experts believe that there is no harm in taking modafinil along with coffee, but moderation is the key here.

What should I know about modafinil abuse and dependence?

As mentioned earlier, modafinil is a Schedule IV controlled substance. The chances of drug dependence with this smart drug are less, but some people may still develop dependence. This nootropic is not advised to people with a history of drug or alcohol abuse, as they are more vulnerable to modafinil abuse as well.