Modafinil Mylan (Modafinil)

• Modafinil is a eugeroic that promotes wakefulness in sleep‑related disorders.
• Narcolepsy: reduces excessive daytime sleepiness and improves alertness.
• Obstructive sleep apnea‑related excessive daytime sleepiness: mitigates residual sleepiness despite optimal apnea therapy.
• Shift work sleep disorder: helps maintain alertness during scheduled work hours that fall outside the normal circadian rhythm.

• Modafinil enhances wakefulness primarily by inhibiting the reuptake of dopamine, which raises extracellular dopamine concentrations in key brain regions. It also modulates orexin, histamine, and norepinephrine pathways, contributing to increased neuronal firing in the hypothalamus and other arousal centers, thereby reducing sleep propensity.

Common Side Effects

• Headache: mild to moderate pain often reported during early treatment.
• Nausea: transient gastrointestinal discomfort.
• Insomnia: difficulty initiating or maintaining sleep.
• Dry mouth: reduced salivation.
• Dizziness: sensation of light‑headedness.
• Anxiety: heightened nervousness or tension.

Serious or Rare Side Effects

• Severe rash or Stevens‑Johnson syndrome: requires immediate medical attention.
• Psychiatric symptoms: emergence of mania, depression, or hallucinations.
• Cardiovascular events: hypertension, palpitations, or arrhythmias.
• Anaphylaxis: acute allergic reaction with airway compromise.
• Hepatotoxicity: abnormal liver function tests or jaundice.

Before initiating therapy, consider the following precautions:

• Assess cardiovascular status: screen for hypertension or arrhythmias.
• Review psychiatric history: use cautiously in patients with depression or psychosis.
• Avoid use in uncontrolled hypertension: may exacerbate blood pressure.
• Evaluate renal and hepatic function: dose adjustment may be needed in impairment.
• Store at ambient temperature below 25°C: keep in the original pack, protect from moisture.

Modafinil may interact with several drug classes. Review patient medication lists carefully.

Major Interactions (Avoid)

• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): increase plasma concentrations.
• CYP3A4 inducers (e.g., rifampin, carbamazepine): reduce therapeutic effect.
• Monoamine oxidase inhibitors: risk of hypertensive crisis.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: may lower contraceptive efficacy.
• Antidepressants (SSRIs, SNRIs): potential for heightened side effects.
• Antihypertensives: possible attenuation of blood‑pressure control.