"Sleep disorder drugs (hypnotic and sedative drugs) overview
Insomnia, a disorder in which there is difficulty sleeping, occurs occasionally in most people but usually lasts only a few days. The body then "corrects" itself "...
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PROVIGIL (modafinil) is indicated to improve wakefulness in adult patients with excessive sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work disorder.
In OSA, PROVIGIL (modafinil) is indicated as an adjunct to standard treatment(s) for the underlying obstruction. If continuous positive airway pressure (CPAP) is the treatment of choice for a patient, a maximal effort to treat with CPAP for an adequate period of time should be made prior to initiating PROVIGIL (modafinil) . If PROVIGIL (modafinil) is used adjunctively with CPAP, the encouragement of and periodic assessment of CPAP compliance is necessary.
In all cases, careful attention to the diagnosis and treatment of the underlying sleep disorder(s) is of utmost importance. Prescribers should be aware that some patients may have more than one sleep disorder contributing to their excessive sleepiness.
The effectiveness of modafinil in long-term use (greater than 9 weeks in Narcolepsy clinical trials and 12 weeks in OSA and SWD clinical trials) has not been systematically evaluated in placebo-controlled trials. The physician who elects to prescribe PROVIGIL (modafinil) for an extended time in patients with Narcolepsy, OSA, or SWD should periodically reevaluate long-term usefulness for the individual patient.
DOSAGE AND ADMINISTRATION
The recommended dose of PROVIGIL (modafinil) is 200 mg given once a day.
For patients with narcolepsy and OSA, PROVIGIL (modafinil) should be taken as a single dose in the morning.
For patients with SWD, PROVIGIL (modafinil) should be taken approximately 1 hour prior to the start of their work shift.
Doses up to 400 mg/day, given as a single dose, have been well tolerated, but there is no consistent evidence that this dose confers additional benefit beyond that of the 200 mg dose (See CLINICAL PHARMACOLOGY and Clinical Trials).
Dosage adjustment should be considered for concomitant medications that are substrates for CYP3A4, such as triazolam and cyclosporine (See PRECAUTIONS: DRUG INTERACTIONS).
Drugs that are largely eliminated via CYP2C19 metabolism, such as diazepam, propranolol, phenytoin (also via CYP2C9) or S-mephenytoin may have prolonged elimination upon coadministration with PROVIGIL (modafinil) and may require dosage reduction and monitoring for toxicity.
In patients with severe hepatic impairment, the dose of PROVIGIL (modafinil) should be reduced to one-half of that recommended for patients with normal hepatic function (See CLINICAL PHARMACOLOGY and PRECAUTIONS).
In elderly patients, elimination of PROVIGIL (modafinil) and its metabolites may be reduced as a consequence of aging. Therefore, consideration should be given to the use of lower doses in this population (See CLINICAL PHARMACOLOGY and PRECAUTIONS).
PROVIGIL® (modafinil) Tablets
100 mg Each capsule-shaped, white, uncoated tablet is debossed with “PROVIGIL (modafinil) ” on one side and “100 MG” on the other.
NDC 63459-101-01 - Bottles of 100
200 mg Each capsule-shaped, white, scored, uncoated tablet is debossed with “PROVIGIL (modafinil) ” on one side and “200 MG” on the other.
NDC 63459-201-01 - Bottles of 100
Store at 20° - 25°C (68° - 77°F).
Distributed by: Cephalon, Inc. Frazer, PA 19355. October 2010.
Last reviewed on RxList: 11/29/2010
This monograph has been modified to include the generic and brand name in many instances.
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