Medical Editor: John P. Cunha, DO, FACOEP
What Is Provigil?
Provigil (modafinil) is a stimulant prescribed to increase wakefulness in patients with excessive sleepiness related to narcolepsy, shiftwork sleep disorder, and obstructive sleep apnea/hypopnea syndrome.
What Are Side Effects of Provigil?
Common side effects of Provigil are:
- headache,
- dizziness,
- upper respiratory tract infection,
- nausea,
- diarrhea,
- nervousness,
- anxiety,
- agitation,
- dry mouth, and
- trouble sleeping (insomnia).
Tell your doctor if you experience serious side effects of Provigil including:
- fever,
- easy bruising or bleeding,
- hallucinations,
- depression,
- chest pain,
- fast/pounding/irregular heartbeat, or
- mental/mood changes (such as confusion, depression, hallucinations, rare thoughts of suicide).
Dosage for Provigil
Provigil dosage is 200 or 400 mg daily.
What Drugs, Substances, or Supplements Interact with Provigil?
Provigil drug interactions include cyclosporine (Sandimmune), theophylline (Theo-24), hormonal contraceptives (for example, Micronor), warfarin (Coumadin), diazepam (Valium), propranolol (Inderal), imipramine (Tofranil), desipramine (Norpramin), phenytoin (Dilantin), carbamazepine (Tegretol), rifampin (Rifadin), Ketoconazole (Nizoral) and itraconazole (Sporanox).
Provigil During Pregnancy and Breastfeeding
Provigil has not been adequately studied in pregnant women and it is unknown if it is excreted in breast milk. Consult your doctor before breastfeeding.
Additional Information
Our Provigil Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SLIDESHOW
Sleep Disorders: Foods That Help Sleep or Keep You Awake See SlideshowGet emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Modafinil can cause skin reactions that may be severe enough to need treatment in a hospital. Stop taking this medicine and get emergency medical help if you have:
- skin rash or hives, blisters or peeling;
- mouth sores, trouble swallowing;
- fever, shortness of breath;
- swelling in your legs;
- dark urine, jaundice (yellowing of the skin or eyes); or
- swelling in your face, eyes, lips, tongue, or throat.
Stop using modafinil and call your doctor at once if you have:
- depression, anxiety, suicidal thoughts or actions;
- hallucinations, unusual thoughts or behavior, aggression, being more active or talkative than usual;
- chest pain, trouble breathing, uneven heart beats; or
- the first sign of any skin rash, no matter how minor you think it might be.
Common side effects may include:
- headache, dizziness;
- feeling nervous or anxious;
- back pain;
- nausea, diarrhea, upset stomach;
- sleep problems (insomnia); or
- stuffy nose.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

QUESTION
Why do we sleep? See AnswerSIDE EFFECTS
The following serious adverse reactions are described elsewhere in the labeling:
- Serious Rash, including Stevens-Johnson Syndrome [see WARNINGS AND PRECAUTIONS]
- Angioedema and Anaphylaxis Reactions [see WARNINGS AND PRECAUTIONS]
- Multi-organ Hypersensitivity Reactions [see WARNINGS AND PRECAUTIONS]
- Persistent Sleepiness [see WARNINGS AND PRECAUTIONS]
- Psychiatric Symptoms [see WARNINGS AND PRECAUTIONS]
- Effects on Ability to Drive and Use Machinery [see WARNINGS AND PRECAUTIONS]
- Cardiovascular Events [see WARNINGS AND PRECAUTIONS]
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
PROVIGIL has been evaluated for safety in over 3,500 patients, of whom more than 2,000 patients with excessive sleepiness associated with OSA, SWD, and narcolepsy.
Most Common Adverse Reactions
In placebo-controlled clinical trials, the most common adverse reactions ( ≥ 5%) associated with the use of PROVIGIL more frequently than placebo-treated patients were headache, nausea, nervousness, rhinitis, diarrhea, back pain, anxiety, insomnia, dizziness, and dyspepsia. The adverse reaction profile was similar across these studies.
Table 1 presents the adverse reactions that occurred at a rate of 1% or more and were more frequent in PROVIGIL-treated patients than in placebo-treated patients in the placebo-controlled clinical trials.
Table 1: Adverse Reactions in Pooled
Placebo-Controlled Trials* in Narcolepsy, OSA, and SWD
PROVIGIL (%) (n = 934) |
Placebo (%) (n = 567) |
|
Headache | 34 | 23 |
Nausea | 11 | 3 |
Nervousness | 7 | 3 |
Rhinitis | 7 | 6 |
Back Pain | 6 | 5 |
Diarrhea | 6 | 5 |
Anxiety | 5 | 1 |
Dizziness | 5 | 4 |
Dyspepsia | 5 | 4 |
Insomnia | 5 | 1 |
Anorexia | 4 | 1 |
Dry Mouth | 4 | 2 |
Pharyngitis | 4 | 2 |
Chest Pain | 3 | 1 |
Hypertension | 3 | 1 |
Abnormal Liver Function | 2 | 1 |
Constipation | 2 | 1 |
Depression | 2 | 1 |
Palpitation | 2 | 1 |
Paresthesia | 2 | 0 |
Somnolence | 2 | 1 |
Tachycardia | 2 | 1 |
Vasodilatation | 2 | 0 |
Abnormal Vision | 1 | 0 |
Agitation | 1 | 0 |
Asthma | 1 | 0 |
Chills | 1 | 0 |
Confusion | 1 | 0 |
Dyskinesia | 1 | 0 |
Edema | 1 | 0 |
Emotional Lability | 1 | 0 |
Eosinophilia | 1 | 0 |
Epistaxis | 1 | 0 |
Flatulence | 1 | 0 |
Hyperkinesia | 1 | 0 |
Hypertonia | 1 | 0 |
Mouth Ulceration | 1 | 0 |
Sweating | 1 | 0 |
Taste Perversion | 1 | 0 |
Thirst | 1 | 0 |
Tremor | 1 | 0 |
Urine Abnormality | 1 | 0 |
Vertigo | 1 | 0 |
* Adverse Reactions that occurred in ≥ 1% of PROVIGIL-treated patients (either 200, 300, or 400 mg once daily) and greater incidence than placebo |
Dose-Dependent Adverse Reactions
In the placebo-controlled clinical trials which compared doses of 200, 300, and 400 mg/day of PROVIGIL and placebo, the following adverse reactions were dose related: headache and anxiety.
Adverse Reactions Resulting in Discontinuation of Treatment
In placebo-controlled clinical trials, 74 of the 934 patients (8%) who received PROVIGIL discontinued due to an adverse reaction compared to 3% of patients that received placebo. The most frequent reasons for discontinuation that occurred at a higher rate for PROVIGIL than placebo patients were headache (2%), nausea, anxiety, dizziness, insomnia, chest pain, and nervousness (each < 1%).
Laboratory Abnormalities
Clinical chemistry, hematology, and urinalysis parameters were monitored in the studies. Mean plasma levels of gamma glutamyltransferase (GGT) and alkaline phosphatase (AP) were found to be higher following administration of PROVIGIL, but not placebo. Few patients, however, had GGT or AP elevations outside of the normal range. Shifts to higher, but not clinically significantly abnormal, GGT and AP values appeared to increase with time in the population treated with PROVIGIL in the placebo-controlled clinical trials. No differences were apparent in alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein, albumin, or total bilirubin.
Postmarketing Experience
The following adverse reactions have been identified during post approval use of PROVIGIL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Hematologic: agranulocytosis
Psychiatric disorders: psychomotor hyperactivity
Read the entire FDA prescribing information for Provigil (Modafinil)
© Provigil Patient Information is supplied by Cerner Multum, Inc. and Provigil Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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