If you have trouble staying awake because of narcolepsy or another sleep disorder, your doctor may prescribe modafinil (Provigil) to help you stay awake during the day.
As with any drug, there are certain precautions you should take to make sure you’re using it safely.
Modafinil (Provigil) Promotes Wakefulness
Modafinil is considered a “wakefulness-promoting” medicine. It’s used to help people with certain sleep disorders feel more alert and stay awake during the day. It’s approved to treat these sleep disorders:
- Narcolepsy, a condition in which you often feel a very strong urge to fall asleep during the day
- Obstructive sleep apnea, in which you stop breathing for several seconds and wake up many times through the night. Some people aren’t even aware this is happening.
- Shift work sleep disorder. This happens when your sleep cycles get out of sync because you work late at night or early in the morning. It can also happen when your work shifts often change from one time of day to another.
Although modafinil is FDA-approved to treat only these three conditions, doctors sometimes use it for different reasons. For example, they may recommend it for people with fatigue due to cancer or multiple sclerosis (MS), and for some people with attention deficit hyperactivity disorder (ADHD).
Modafinil (Provigil) Works on Brain Chemicals
Doctors think modafinil helps you stay awake by raising your brain’s levels of dopamine and other neurotransmitters. Higher levels of these brain chemicals, which carry messages between cells in your brain and other parts of your body, help you feel more awake.
You’ll Probably Take Modafinil (Provigil) Once a Day
Your doctor can prescribe either 100-milligram or 200-milligram tablets. They’ll choose your dosage based on your age, medical condition, and how long you’ve been taking the drug.
Most people take modafinil once a day, either in the morning or right before their night shift. If you still feel tired during the day, your doctor may suggest taking one dose in the morning and a second at midday.
Modafinil doesn’t usually keep you awake at night. But let your doctor know if you have trouble falling asleep.
Modafinil (Provigil) Takes Effect Quickly
The drug usually kicks in quickly, within 30 minutes to an hour. You should feel its full effects within 2 hours of taking it.
Most Common Side Effects of Modafinil (Provigil) Are Mild
If you take higher doses of modafinil, you may have headaches, anxiety, or both. These things can also happen with lower doses. Other common side effects of the drug are:
- Headaches
- Nervousness
- A stuffy or runny nose
- Diarrhea
- Back pain
- Trouble sleeping (insomnia)
- Dizziness
- Stomach pain
Most of the time, these side effects are mild. They may go away within a few weeks as your body gets used to the drug.
Modafinil (Provigil) Could Cause Serious Side Effects
Serious side effects of modafinil are possible, although rare. They include:
- A severe rash or Stevens-Johnson syndrome, which is caused by a reaction to medication. This syndrome starts with a fever and flu-like symptoms and then causes a rash, often with blisters.
- Swelling, especially of your tongue, throat, and mouth
- A rapid or weak pulse
- Trouble breathing
- Nausea and vomiting
- Sleepiness that doesn't go away. Don't drive or do anything else that could be dangerous if this happens to you.
- Hallucinations, delusions, mania (periods of abnormally high mood and energy), aggression, and thoughts of suicide or self-harm. These issues most often affect people who have a history of psychiatric disorders.
If you have any of these side effects, you need prompt medical care. Call your doctor or go to a nearby emergency department right away.
Modafinil (Provigil) Comes With Warnings and Precautions
There are a few safety issues you should keep in mind when you take modafinil:
Interactions with other medicines. Modafinil can cause problems when you take it with some other medications. These include drugs used to treat:
- High blood pressure
- Schizophrenia and other serious mental health disorders
- ADHD
- Depression
Combining these drugs with modafinil can cause side effects or change the way the other drugs work in your body.
Tell your doctor about all the prescription and over-the-counter medicines and dietary supplements you use before you start taking modafinil.
Pregnancy and breastfeeding. Doctors aren’t sure whether modafinil is safe during pregnancy. If you’re pregnant, get pregnant while taking the drug, or plan to get pregnant, discuss the risks and benefits of the treatment with your doctor.
It’s also not clear whether you could pass modafinil to your baby through breast milk. If you're breastfeeding, or plan to, talk to your doctor about the risks of this drug to your baby.
Hormone-based birth control. Modafinil can make hormonal birth control – including pills, patches, rings and some IUDs – less effective. Ask your doctor if you need to use another type of birth control while you take this drug.
Alcohol. Your doctor may advise you to avoid drinking when you’re taking modafinil. It’s possible the drug may cause problems if you drink alcohol when you take it. This issue hasn’t been well-studied.
Addiction and drug dependence. Tell your doctor if you have a history of mental health conditions or drug or alcohol misuse or abuse. These things can make modafinil dependency more likely. Your doctor may want to check on you more often. Or they may prescribe a different drug for your sleep disorder.
Modafinil (Provigil) May Not Be for Everyone
Your doctor will be cautious about prescribing modafinil if you’re affected by any of these situations, which can raise your risk for side effects:
Liver or kidney disease. If you have these conditions, your doctor could prescribe a lower dose of the medication or suggest another treatment.
Certain heart problems. Experts don’t recommend taking modafinil if you have:
- Left ventricular hypertrophy, a thickening of your heart's left pumping chamber
- Mitral prolapse, a heart valve disease
- Damage to your heart valves and vessels from chemotherapy or other cancer treatments
Mental health disorders. Tell your doctor if you have a history of psychosis, mania, or both.
Some people who’ve had these mental health conditions get hallucinations, delusions, mania, aggression, and thoughts of suicide while taking modafinil.
Young age. Modafinil isn’t approved for people younger than 17.
Modafinil (Provigil) Has Been Shown to Help People Function
In clinical studies, people who took modafinil had less daytime sleepiness. But the drug didn’t completely get rid of their tiredness. On average, people in these studies said they felt about 50% more awake. That means your level of wakefulness may not return to entirely normal levels when you take the drug.
People who took the drug also said it helped them function better day-to-day and improved their quality of life. Those with shift work disorder had fewer car accidents or near-accidents during their commutes.
You may get fewer benefits from modafinil over time. Some people in research studies said the drug didn’t work as well after they’d taken it for about 2 years.
