Stimulants modafinil

Modafinil (Provigil). The newest stimulant, modafinil, is not, pharmacologically, a true stimulant. Nevertheless, it is an effective treatment for narcolepsy at doses from 200 to 400mg/day. Several studies indicate that modahnil has little potential for abuse and is easier to tolerate than other stimulants. Modafinil has been studied in the treatment of ADHD. Though not approved for marketing by the FDA at the time of this writing, it may gain the indication in the near future. 

Modafinil is a Schedule IV medication and does not require a triplicate prescription. Its mechanism of action is unclear but is thought to differ from those of conventional stimulants. Modafinil is metabolized by the liver and excreted by the kidneys. Its half-life is approximately 15 hours. It is available in 100- and 200-mg tablets. The typical daily dose is 200 00 mg every morning this dose should be reduced in elderly or hepatically impaired patients. 

MEXILETINE CNS STIMULANTS-MODAFINIL May cause l mexiletine levels if CYP1A2 is the predominant metabolic pathway and alternative metabolic pathways are either genetically deficient or affected Modafinil is a moderate inducer of CYP1A2 in a concentration-dependent manner Be aware... 

CLOPIDOGREL CNS STIMULANTS-MODAFINIL May cause moderate t in plasma concentrations of these substrates Modafinil is a reversible inhibitor of CYP2C19 when used in therapeutic doses Be aware... 

SYMPATHOMIMETICS CNS STIMULANTS-MODAFINIL May l modafinil levels with dexamfetamine, methylphenidate Due to delayed absorption Be aware... 

PHENOBARBITONE CNS STIMULANTS-MODAFINIL 1.1 plasma concentrations of modafinil with possibility of 1 therapeutic effect 2. May cause moderate in plasma concentrations of phenobarbitone and primidone 1. Induction of CYP3A4, which has a partial role in the metabolism of modafinil 2. Modafinil is a reversible inhibitor of CYP2C19 when used in therapeutic doses 1 and 2. Be aware... 

PHENYTOIN CNS STIMULANTS-MODAFINIL May 1 modafinil levels Induction of CYP3A4, which has a partial role in the metabolism of modafinil Be aware... 

CICLOSPORIN CNS STIMULANTS -MODAFINIL 1 ciclosporin levels up to 50%, with risk of lack of therapeutic effect t metabolism of ciclosporin. Modafinil is a moderate inducer of CYP3A4 Monitor ciclosporin levels... 

INDINAVIR, NELFINAVIR, RITONAVIR, SAQUINAVIR CNS STIMULANTS -MODAFINIL t plasma concentrations of modafinil, with risk of adverse effects Due to inhibition of CYP3A4, which has a partial role in the metabolism of modafinil Be aware. Warn patients to report dose-related adverse effects, e.g. headache, anxiety... 

Compared to stimulants, modafinil has a novel mechanism of action, novel therapeutic uses, and less abuse potential, but is often inaccurately classified as a stimulant... 

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