armodafinil

Contraindicated in:

Hypersensitivity to modafinil or armodafinil.

Use Cautiously in:

Concurrent alcohol ingestion;
History of drug abuse, especially history of stimulant abuse;
Recent MI or unstable angina;
Severe hepatic impairment (↓ dose);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.
Geri: Plasma concentrations may by ↑ due to ↓ clearance (lower dose may be necessary);

Adv. Reactions/Side Effects ⬆ ⬇

CV: ↑BP

Derm: DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

GI: nausea, dry mouth

Neuro: dizziness, headache, insomnia, aggression, anxiety, delusions, hallucinations, mania, SUICIDAL THOUGHTS

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)including anaphylaxis and angioedema)

Interactions ⬆ ⬇

Drug-drug:

CYP3A inhibitors, including ketoconazole and erythromycin may ↑ levels and risk of toxicity.
CYP3A inducers, including carbamazepine, phenobarbital, and rifampin may ↓ levels and effectiveness.
May ↓ levels and effectiveness of hormonal contraceptives, cyclosporine midazolam and triazolam.
May ↑ levels and risk of toxicity of phenytoin, diazepam, propranolol, omeprazole, and clomipramine.
Use cautiously with MAO inhibitors and other CNS stimulants.

Availability ⬆ ⬇

(Generic available)

Tablets: 50 mg; 150 mg; 200 mg; 250 mg

Route/Dosage ⬆ ⬇

Obstructive Sleep Apnea/Hypopnea Syndrome and Narcolepsy

PO (Adults ): 150–250 mg once daily in the morning.

Shift Work Sleep Disorder

PO (Adults ): 150 mg once daily one hr before start of work.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Produces CNS stimulation.

Therapeutic effects:

Improved wakefulness.

Classifications ⬆ ⬇

Therapeutic Classification: central nervous system stimulants

Pharmacokinetics ⬆ ⬇

Absorption: Readily absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized (partially by the CYP3A4 isoenzyme system); <10% excreted in urine.

Half-Life: 15 hr.

Contr. Subst. Schedule ⬆ ⬇

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	2 hr	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Advise to take as directed. Advise patient that level of wakefulness may not return to normal. If used as an adjunct to CPAP, encourage patient to continue to use CPAP and other modalities. Inform patient that armodafinil does not take the place of getting enough sleep.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications. Advise patient to avoid alcohol use during therapy.
Advise patient that sharing this medication with others, even those with the same symptoms, is dangerous and illegal.
May impair judgment. Advise patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to notify health care professional immediately if rash, hives, mouth sores, blisters, peeling skin, swelling of face, eyes, lips, tongue, or throat, trouble swallowing or breathing, hoarse voice, or other allergic reactions occur.Patients should also notify health care professional if depression, anxiety, hallucinations, mania, thoughts of suicide or other mental problems (mania, delusions, hallucinations, suicidal ideation, aggression), or heart problems, including chest pain, occur.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Advise patient to use nonhormonal methods of contraception during and for 1 mo following discontinuation of therapy. Encourage pregnant patients to enroll in pregnancy registry by calling 1-866-404-4106.

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Indications ⬇

Contraind./Precautions ⬆ ⬇