Provigil (modafinil) Disease Interactions
There are 4 disease interactions with Provigil (modafinil):
Modafinil is extensively metabolized by the liver. The plasma clearance of modafinil may be decreased and the half-life prolonged in patients with impaired hepatic function. Therapy with modafinil should be administered cautiously at reduced dosages in patients with severe liver disease. In clinical studies, the oral clearance of modafinil was decreased by approximately 60% and the steady-state concentration doubled in patients with cirrhosis compared to healthy patients.
In clinical trials, a few patients treated with modafinil developed chest pain, palpitations, dyspnea and transient ischemic T-wave changes in association with mitral valve prolapse or left ventricular hypertrophy. The manufacturer recommends that modafinil not be used in patients with a history of left ventricular hypertrophy or ischemic ECG changes, chest pain, arrhythmia or other clinically significant manifestations of mitral valve prolapse in association with central nervous system (CNS) stimulant use. In addition, caution is advised in patients with cardiovascular disease due to other causes, particularly hypertension and/or a recent history of myocardial infarction or unstable angina, since the use of modafinil has not been evaluated in such patients.
The use of modafinil (multiple doses of 600 mg/day) was associated with the development of ideas of reference, paranoid delusions and auditory hallucinations in one healthy male volunteer with sleep deprivation. Since other central nervous system stimulants, most notably amphetamines, have been reported to exacerbate symptoms of behavior disturbance and thought disorder in psychotic patients, the manufacturer of modafinil recommends that the drug be administered cautiously in patients with a history of psychosis.
Modafinil is primarily metabolized by the liver and subsequently eliminated by the kidney, predominantly as inactive metabolites. In one study, the administration of a single 200 mg dose to subjects with severe chronic renal failure (mean creatinine clearance = 16.6 mL/min) did not significantly alter the pharmacokinetics of modafinil but resulted in a ninefold increase in the exposure to modafinil acid, an inactive metabolite. The clinical significance of such accumulation in the plasma is unknown. Therapy with modafinil should be administered cautiously in patients with impaired renal function.
You should also know about...
Provigil (modafinil) drug Interactions
There are 393 drug interactions with Provigil (modafinil)
Provigil (modafinil) alcohol/food Interactions
There is 1 alcohol/food interaction with Provigil (modafinil)
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2013 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.