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.

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Provigil (modafinil) drug Interactions

There are 347 drug interactions with Provigil (modafinil)

Provigil (modafinil) food/lifestyle Interactions

There is 1 food/lifestyle interaction with Provigil (modafinil)

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