Key Points

• Nuvigil (armodafinil) is the R-enantiomer of Provigil (modafinil). They are both oral medications used to improve wakefulness in certain adults.
• The dosage for Nuvigil and Provigil is different, but both medications are available only in tablet form. Nuvigil comes in more strengths than Provigil.
• Nuvigil and Provigil are available as brand-name and generic versions. They are both classified as a controlled substance.
• Side effects are similar between Nuvigil and Provigil.

Nuvigil and Provigil treat the same conditions

Both Nuvigil and Provigil are FDA approved for improving wakefulness in adults with:

• Narcolepsy
• Obstructive sleep apnea
• Shift work disorder

They are also both classified as a Schedule IV controlled substance due to their risk of abuse. Provigil was FDA approved in 1998, and Nuvigil was approved in 2007.

In a small study comparing Nuvigil 150 mg and Provigil 200 mg for the treatment of excessive sleepiness associated with shift work sleep disorder, both medications performed similarly. However, another study of over 900 patients showed that Nuvigil 200 mg might work better to improve wakefulness in patients with obstructive sleep apnea compared to Provigil 200 mg.

Nuvigil and Provigil work similarly

Nuvigil and Provigil have similar chemical structures, and work the same way to improve wakefulness. Armodafinil is the R-enantiomer of modafinil, which means it is a purified version of one of two mirror-image molecules that make up modafinil.

Both medications are central nervous system stimulants. They are thought to improve wakefulness by affecting different neurotransmitters in the brain, such as dopamine, norepinephrine, orexin, histamine, and glutamate.

Nuvigil comes in more strengths

One difference between Nuvigil and Provigil is that they are available in different strengths. While both medications come in oral tablets, Nuvigil is available in more strengths.

Nuvigil comes in 50 mg, 150 mg, 200 mg, and 250 mg tablets.

Provigil is available in 100 mg and 200 mg strengths.

Nuvigil and Provigil have different dosages

Even though Nuvigil and Provigil are used to treat the same conditions, they have different recommended dosages.

Narcolepsy

• Provigil: The recommended dose is 200 mg by mouth once a day in the morning.
• Nuvigil: The recommended dose is 150 mg to 250 mg by mouth once a day in the morning.

Obstructive sleep apnea

• Provigil: The recommended dose is 200 mg by mouth once a day in the morning.
• Nuvigil: The recommended dose is 150 mg to 250 mg by mouth once a day in the morning.

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Shift work disorder

• Provigil: The recommended dose is 200 mg by mouth once a day 1 hour before the start of the work shift.
• Nuvigil: The recommended dose is 150 mg by mouth once a day 1 hour before the start of the work shift.

For both medications, it is recommended to take a lower dose if you have severe liver problems or if you are older in age.

The effects of Nuvigil might last longer

Some research suggests that Nuvigil might last longer than Provigil, even though their half-lives are similar. A medication’s half-life is the time it takes for it to reach 50% of the amount it was in your blood after you took a dose. One study showed that levels of Nuvigil are higher in the blood late in the day when compared to Provigil. If you need to put off sleepiness for a longer period of time, Nuvigil might be a better option.

Food might delay Nuvigil longer than Provigil

Taking Nuvigil or Provigil with food does not affect how much medication is absorbed from your stomach. However, studies showed that food delayed the peak concentration of Provigil by 1 hour and Nuvigil by 2-4 hours. While you can take both medications with or without food, taking it on an empty stomach may help them work faster.

Many side effects of Nuvigil and Provigil are similar

Side effects reported from patients taking Nuvigil or Provigil in clinical studies submitted to the FDA for approval were mostly similar, with a few exceptions. Below are lists of side effects that are common from taking Nuvigil or Provigil.

Common side effects from Nuvigil in clinical studies (incidence of 4% or greater):

• Headache
• Nausea
• Dizziness
• Trouble sleeping (insomnia)
• Anxiety
• Diarrhea
• Dry mouth

Common side effects from Provigil in clinical studies (incidence of 4% or greater):

• Headache
• Nausea
• Nervousness
• Rhinitis
• Back pain
• Diarrhea
• Anxiety
• Dizziness
• Indigestion
• Poor appetite
• Dry mouth
• Nose and throat inflammation

If you experience bothersome side effects from either medication, contact your healthcare provider to discuss ways to manage them.

This is not all of the information you need to know to take Nuvigil or Provigil safely and effectively. Talk to your healthcare provider for more information.

References

Darwish, M., et. al. (2009). Armodafinil and modafinil have substantially different pharmacokinetic profiles despite having the same terminal half-lives: analysis of data from three randomized, single-dose, pharmacokinetic studies. In: Clinical Drug Investigation. DOI: https://doi.org/10.2165/11315280-000000000-00000

Greenblat, K., et. al. (2023). Modafinil. In: StatPearls [Internet]. Accessed 06/28/2024 at https://www.ncbi.nlm.nih.gov/books/NBK531476/

Mona, D., et. al. (2009). Comparison between armodafinil and modafinil for the treatment of excessive sleepiness associated with shift work disorder, treated obstructive sleep apnea, or narcolepsy using pharmacokinetic/pharmacodynamic models. In: CHEST Journal. DOI: https://doi.org/10.1378/chest.136.4_MeetingAbstracts.70S-b

Nuvigil [package insert]. (Revised Dec 2022). Cephalon, LLC. Accessed 06/28/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d878aed0-ddbf-8fa1-abf7-d3e480260845

Provigil [package insert]. (Revised Dec 2022). Cephalon, LLC. Accessed 06/28/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e16c26ad-7bc2-d155-3a5d-da83ad6492c8

Tembe, D. V., et. al. (2011). Armodafinil versus Modafinil in Patients of Excessive Sleepiness Associated with Shift Work Sleep Disorder: A Randomized Double Blind Multicentric Clinical Trial. In: Neurology Research International. DOI: https://doi.org/10.1155%2F2011%2F514351

Wisor, J. (2013). Modafinil as a Catecholaminergic Agent: Empirical Evidence and Unanswered Questions. In: Frontiers in Neurology. DOI: https://doi.org/10.3389%2Ffneur.2013.00139

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