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armodafinil (ar-moh-DA-fih-nil) is a drug that is used to treat certain sleep disorders, such as narcolepsy. It makes patients feel more alert and awake. It is also being studied in the treatment of insomnia and fatigue in patients treated for cancer. Armodafinil acts in a part of the brain that controls sleep and wakefulness. It is a type of wakefulness-promoting agent. Also called Nuvigil.

Information about Armodafinil

Modafinil and its R-enantiomer armodafinil are central nervous system stimulants used to improve wakefulness in patients with excessive sleepiness. 

Liver safety of Armodafinil

Both modafinil and armodafinil are associated with a low rate of serum aminotransferase elevations during therapy, but they have not been implicated in cases of clinically apparent acute liver injury.

Mechanism of action of Armodafinil

Modafinil (moe daf' i nil) is a non-amphetamine central nervous system (CNS) stimulant whose mechanism of action is not entirely clear.  Modafinil is structurally unrelated to the amphetamines, and it does not appear to affect release of CNS norepinephrine or dopamine.  Modafinil is a racemic mixture of S and R enantiomers, whereas armodafinil (ar" moe daf' i nil) is the R enantiomer only.  Both enantiomers have CNS activating actions, but they differ in pharmacokinetics and half-life.  Modafinil and armodafinil increase wakefulness and both have been shown to be helpful in conditions with excessive sleepiness (narcolepsy, obstructive sleep apnea and shift-work sleep disorder), and have been studied off label to treat fatigue associated with chronic illness such as cancer, Parkinson’s disease, HIV/AIDs and multiple sclerosis. 

FDA approval information for Armodafinil

Modafinil was approved for use in the United States in 1998 and armodafinil in 2007. 

Dosage and administration for Armodafinil

Modafinil is available in tablets of 100 and 200 mg in generic forms and under the brand name Provigil, the usual dose in adults being 200 mg once daily in the morning or an hour before a work shift.  Armodafinil is available in tablets of 50, 150 and 250 mg under the brand name Nuvigil, the usual dose in adults being 150 to 250 mg once daily.  Armodafinil is also approved for treatment of sleepiness due to jet lag, a lower dose of 50 to 150 mg being recommended. 

Side effects of Armodafinil

The most common side effects of both agents include headache, anxiety nervousness, nausea, decreased appetite, palpitations and disturbed sleep.  Modafinil and armodafinil are now classified as category IV controlled substances, indicating that they have a potential for abuse and can lead to physical or psychological dependence.

The following are CNS stimulants

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