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Wakefulness-Promoting Medicines


Generic NameBrand Name
armodafinilNuvigil, Provigil
modafinilNuvigil, Provigil

Modafinil or armodafinil is taken as a pill to decrease sleepiness during the day.

How It Works

Modafinil and armodafinil work by affecting chemicals in the brain. The effects improve alertness and memory.

Why It Is Used

Modafinil and armodafinil are used to relieve extreme sleepiness in people who are using continuous positive airway pressure (CPAP) therapy to treat sleep apnea but are still sleepy during the day. People who work night shifts may take modafinil to stay alert.

How Well It Works

In people with sleep apnea who used CPAP, treatment with modafinil or armodafinil improved alertness, reduced tiredness, and improved memory.1, 2

Modafinil also helps people who have shift work sleep disorder stay awake when they work nights.3 Shift work sleep disorder is trouble sleeping during the day because you work nights. It also causes you to be sleepy at night when you need to be alert to work.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Callor other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

Common side effects of this medicine include:

When side effects occur, they are usually mild to moderate.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Wakefulness-promoting medicines are recommended only after continuous positive airway pressure (CPAP) therapy alone does not get rid of daytime sleepiness in a person who has sleep apnea. The CPAP therapy should continue during modafinil or armodafinil treatment.

Some medicines may be affected by modafinil and armodafinil, including warfarin, cyclosporin, and tricyclic antidepressants (such as clomipramine and desipramine). Before you start using modafinil or armodafinil, tell your doctor about all of the other medicines you are taking.

People who have severe liver disease may need a lower dose of modafinil or armodafinil.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Wakefulness-promoting medicines may interfere with birth control methods that use a form of estrogen (ethinyl estradiol), such as birth control pills, the birth control patch, and the vaginal ring. You may need to use another form of birth control while you are taking modafinil or armodafinil.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.



  1. Hirshkowitz M, et al. (2007). Adjunct armodafinil improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome. Respiratory Medicine, 101(3): 616–627.

  2. Black JE, Hirshkowitz M (2005). Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep, 28(4): 464–471.

  3. Czeisler CA, et al. (2005). Modafinil for excessive sleepiness associated with shift-work sleep disorder. New England Journal of Medicine, 353(5): 476–486.


ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerMark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine
Last RevisedMay 14, 2012

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