Artvigil: Enhance Wakefulness and Cognitive Performance
| Product dosage: 150 mg | |||
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Synonyms | |||
Artvigil is a prescription medication containing armodafinil, the R-enantiomer of modafinil, designed to promote wakefulness in individuals with excessive sleepiness associated with narcolepsy, obstructive sleep apnea (OSA), and shift work sleep disorder (SWSD). As a eugeroic or wakefulness-promoting agent, it functions by altering the natural chemicals (neurotransmitters) in the brain area that controls sleep and wakefulness. Unlike traditional stimulants, Artvigil offers a smoother, more sustained alertness with a lower potential for abuse, making it a valuable tool in managing sleep-related disorders and off-label cognitive enhancement under strict medical supervision. Its targeted mechanism provides a focused state of wakefulness without the jitteriness or severe crash associated with amphetamine-based treatments.
Features
- Active Ingredient: Armodafinil (150 mg per tablet)
- Drug Class: Eugeroic (Wakefulness-Promoting Agent)
- Mechanism of Action: Selective dopamine reuptake inhibitor; influences histamine, norepinephrine, orexin, and GABA systems
- Onset of Action: Approximately 1-2 hours post-administration
- Duration of Effect: Up to 12-15 hours
- Bioavailability: High oral bioavailability
- Half-Life: Approximately 15 hours
- Formulation: Oral tablet
- Prescription Status: Schedule IV controlled substance (US); prescription-only globally
- Manufacturer: Various pharmaceutical companies under license
Benefits
- Promotes sustained wakefulness and alertness throughout the day, reducing episodes of unintended sleep in narcolepsy and SWSD.
- Improves cognitive functions such as memory, focus, and executive function, particularly in individuals with sleep deprivation.
- Enhances quality of life by allowing normal daily activities, work productivity, and social engagement without sleep interference.
- Lower abuse potential compared to traditional stimulants like amphetamines, offering a safer long-term profile for appropriate patients.
- Does not typically cause euphoria or significant mood alterations when used at prescribed doses, minimizing recreational use risk.
- May improve adherence to positive airway pressure therapy in OSA patients by reducing residual daytime sleepiness.
Common use
Artvigil is primarily FDA-approved for the treatment of excessive sleepiness associated with narcolepsy, obstructive sleep apnea (OSA) (as adjunctive therapy to standard treatment for residual sleepiness), and shift work sleep disorder (SWSD). In clinical practice, it is also used off-label for attention deficit hyperactivity disorder (ADHD), fatigue associated with multiple sclerosis, depression, and cancer-related fatigue. It is sometimes utilized by healthy individuals seeking cognitive enhancement, though this is not an approved indication and carries risks without medical oversight.
Dosage and direction
The standard recommended dose for Artvigil (armodafinil) is 150 mg or 250 mg taken orally once daily in the morning, depending on the condition and individual response.
- For narcolepsy or OSA: 150 mg or 250 mg once daily in the morning.
- For shift work sleep disorder: 150 mg taken approximately 1 hour before the start of the work shift.
Dosage should be individualized based on efficacy and tolerability. It can be taken with or without food, though a high-fat meal may delay absorption. Do not crush or chew the tablet; swallow whole with water. Do not increase dosage or frequency without consulting a physician. The maximum recommended daily dose is 250 mg.
Precautions
- Artvigil may cause dizziness or blurred vision; avoid driving or operating machinery until you know how it affects you.
- Use with caution in patients with a history of psychosis, depression, mania, or cardiovascular disease due to potential exacerbation.
- Not recommended for use in patients with severe hepatic impairment; dosage adjustment is necessary in moderate hepatic impairment.
- May interact with hormonal contraceptives (e.g., birth control pills), reducing their effectiveness; alternative or additional non-hormonal contraception is advised during and for one month after discontinuation.
- Long-term use requires periodic evaluation of sleep patterns and potential dependence, though risk is lower than with stimulants.
- Avoid alcohol consumption as it may increase the risk of side effects or reduce alertness.
Contraindications
- Hypersensitivity to armodafinil, modafinil, or any component of the formulation.
- History of left ventricular hypertrophy or ischemic ECG changes, chest pain, or arrhythmia in association with previous modafinil/armodafinil use.
- Patients with a history of symptomatic cardiovascular disease such as mitral valve prolapse, myocardial infarction, or unstable angina.
- Severe hypertension uncontrolled by medication.
- Use in pregnancy or breastfeeding unless potential benefits outweigh risks (pregnancy category C).
- Concomitant use with drugs that are strong CYP3A4 inducers or inhibitors without careful monitoring.
Possible side effect
Common side effects (≥1%) may include:
- Headache
- Nausea
- Dizziness
- Insomnia
- Anxiety
- Dry mouth
- Diarrhea
Less common but serious side effects requiring medical attention:
- Severe skin reactions (e.g., Stevens-Johnson syndrome)
- Psychiatric symptoms (e.g., depression, hallucinations, aggression)
- Chest pain, palpitations, or irregular heartbeat
- Signs of allergic reaction (e.g., rash, itching, swelling)
- Symptoms of liver problems (e.g., dark urine, jaundice)
Most side effects are mild to moderate and often diminish with continued use.
Drug interaction
Artvigil is primarily metabolized by CYP3A4 and can induce CYP3A4, CYP2B6, and possibly other enzymes, leading to numerous potential interactions:
- Hormonal contraceptives (e.g., ethinyl estradiol): Effectiveness may be reduced.
- CYP3A4 substrates (e.g., cyclosporine, midazolam, triazolam): Concentrations may be decreased.
- CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): May increase armodafinil levels.
- CYP3A4 inducers (e.g., carbamazepine, phenobarbital): May decrease armodafinil levels.
- Warfarin: Monitoring of prothrombin time is recommended due to potential decreased efficacy.
- Monoamine oxidase inhibitors (MAOIs): Concurrent use is not recommended due to theoretical risk of hypertension.
- Other CNS stimulants or depressants: Additive effects possible.
Always inform your healthcare provider of all medications, including OTC drugs and supplements.
Missed dose
If a dose is missed, take it as soon as you remember unless it is too close to your usual bedtime, as it may cause insomnia. If it is near bedtime, skip the missed dose and resume your regular dosing schedule the next day. Do not double the dose to catch up.
Overdose
Symptoms of overdose may include:
- Agitation
- Insomnia
- Anxiety
- Confusion
- Tachycardia
- Hypertension
- Hallucinations
In case of suspected overdose, seek immediate medical attention or contact a poison control center. Treatment is symptomatic and supportive; there is no specific antidote. Ensure adequate hydration and monitor cardiac and mental status.
Storage
Store at room temperature (20-25°C or 68-77°F), in a tightly closed container, away from light, moisture, and heat. Do not store in the bathroom. Keep out of reach of children and pets. Do not flush medications down the toilet or pour into a drain unless instructed to do so.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here. Artvigil is a prescription medication and should be used only under the supervision of a healthcare professional.
Reviews
“Artvigil has been a game-changer for my shift work disorder. I no longer struggle to stay alert during night shifts, and I don’t experience the jitters I had with other medications. It’s smooth and effective.” – Mark T., verified patient
“After years of fatigue from narcolepsy, Artvigil gave me back my daytime functionality. I can work full-time and enjoy time with my family without constant sleep attacks. The only side effect I notice is occasional mild headache.” – Sarah L., verified patient
“My psychiatrist prescribed Artvigil off-label for ADHD after stimulants caused anxiety. It helps with focus and organization without making me feel wired. It’s not as intense as adderall, but much smoother and longer-lasting.” – James K., verified patient
“I experienced some insomnia when I first started, but after adjusting the timing (taking it right upon waking), it works perfectly. I’ve been using it for OSA-related sleepiness for over a year with consistent results.” – Linda R., verified patient
“As a medical resident working long hours, Artvigil helps me stay sharp and alert. I use it responsibly and only when needed. It doesn’t replace sleep, but it makes manageable those unavoidable rough patches.” – Dr. Alex P., verified patient