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Therefore, concurrent use of flibanserin and CYP3A4 inducers, such as modafinil or armodafinil, is not What Is The Maximum Dose. In addition, modafinil and armodafinil are inhibitors of CYP2C19, a minor metabolic pathway of flibanserin.

Azole antifungals, such as fluconazole, are significant inhibitors of this isoenzyme and may reduce the clearance of modafinil. Fluoxetine: Moderate Although no clinical data are available, fluoxetine may inhibit the clearance and potentiate the actions of modafinil. Modafinil is metabolized by CYP3A4 isozyme, a pathway that fluoxetine is known to inhibit.

Food: Moderate Food delays the rate, but not the extent, of modafinil absorption by approximately one hour. A delayed onset of action of a modafinil dose may result from this interaction, but this may not be clinically significant to the patient. Patients may take modafinil with or without food. Moderate The incidence of marijuana Provigil Maximum Dosage adverse effects may change following coadministration with modafinil. Fosamprenavir: Major Caution is advised when administering modafinil with fosamprenavir, as concurrent use may reduce the plasma concentrations of fosamprenavir.

Modafinil is an inducer of the hepatic isoenzyme CYP3A4. Amprenavir, the active metabolite of fosamprenavir, is a substrate of CYP3A4. Glasdegib: Major Avoid coadministration of glasdegib and modafinil due to the potential for decreased glasdegib exposure and risk of decreased efficacy. If concurrent use cannot be avoided, increase Provigil Maximum Dosage glasdegib dosage i.

Resume the previous dose of glasdegib after modafinil has been discontinued for 7 days. Grapefruit juice: Moderate Grapefruit juice has been reported to decrease the metabolism of drugs that are metabolized via the CYP3A4 isoenzyme; grapefruit juice inhibits CYP3A4 in enterocytes. Because modafinil is significantly metabolized through CYP3A4, patients should be advised to not significantly alter their grapefruit juice ingestion.

Green Tea: Major Some, but not all, green tea products contain caffeine. Additive CNS stimulant effects are likely to occur when caffeine is coadministered with other CNS stimulants or psychostimulants. Caffeine should be avoided or used cautiously with modafinil. Guaifenesin; Hydrocodone: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Guaifenesin; Hydrocodone; Pseudoephedrine: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence. Homatropine; Hydrocodone: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Hydantoin concentrations may increase.

Detailed dosage guidelines and administration information for Provigil (modafinil). .serp-item__passage{color:#} The recommended dosage of PROVIGIL for patients with SWD is mg taken orally once a day as a single dose approximately 1 hour prior to the start of. Recommended Provigil Dosage instructions for studying, focus and ADHD. What is the maximum safe dose for adults and how to prevent tolerance?

Monitor carefully for signs of toxicity; phenytoin concentration Provigil Maximum Dosage may be helpful. Hydrocodone: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical Provigi.

Hydrocodone; Ibuprofen: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Hydrocodone; Phenylephrine: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome Dosafe patients who have developed physical dependence. Hydrocodone; Potassium Guaiacolsulfonate: Moderate Concomitant use of hydrocodone with modafinil Maxiimum decrease hydrocodone levels; this may result in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Moderate Concomitant use of hydrocodone with modafinil can decrease hydrocodone levels; this may result in Provigil Maximum Dosage efficacy Provigil Maximum Dosage onset of a withdrawal syndrome in patients who have developed physical dependence. Hydrocodone; Pseudoephedrine: Moderate Concomitant use of hydrocodone with modafinil can Provigil Maximum Dosage hydrocodone levels; this may result in decreased efficacy or onset Provigli a withdrawal syndrome in patients who have developed physical dependence.

Ibrutinib: Moderate Use ibrutinib and modafinil together with caution; decreased ibrutinib levels Provigil Maximum Dosage occur resulting in reduced ibrutinib efficacy.

Monitor patients for signs of decreased ibrutinib efficacy if these agents are used together. Simulations suggest that coadministration with a moderate CYP3A4 inducer may decrease ibrutinib exposure by 3-fold. Ibuprofen; Oxycodone: Dossage Monitor for reduced efficacy of oxycodone and signs of opioid withdrawal if coadministration with modafinil is necessary; consider increasing the dose of oxycodone as needed.

Ifosfamide: Moderate Closely monitor for increased ifosfamide-related toxicities e. Isavuconazonium: Major Coadministration of isavuconazonium with modafinil is not recommended as there is a potential for elevated modafinil concentrations and decreased isavuconazonium concentrations.

Decreased isavuconazonium concentrations may lead Provigil Maximum Dosage a reduction of antifungal efficacy and the potential for treatment failure. Isavuconazole, the active moiety of isavuconazonium, is a sensitive substrate and inhibitor of CYP3A4. It is known that many other CNS stimulants may induce severe cardiovascular and cerebrovascular responses if administered in combination with drugs with non-selective MAO inhibitor activity.

Until more is known regarding the pharmacology of modafinil, it is prudent avoid the use of modafinil in the presence of an MAO inhibitor.

Due to the prolonged duration of action of MAOIs, a period of at least 14 days between the last dose of the MAOI and the first dose of modafinil should elapse. Observation of the patient for increased effects from modafinil may be needed. Click at this page Major Avoid coadministration of ivabradine and modafinil. Coadministration may decrease the plasma concentrations of ivabradine resulting in the potential for treatment failure.

Caution should be utilized when CYP3A4 inducers are coadministered with ixabepilone, and alternative therapies with low enzyme induction potential should be considered.

Azole antifungals are significant inhibitors of this isoenzyme and may reduce the clearance of modafinil. Lansoprazole; Amoxicillin; Clarithromycin: Major Coadministration of modafinil and clarithromycin may decrease clarithromycin serum concentrations due to CYP3A4 enzyme induction.

Lefamulin: Major Avoid coadministration of lefamulin with modafinil unless the benefits outweigh the risks as concurrent use may decrease lefamulin exposure and efficacy. Lemborexant: Major Avoid coadministration of lemborexant and modafinil as concurrent use may decrease lemborexant exposure which may reduce efficacy.

Letermovir: Major Concurrent administration of letermovir and modafinil is not recommended. Use of these drugs together may decrease letermovir plasma concentrations, resulting in a potential loss of letermovir efficacy.

Leuprolide; Norethindrone: Major Modafinil may cause failure of Provigil Maximum Dosage contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products. Levonorgestrel: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products. Levonorgestrel; Ethinyl Estradiol: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products.

Levonorgestrel; Ethinyl Estradiol; Ferrous Bisglycinate: Major Dosaye may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products. Lidocaine: Moderate Concomitant use of systemic lidocaine and modafinil may decrease lidocaine plasma concentrations. Lidocaine; Epinephrine: Moderate Concomitant use of systemic lidocaine and modafinil may decrease lidocaine plasma concentrations.

Lidocaine; Prilocaine: Moderate Concomitant use of systemic lidocaine and modafinil may decrease lidocaine plasma concentrations. Linagliptin: Moderate Concomitant use of linagliptin with modafinil may result in decreased serum concentrations of linagliptin.

Linagliptin; Metformin: Moderate Concomitant use of linagliptin with modafinil may result in decreased serum concentrations of linagliptin. Linezolid: Moderate Linezolid is an Provigil Maximum Dosage which is a reversible, non-selective Maximmum of MAO.

Administration of modafinil to patients receiving linezolid may invoke a hypertensive reaction. Such drugs should be avoided during and for up to 2 weeks following the discontinuation of linezolid. Lisdexamfetamine: Moderate The use of modafinil with other psychostimulants, including amphetamines e. Lonafarnib: Major Avoid coadministration of lonafarnib and modafinil; concurrent use may increase the exposure of lonafarnib and the risk of adverse effects.

The Provigiil of modafinil may also be increased. Provlgil coadministration is unavoidable, closely monitor patients for adverse reactions from both drugs. Loperamide: Moderate The plasma concentration and efficacy of Provigil Maximum Dosage may be reduced when administered concurrently with modafinil. Loperamide; Simethicone: Moderate The plasma concentration and efficacy of loperamide may be reduced when administered concurrently with modafinil.

Lopinavir; Ritonavir: Major Concurrent administration of modafinil with ritonavir may result in elevated plasma concentrations of modafinil and decreased concentrations of ritonavir. Lorlatinib: Major Avoid concomitant use of lorlatinib and modafinil due to decreased plasma concentrations of lorlatinib, which may reduce its efficacy. If concomitant use is necessary, increase the dose of lorlatinib to mg PO once daily.

Lumateperone: Major Avoid coadministration of lumateperone and modafinil as concurrent use may decrease lumateperone exposure which may reduce efficacy. Lurasidone: Moderate Because lurasidone is primarily metabolized by CYP3A4, decreased plasma concentrations of lurasidone may occur when the drug is co-administered with inducers of CYP3A4.

Concurrent use of lurasidone and CYP3A4 inducers, such Provigil Maximum Dosage modafinil, may lead to a decrease in efficacy of lurasidone. If lurasidone is used with a moderate CYP3A4 inducer, it may be necessary to increase the lurasidone dose after chronic treatment 7 days or more. Https://topmodafinilrxpills.com/5-how-can-i-buy-provigil-online-boq.php Major Discontinue modafinil and allow a sufficient washout period to pass before administering macimorelin.

Use of these drugs together can significantly decrease macimorelin plasma concentrations, and may result in a false positive test for growth hormone deficiency. Maraviroc: Provigil Maximum Dosage Use caution if Provigil Maximum Dosage of maraviroc with modafinil is necessary, due to a possible decrease in maraviroc exposure. Monitor for a decrease in maraviroc efficacy with concomitant use. Medroxyprogesterone: Provigol Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products.

Meloxicam: Moderate Consider a meloxicam dose reduction and monitor for adverse reactions if coadministration with modafinil is necessary. Privigil is metabolized to ethinyl estradiol. Female patients of child-bearing potential should be advised to discuss contraceptive options with their health care provider to prevent unintended pregnancies. Methamphetamine: Moderate The use of modafinil with other psychostimulants, Provivil amphetamines e.

Provigil (modafinil)

Methylphenidate Derivatives: Major The use of modafinil with other psychostimulants, including Dowage or its derivatives, has not been extensively go here. Single dose studies of methylphenidate combined with modafinil noted that Provigil Maximum Dosage rate of absorption of modafinil was delayed up to one hour by the presence of methylphenidate; no changes occurred in the metabolism and extent of absorption of either medication.

Mitotane: Minor Avoid the concomitant use of mitotane with modafinil; if coadministration cannot be avoided, monitor for decreased efficacy of modafinil. Mitotane is a strong CYP3A4 inducer. A non-CYP related pathway is the most rapid in metabolizing modafinil, suggesting that there is a low probability of substantive effects on the overall pharmacokinetic profile of modafinil due to CYP inhibition by concomitant medications; however, due to the partial involvement of CYP3A in modafinil metabolism, there is a potential for decreased plasma concentrations with strong CYP3A inducers such as mitotane.

Monoamine oxidase inhibitors: Major Modafinil has not been Prrovigil for drug interactions with monoamine oxidase inhibitors MAOIs. Nanoparticle Albumin-Bound Paclitaxel: Moderate Monitor for decreased efficacy of nab-paclitaxel if Povigil with modafinil is necessary due to the risk of decreased plasma concentrations of paclitaxel.

Nanoparticle Albumin-Bound Sirolimus: Moderate Monitor for loss of efficacy of sirolimus during coadministration of modafinil; a sirolimus dose adjustment may be necessary. Monitor sirolimus serum concentrations as appropriate. Modafinil concentrations may increase with concurrent nefazodone use.

Because modafinil is itself an inducer of the CYP3A4 isoenzyme, drug interactions due to CYP3A4 enzyme inhibition by other medications may be complex and difficult to Doxage.

Neratinib: Dosqge Avoid concomitant use Provigil Maximum Dosage modafinil with neratinib due to decreased efficacy of neratinib. Nirmatrelvir; Ritonavir: Major Concurrent administration of modafinil with ritonavir may result in elevated plasma concentrations of modafinil and decreased concentrations of ritonavir. Moderate Monitor for a diminished response to nirmatrelvir if concomitant use of modafinil is necessary.

Concomitant use of nirmatrelvir and modafinil may reduce the therapeutic effect of nirmatrelvir. Nisoldipine: Major Provvigil coadministration of nisoldipine with modafinil due Ptovigil decreased plasma concentrations of nisoldipine.

Alternative antihypertensive therapy should be considered. Coadministration with a strong CYP3A4 inducer lowered nisoldipine plasma concentrations Provgil undetectable levels.

Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products. Norethindrone: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products.

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Norethindrone; Ethinyl Estradiol: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products.

Norethindrone; Ethinyl Estradiol; Ferrous fumarate: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products. Norgestimate; Ethinyl Estradiol: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these click to see more. Norgestrel: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or Provigil Maximum Dosage due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products.

Olanzapine; Fluoxetine: Moderate Although no clinical data are available, fluoxetine may inhibit the clearance and potentiate the actions of modafinil. Olaparib: Major Avoid coadministration of olaparib with modafinil due to the risk of decreasing the efficacy of olaparib. Ombitasvir; Paritaprevir; Ritonavir: Contraindicated Provigil Maximum Dosage administration of modafinil with dasabuvir; ombitasvir; paritaprevir; ritonavir or ombitasvir; paritaprevir; ritonavir is contraindicated.

Omeprazole; Amoxicillin; Rifabutin: Moderate Drugs that exhibit significant induction of the hepatic microsomal CYP3A4 isoenzyme may potentially increase the metabolism of modafinil. These medications include rifabutin. Plasma concentrations and efficacy of modafinil may be reduced if these drugs are administered concurrently.

Oxycodone: Moderate Monitor for reduced efficacy of oxycodone and signs of opioid withdrawal if coadministration Provigil Maximum Dosage modafinil is necessary; consider increasing the dose of oxycodone as needed. Coadministration of pazopanib and modafinil, a CYP3A4 substrate, may cause an increase in systemic concentrations of modafinil. In addition, modafinil is an inducer of CYP3A4 and may cause a decrease in Provigil Maximum Dosage concentrations of pazopanib.

Use caution when administering these drugs concomitantly. Pemigatinib: Major Avoid coadministration of pemigatinib and modafinil due to the risk of decreased pemigatinib exposure which may reduce its efficacy. Pemoline: Major The use of modafinil Provigil Maximum Dosage other psychostimulants, including pemoline, has not been extensively studied.

Perampanel: Major Start perampanel at a higher initial dose of 4 mg once daily at bedtime when using concurrently with modafinil due to a potential reduction in perampanel plasma concentration.

If introduction or withdrawal of modafinil occurs during perampanel therapy, closely monitor patient response; a dosage adjustment may be necessary. Moderate inducers of CYP3A4 Provigil Maximum Dosage reduce pimavanserin exposure, Provigil Maximum Dosage decreasing the effectiveness of pimavanserin. Posaconazole: Moderate Posaconazole and modafinil should be coadministered with caution due to an increased potential for modafinil-related adverse events.

Posaconazole is a potent inhibitor of CYP3A4, an isoenzyme responsible for the metabolism of modafinil. These drugs used in combination may result in elevated modafinil plasma concentrations, causing an increased risk for modafinil-related adverse events. Praziquantel: Major In vitro and drug interactions studies suggest that the CYP3A4 isoenzyme is the major enzyme involved in praziquantel metabolism.

Therefore, use of praziquantel with modafinil, a CYP3A4 inducer, should be done with caution as concomitant use may produce therapeutically ineffective concentrations of praziquantel. Progesterone: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products.

Progestins: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products. In theory, dosage reductions may be required for drugs that are largely eliminated via CYP2C19 metabolism such as propranolol during coadministration with modafinil.

Relugolix; Estradiol; Norethindrone acetate: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of the progestins in these products. Ribociclib: Moderate Monitor for an increase in modafinil-related adverse reactions if coadministration with ribociclib is necessary. Modafinil has multiple pathways for metabolism including non-CYP-related pathways; however, due to partial involvement of the CYP3A enzymes, concomitant use of strong CYP3A4 inhibitors such as ribociclib could increase plasma concentrations of modafinil.

Ribociclib; Letrozole: Moderate Monitor for an increase in modafinil-related adverse reactions if coadministration with ribociclib is Provigil Maximum Dosage. Rifabutin: Moderate Drugs that exhibit significant induction of the hepatic microsomal CYP3A4 isoenzyme may potentially increase the metabolism of modafinil. Rifampin: Major Rifampin exhibits significant induction of the hepatic microsomal CYP3A4 isoenzyme and may potentially increase the metabolism of modafinil. Rifapentine: Moderate Monitor for decreased efficacy of modafinil if coadministration with rifapentine is necessary.

The probability of effect of rifapentine on modafinil exposure is low due to the existence of multiple pathways for modafinil metabolism, as well as the fact that a non-CYP-related pathway is the most rapid in metabolizing modafinil; however, plasma concentrations of modafinil may be impacted by strong CYP3A4 inducers.

Rilpivirine: Moderate Close clinical monitoring is advised when administering modafinil with rilpivirine due to the potential for rilpivirine treatment failure. Riluzole: Moderate Coadministration of riluzole with modafinil may result in decreased riluzole efficacy. In vitro findings suggest decreased riluzole exposure is likely. Rimegepant: Major Avoid coadministration of rimegepant with modafinil; concurrent use may significantly decrease rimegepant exposure which may result in loss of efficacy.

Ritonavir: Major Concurrent administration of modafinil with ritonavir may result in elevated plasma concentrations of modafinil and decreased concentrations of ritonavir.

Rivaroxaban: Minor Coadministration of rivaroxaban and modafinil may result in decreased rivaroxaban exposure and may decrease click efficacy of rivaroxaban. If these drugs are administered concurrently, monitor the patient for signs of lack of efficacy of rivaroxaban.

Roflumilast: Major Coadminister modafinil and roflumilast cautiously as this may lead to reduced systemic exposure to roflumilast. In pharmacokinetic study, administration of a single dose Provigil Maximum Dosage roflumilast in patients receiving another CYP3A4 inducer, rifampin, resulted in decreased roflumilast Cmax and AUC, as well as increased Cmax and decreased AUC of the active metabolite roflumilast N-oxide.

Coadministration of a CYP3A4 inducer, like modafinil, may decrease systemic concentrations of romidepsin. Use caution when concomitant administration of these agents is necessary. When used with drugs that are CYP3A4 inducers such as modafinil, a dose adjustment is not necessary, but closely monitor patients and titrate the ruxolitinib dose based on safety and efficacy. Segesterone Acetate; Ethinyl Estradiol: Major Modafinil may cause failure of oral contraceptives or hormonal contraceptive-containing implants or devices due to induction of CYP3A4 isoenzyme metabolism of ethinyl estradiol in these products.

Selegiline: Moderate Use caution during concomitant use of selegiline and modafinil. Modafinil has not been evaluated for drug interactions with monoamine oxidase inhibitors MAOIs ; however, it Provigil Maximum Dosage known that many other CNS stimulants may induce severe cardiovascular reactions, such as hypertensive crisis, if administered in combination with drugs with non-selective MAO inhibitor activity. Selpercatinib: Major Avoid coadministration of selpercatinib and modafinil due to the risk of decreased selpercatinib exposure which may reduce its efficacy.

Selumetinib: Major Avoid coadministration of selumetinib and modafinil due to the risk of decreased selumetinib exposure which may reduce its efficacy. Sertraline: Moderate Dose adjustments of sertraline, a substrate for CYP2C19, may be necessary when used concomitantly with modafinil. Elimination of sertraline may be prolonged by modafinil via inhibition of CYP2C19, with resultant higher systemic exposure. Monitor for adverse effects, such as serotonin excess, and reduce the sertraline dosage if needed.

Simeprevir: Major Avoid concurrent use of simeprevir and modafinil. Induction of CYP3A4 by modafinil may significantly reduce the plasma concentrations of simeprevir, resulting in treatment failure.

Monitor patients for adverse effects of modafinil, such as CNS effects. Sirolimus: Moderate Monitor for loss of efficacy of sirolimus during coadministration of modafinil; a sirolimus dose adjustment may be necessary. Taking these drugs together may significantly decrease velpatasvir plasma concentrations, potentially resulting in Provigil Maximum Dosage of antiviral efficacy.

Taking these drugs together may significantly decrease voxilaprevir plasma concentrations, potentially resulting in loss Provigil Anger antiviral efficacy. Solriamfetol: Moderate Monitor blood pressure and heart rate during coadministration of solriamfetol, a norepinephrine and dopamine reuptake inhibitor, and modafinil, a CNS stimulant.

Coadministration of solriamfetol with other drugs that increase blood pressure or heart rate has not been evaluated. Sonidegib: Major Avoid the concomitant use of sonidegib and modafinil; sonidegib exposure may be significantly decreased and its efficacy reduced. Avoid the use of sorafenib with a strong Provigil Maximum Dosage inducer. If a strong CYP3A4 inducer must be coadministered with sorafenib, consider a sorafenib dose increase.

John's Wort, Hypericum perforatum: Major St. John's wort, Hypericum Perforatum may reduce the neuronal uptake of monoamines Provigil Maximum Dosage should be used cautiously with sympathomimetics. Sufentanil: Moderate Because the dose of the sufentanil sublingual tablets cannot be titrated, consider an alternate opiate if modafinil must be administered. Monitor for reduced efficacy of Provigil Maximum Dosage injection and signs of opioid withdrawal if coadministration with modafinil is necessary; consider increasing the dose of sufentanil Provigil Maximum Dosage as needed.

If modafinil is discontinued, consider a dose reduction of sufentanil injection and frequently monitor for signs or respiratory depression and sedation. Concomitant use with CYP3A4 inducers can decrease sufentanil concentrations; this may result in Provigil Maximum Dosage efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence. Tasimelteon: Moderate Caution is recommended during concurrent use of tasimelteon and modafinil or armodafinil.

Because tasimelteon is metabolized via CYP3A4 and CYP1A2, inducers of these isoenzymes, such as modafinil and armodafinil, may reduce the efficacy of tasimelteon. Tazemetostat: Major Avoid coadministration of tazemetostat with Provigil Maximum Dosage as concurrent use may decrease Provigil Maximum Dosage exposure, which may reduce its efficacy. Telaprevir: Moderate Close clinical monitoring is advised when administering modafinil with telaprevir due to an increased potential for modafinil-related adverse events and the potential for telaprevir treatment failure.

If modafinil dose adjustments are made, re-adjust the dose upon completion of telaprevir treatment. Although this interaction has not been studied, predictions about the interaction can be made based on the metabolic pathways of modafinil and telaprevir.

Modafinil is a substrate and inducer of the hepatic isoenzyme CYP3A4; telaprevir is a substrate and an inhibitor of this isoenzyme. When used in combination, the plasma concentrations of modafinil may increase and the plasma concentrations of telaprevir may decrease. Telithromycin: Major Concomitant administration of CYP3A4 inducers, such as modafinil, are expected to cause subtherapeutic concentrations of telithromycin and loss of efficacy. In addition, telithromycin is a competitive substrate and inhibitor of CYP3A4; coadministration of telithromycin Provigil Maximum Dosage other drugs metabolized by CYP3A4, such as modafinil, may result in increased plasma concentrations and an increase of therapeutic or adverse Nuvigil Comparison. Temsirolimus: Moderate Use caution if coadministration of temsirolimus with modafinil is necessary, and monitor for decreased efficacy of temsirolimus.

The manufacturer of temsirolimus recommends a dose increase if coadministered with a strong CYP3A4 inducer, but recommendations are not available for concomitant use of moderate CYP3A4 inducers.

Terbinafine: Moderate Caution is advised when administering terbinafine with modafinil. Although this interaction has not been studied by the manufacturer, and published literature suggests the potential for interactions to be low, taking these drugs together may alter the systemic exposure of terbinafine.

Predictions about the interaction can be made based on the metabolic pathways of both drugs. Monitor patients for adverse reactions and breakthrough fungal infections if these drugs are coadministered. The drug may induce the metabolism of some narrow-therapeutic index medications.

Patients on theophylline or aminophylline may need to be monitored for reduced methylxanthine efficacy when modafinil is added to therapy. In some cases, monitoring of theophylline concentrations may be helpful. When modafinil is discontinued, monitor the patient for potential increases in theophylline concentrations. In some cases, monitoring of theophylline concentrations may be helpful.

Modafinil is an inducer of CYP3A4. Coadministration may result in reduced plasma concentration and subsequent reduced effectiveness of tolvaptan therapy and should be avoided.

If coadministration is unavoidable, an increase in the tolvaptan dose may be necessary and patients should be monitored for decreased effectiveness of tolvaptan. Tranylcypromine: Major Modafinil has not been evaluated for drug https://topmodafinilrxpills.com/7-reviews-of-provigil-kyhuk.php with monoamine oxidase inhibitors MAOIs.

Triazolam: Moderate Modafinil has been reported to induce the metabolism of triazolam via induction of the hepatic microsomal CYP3A4 isoenzyme.

If a patient is receiving triazolam and modafinil Provigil Maximum Dosage introduced, monitor the patient for decreased clinical response to the benzodiazepine. Conversely, if modafinil is discontinued in such a patient, the triazolam dosage may need to Provigil Maximum Dosage adjusted downward after modafinil cessation. Tucatinib: Moderate Monitor for an increase in modafinil-related adverse reactions if coadministration with tucatinib is necessary.

Modafinil has multiple pathways for metabolism including non-CYP-related pathways; however, due to partial involvement of the CYP3A enzymes, concomitant use of strong CYP3A4 inhibitors such as tucatinib could increase plasma concentrations of modafinil. Ubrogepant: Major Increase the initial and second dose of ubrogepant to mg if coadministered with modafinil as concurrent use may decrease ubrogepant exposure and reduce its efficacy.

Concomitant use may decrease the plasma concentration and effectiveness of ulipristal. Vemurafenib: Major Concomitant use of vemurafenib and modafinil may result in decreased concentrations of both agents.

Both are CYP3A4 substrates and inducers. Use caution and monitor patients for therapeutic effects. Visit web page Major Avoid the concomitant use of venetoclax and modafinil; venetoclax levels may be decreased and its efficacy reduced. Consider alternative agents. Use of venetoclax with a moderate CYP3A4 inducer has not been evaluated.

Agents that induce CYP3A4 may increase the metabolism of vincristine and decrease the Provigil Maximum Dosage of drug, including modafinil. Patients receiving these drugs concurrently with vincristine should Provigil Maximum Dosage monitored for possible loss of vincristine efficacy. Each test session was terminated after 20 minutes if no sleep occurred or 15 minutes after sleep onset. For a successful trial, both measures had to show statistically significant improvement.

The MWT measures latency in minutes to sleep onset averaged over 4 test sessions at 2 hour intervals following nocturnal polysomnography. For each test session, the subject was asked to attempt to remain awake without using extraordinary measures. Each test session was terminated after 20 minutes if no sleep occurred or 10 minutes after sleep onset.

Patients were rated by evaluators who had no access to any data about the patients other than a measure of their baseline severity. Evaluators were not given any specific guidance about the criteria they were to apply when rating patients. Both studies demonstrated improvement in objective and subjective measures of excessive daytime sleepiness for both the mg and mg doses compared to placebo.

The criteria include either: 1 excessive sleepiness or insomnia, plus frequent episodes of impaired breathing during sleep, and associated features such as loud snoring, morning headaches and dry mouth upon awakening; or 2 excessive sleepiness or insomnia and polysomnography demonstrating one of the following: more than five obstructive apneas, each greater than 10 seconds in duration, per hour of sleep and one or more of the following: frequent arousals from sleep associated with the apneas, bradytachycardia, and arterial oxygen desaturation in Provigil Maximum Dosage with the apneas.

CPAP use continued throughout the study. The primary measure of effectiveness was the change from baseline on the ESS at final visit. At week 4, the ESS was reduced by 4. All patients met the criteria for chronic SWD. The criteria include: 1 either, a a primary complaint of excessive sleepiness or insomnia which is temporally associated with a work period usually night work that occurs during the habitual sleep phase, or b polysomnography and the MSLT demonstrate loss of a normal sleep-wake pattern i.

It should be noted that not Provigil Maximum Dosage patients with a complaint of sleepiness who are also engaged in shift work meet the criteria for the diagnosis of SWD. In the clinical trial, only patients who were symptomatic for at least 3 months were enrolled.

Advise patients to stop taking PROVIGIL and to notify their physician right Provigil Maximum Dosage if they develop a rash, hives, mouth sores, blisters, peeling skin, trouble swallowing or breathing, or a related allergic phenomenon. Advise patients not to alter their previous behavior with regard to potentially dangerous activities e.

Inform patients that it may be critical that they continue to take their previously prescribed treatments e. Advise patients to stop taking PROVIGIL and contact their physician right away if they experience chest pain, rash, depression, anxiety, or signs of psychosis or mania. Advise patients to notify their physician if they become pregnant or intend to become pregnant during therapy. Caution patients regarding the potential increased risk of pregnancy when using steroidal contraceptives including Provigil Maximum Dosage or implantable contraceptives with PROVIGIL and for one month after discontinuation of therapy.

There may be new information. This information does not take the Provigil Maximum Dosage of talking with your doctor about your medical condition or treatment. PROVIGIL may cause serious side effects including a serious rash or a serious allergic reaction that may affect parts of your body such as your liver or blood cells.

Any of these may need to be treated in a hospital and may be life-threatening. If you have a severe rash with PROVIGIL, stopping the medicine may not keep the rash from becoming life-threatening or causing you to be permanently disabled or disfigured. PROVIGIL is a prescription medicine used to improve wakefulness in adults who are very sleepy due to one of the following diagnosed sleep disorders:.

Follow your doctor's advice about good sleep habits and using other treatments. Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs. Tell your doctor about all of your medical conditions including, if you:. Tell your doctor about all the medicines you takeincluding prescription and over-the-counter medicines, vitamins, and herbal supplements.

Know the medicines you take. Keep a list of them The Medicine show it to your doctor and pharmacist when you get a new medicine.

For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. It may harm them and it is against the law.

If you would like more information, talk with your doctor. For more information, call Inactive Ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, croscarmellose sodium, povidone, and magnesium stearate. Rx only teva.

Dosing regimen effects of modafinil for improving daytime wakefulness in patients with narcolepsy

DailyMed will deliver notification of updates and additions to Drug Label information currently shown on this site through its RSS feed.

DailyMed will deliver this notification to your desktop, Web browser, or e-mail depending on the RSS Reader you select to use. Due to inconsistencies Profigil the drug labels on DailyMed and the pill images provided by RxImagewe no longer display the RxImage pill images associated with drug labels.

We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. View Package Photos. Drug Label Info. NDC National Drug Code - Each drug product is Provigjl this unique number which can be found on the drug's outer packaging. Approval: The following serious adverse reactions are described elsewhere in the labeling: Serious Rash, including Stevens-Johnson Syndrome [see Warnings and Precautions 5. Table 1. Cardiovascular: Stroke Hematologic: agranulocytosis Psychiatric disorders: psychomotor hyperactivity.

The chemical structure is:. Gender The pharmacokinetics of modafinil are not affected by gender. Race The Provigil Maximum Dosage of race on the pharmacokinetics of modafinil has not been studied. Hepatic Impairment The pharmacokinetics and metabolism of modafinil were examined in patients with cirrhosis of the liver 6 men and 3 women. Therefore, the blood levels and effectiveness of drugs that are substrates for CYP3A enzymes e.

There was no apparent change in the elimination rate of ethinyl estradiol. Cyclosporine Maxmium One case of an interaction between modafinil and cyclosporine, a substrate of CYP3A4, has been reported in a 41 year old Proivgil who had undergone an organ transplant. The interaction was postulated to be due to the increased metabolism of cyclosporine, since no other factor expected to affect the disposition of the drug had changed. Proigil, in a clinical study with armodafinil using caffeine as a probe substrate, no significant effect on CYP1A2 activity was observed.

Drugs Metabolized by CYP2C9 In vitro data demonstrated that modafinil produced an apparent concentration-related suppression of expression of CYP2C9 activity suggesting that there is a potential for a metabolic interaction between modafinil and the substrates of this enzyme e. Warfarin: Concomitant administration of modafinil with warfarin did not produce significant changes in the pharmacokinetic profiles of R- and S-warfarin.

However, Provigil Maximum Dosage only a single dose of warfarin was tested in this study, an interaction cannot be ruled out [see Drug Interactions 7 ]. CYP2C19 is also reversibly inhibited, with similar potency, by a circulating metabolite, modafinil sulfone.

Although the maximum plasma concentrations of modafinil sulfone are much lower than those of parent modafinil, the combined effect of both compounds could Maimum sustained partial inhibition of Provigil Maximum Dosage enzyme. Therefore, exposure to some drugs that are substrates for CYP2C19 e. Interactions with CNS Active Drugs Concomitant administration of modafinil with methylphenidate or dextroamphetamine produced no significant alterations on the pharmacokinetic profile of modafinil or either stimulant, even though the absorption of modafinil was delayed for approximately one hour.

Concomitant modafinil or clomipramine did not alter the pharmacokinetic profile of either drug; however, one incident of increased levels of clomipramine and its active metabolite desmethylclomipramine was Provigil Maximum Dosage in a patient with narcolepsy during treatment with modafinil. CYP2C19 also provides an ancillary pathway for the metabolism of certain tricyclic antidepressants e.

In tricyclic-treated patients deficient in CYP2D6 i. Concomitant administration of armodafinil with quetiapine reduced the systemic exposure of quetiapine. Interaction with P-Glycoprotein An in vitro study demonstrated that armodafinil is Povigil substrate of P-glycoprotein.

The impact of inhibition of P-glycoprotein is not known. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices.

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The recommended dosage of PROVIGIL for patients with narcolepsy or OSA is mg taken orally once a day as a single dose in the morning. Doses up to mg/day. The recommended dose is mg PO once daily as a single dose in the morning. While doses up to mg PO once daily have been well tolerated, there is no.

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