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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
You might struggle with extreme sleepiness during the day if you work the night shift. But with proper treatment like Armodafinil (Nuvigil) or modafinil (Provigil), you can stay awake and feel more alert. These medications can be prescribed if you’ve been diagnosed with shift work disorder (SWD), narcolepsy, or obstructive sleep apnea (OSA). As wakefulness-promoting agents, armodafinil and modafinil have stimulant-like effects.
While their exact mechanism of action is unknown, armodafinil and modafinil are believed to work in the central nervous system (CNS) and boost dopamine activity in the brain. Their effects may be similar to other stimulants such as amphetamine (Adderall) and methylphenidate (Concerta). However, they are structurally different than other stimulants.
Both armodafinil and modafinil are Schedule IV drugs that have a low potential for abuse and dependence. They are controlled substances only available with a prescription.
What are the main differences between armodafinil and modafinil?
Armodafinil, sold under the brand name Nuvigil, is a newer drug compared to modafinil. It was approved in 2007 as the R-enantiomer of modafinil. Enantiomers are molecules that are mirror images of each other—think left and right-handed gloves. In this way, armodafinil has a slightly different chemical structure compared to modafinil.
Armodafinil may have a longer half-life compared to modafinil (brand-name Provigil). In some cases, armodafinil may be considered a stronger drug with better wakefulness effects. While both drugs can have similar side effects, some side effects may be more common in one drug versus the other.
| Main differences between armodafinil and modafinil | ||
|---|---|---|
| Armodafinil | Modafinil | |
| Drug class | Stimulant-like drug Wakefulness promoting agent |
Stimulant-like drug Wakefulness promoting agent |
| Brand/generic status | Brand and generic versions available | Brand and generic versions available |
| What is the brand name? | Nuvigil | Provigil |
| What form(s) does the drug come in? | Oral tablet | Oral tablet |
| What is the standard dosage? | 150 mg once per day | 200 mg once per day |
| How long is the typical treatment? | Long term or as directed by a physician | Long term or as directed by a physician |
| Who typically uses the medication? | Adults and young adults 17 years and older | Adults and young adults 17 years and older |
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Conditions treated by armodafinil and modafinil
Armodafinil and modafinil are prescription drugs that are FDA-approved to treat daytime sleepiness related to narcolepsy, shift work disorder, and obstructive sleep apnea. These medical conditions are characterized by inadequate feelings of rest which results in excessive sleepiness. Both drugs improve wakefulness in those who struggle with excessive fatigue and sleepiness throughout the day.
Armodafinil and modafinil have also been studied for off-label purposes. Some studies show that modafinil can be an effective treatment option for fatigue that occurs as a result of cancer and cancer treatment. In adults who are actively receiving cancer treatment, modafinil may help offset excessive tiredness from chemotherapy.
In those with multiple sclerosis, lower doses of modafinil may be effective for treating symptoms of fatigue. However, most data suggest that modafinil should not be used as a first-line option for this condition.
Other off-label uses include treatment for psychiatric disorders like depression and attention deficit-hyperactivity disorder (ADHD). Armodafinil or modafinil may be effective for treating symptoms of these disorders but they are not recommended as initial treatment options.
| Condition | Armodafinil | Modafinil |
| Narcolepsy | Yes | Yes |
| Shift work disorder | Yes | Yes |
| Obstructive sleep apnea | Yes | Yes |
| Cancer-related fatigue | Off-label | Off-label |
| Multiple sclerosis-related fatigue | Off-label | Off-label |
| Psychiatric disorders such as depression and ADHD | Off-label | Off-label |
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Is armodafinil or modafinil more effective?
Armodafinil and modafinil are similarly effective for treating sleepiness from sleep disorders like narcolepsy, obstructive sleep apnea, and shift work disorder. However, armodafinil may have longer-lasting effects compared to modafinil.
In a 12-week randomized, clinical trial, both armodafinil and modafinil improved sleepiness in subjects working the night shift. Results found that armodafinil and modafinil were comparable with similar safety scores.
In a meta-analysis comparing armodafinil and modafinil for obstructive sleep apnea, both drugs were found to be effective for treating sleepiness. Patients taking either drug tolerated side effects and experienced improved daytime wakefulness.
Armodafinil has been shown to have higher plasma concentrations in the body later in the day. Higher armodafinil levels in the body may result in better wakefulness compared to modafinil.
While either drug can be used as a treatment for excessive sleepiness, it is best to consult a doctor for medical advice. Currently, there are no definitive studies that say one is more effective than the other.
Coverage and cost comparison of armodafinil vs. modafinil
Armodafinil is usually prescribed as a 250 mg tablet taken once daily. It is widely available as a generic medication that is covered by Medicare and insurance plans. Generic Nuvigil can cost an average retail price over $500. This price can be brought down with a SingleCare discount card. Instead of paying higher prices, armodafinil can be purchased for as low as $277.
Depending on your insurance plan, modafinil may be covered. In fact, Medicare and most insurance plans cover modafinil for approved purposes. The average cost of modafinil can cost over $600. At participating pharmacies, you can use a SingleCare savings card to save money. Savings for modafinil can result in a lower price of $35-$280 depending on which pharmacy you use.
| Armodafinil | Modafinil | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare? | Yes | Yes |
| Standard dosage | 150 mg tablets | 200 mg tablets |
| Typical Medicare copay | $15-$217 | $11-$392 |
| SingleCare cost | $277 | $35-$280 |
Common side effects of armodafinil vs. modafinil
The most common side effects associated with armodafinil and modafinil are headache, nausea, dizziness, and insomnia. Modafinil may be more likely to cause other side effects such as nervousness, nasal congestion (rhinitis), diarrhea, and back pain.
Both medications can also cause dry mouth, indigestion (dyspepsia), and anxiety. Side effects related to weight loss can also occur. Some people who take armodafinil or modafinil may experience decreased appetite.
Other rare but serious side effects include allergic reactions such as rash and shortness of breath. Psychiatric side effects such as depression or psychosis are also possible. Seek medical attention if you experience these side effects.
| Armodafinil | Modafinil | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Headache | Yes | 17% | Yes | 34% |
| Nausea | Yes | 7% | Yes | 11% |
| Nervousness | Yes | 1% | Yes | 7% |
| Insomnia | Yes | 5% | Yes | 5% |
| Dizziness | Yes | 5% | Yes | 5% |
| Diarrhea | Yes | 4% | Yes | 6% |
| Back pain | No | – | Yes | 6% |
| Nasal congestion | No | – | Yes | 7% |
| Indigestion | Yes | 2% | Yes | 5% |
| Dry mouth | Yes | 4% | Yes | 4% |
| Anxiety | Yes | 4% | Yes | 5% |
| Decreased appetite | Yes | 1% | Yes | 4% |
This may not be a complete list. Consult your doctor or pharmacist for possible side effects.
Source: DailyMed (armodafinil), DailyMed (modafinil)
Drug interactions of armodafinil vs. modafinil
Armodafinil and modafinil share many of the same drug interactions. These medications can act as inducers of the CYP3A4 enzyme and inhibitors of the CYP2C19 enzyme. In other words, they can affect how certain drugs are processed in the body.
Armodafinil and modafinil may reduce the effectiveness of steroidal contraceptives. Alternative methods of contraception are recommended during treatment with armodafinil or modafinil and for one month after discontinuation of these drugs.
Armodafinil and modafinil may increase the clearance of cyclosporine from the body. If taken together, the effectiveness of cyclosporine may be reduced. On the other hand, armodafinil and modafinil may increase the levels of other drugs known as CYP2C19 substrates. Increased drug levels may lead to adverse effects.
| Drug | Drug Class | Armodafinil | Modafinil |
| Ethinyl estradiol Norethindrone |
Steroidal contraceptive | Yes | Yes |
| Cyclosporine | Immunosuppressant | Yes | Yes |
| Omeprazole Phenytoin Diazepam |
CYP2C19 substrates | Yes | Yes |
This may not be a complete list of all possible drug interactions. Consult a doctor with all the medications you may be taking.
Warnings of armodafinil and modafinil
Both armodafinil and modafinil can cause serious rash. These drugs should be discontinued immediately in cases of severe rash. Do not take these drugs if you have a suspected allergy to any of their active ingredients.
Doses of armodafinil or modafinil may need to be adjusted in order to improve sleepiness during the day. While optimizing doses, persistent sleepiness can still occur. Therefore, it’s important to avoid driving or participating in dangerous activities when first starting a drug like armodafinil or modafinil.
Armodafinil and modafinil may cause psychiatric symptoms especially in those with a history of psychosis, depression, or mania. These medications should be monitored or even discontinued in severe cases of psychiatric effects.
Stimulant-like drugs may cause adverse effects in the heart and cardiovascular system. Those with high blood pressure may need to be monitored when first starting armodafinil or modafinil. Consult a doctor if you experience chest pain, shortness of breath, or palpitations (rapid heartbeat).
Frequently asked questions about armodafinil vs. modafinil
What is armodafinil?
Armodafinil is also known by its brand name Nuvigil. Armodafinil is used to treat excessive sleepiness from narcolepsy and other sleep disorders. It comes in 50 mg, 150 mg, 200 mg, and 250 mg tablets.
What is modafinil?
Modafinil is the generic name for Provigil. Modafinil is FDA-approved to treat daytime sleepiness that results from sleep disorders. It can treat obstructive sleep apnea, narcolepsy, and shift work disorder.
Are armodafinil and modafinil the same?
Armodafinil and modafinil contain similar ingredients but they are not the same. Armodafinil contains the R-enantiomer of modafinil. Modafinil contains a racemic mixture of R- and S-modafinil.
Is armodafinil or modafinil better?
Armodafinil and modafinil are similar in effectiveness and safety. However, armodafinil may have higher levels in the body over the course of the day. The effects of armodafinil may last longer compared to modafinil.
Can I use armodafinil or modafinil while pregnant?
No. Armodafinil and modafinil are not usually recommended during pregnancy. Discuss your treatment options with a doctor if you are pregnant or breastfeeding.
Can I use armodafinil or modafinil with alcohol?
It is not recommended to take armodafinil or modafinil while drinking alcohol. Drinking alcohol while on armodafinil or modafinil may cause adverse side effects.
Can you take armodafinil and modafinil together?
Armodafinil and modafinil are not often taken together. Both armodafinil and modafinil contain similar active ingredients. Taking armodafinil and modafinil together may increase the risk of adverse effects.
Will armodafinil show on a drug test?
No. Drug tests do not usually screen for armodafinil. Armodafinil does not contain amphetamine so false positives for amphetamine are rare.
Can you take armodafinil every day?
Armodafinil works best when it is taken every day. It is recommended to take a single dose of armodafinil at the same time every day, usually in the morning.
