Monday 5 September 2016

Nuvigil



Generic Name: armodafinil (Oral route)

ar-moe-DAF-i-nil

Commonly used brand name(s)

In the U.S.


  • Nuvigil

Available Dosage Forms:


  • Tablet

Therapeutic Class: CNS Stimulant


Chemical Class: Amphetamine Related


Uses For Nuvigil


Armodafinil is used to help people who have narcolepsy, obstructive sleep apnea (also called hypopnea syndrome), or shift work sleep disorders to stay awake during the day. This medicine does not cure these conditions and will only work as long as you continue to take it.


This medicine is available only with your doctor's prescription.


Before Using Nuvigil


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Appropriate studies have not been performed on the relationship of age to the effects of armodafinil in children younger than 17 years of age. Safety and efficacy have not been established.


Geriatric


Although appropriate studies on the relationship of age to the effects of armodafinil have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of armodafinil in the elderly. However, elderly patients may have a slower removal of this medicine from the body, which may require an adjustment in the dose for patients receiving armodafinil.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Midazolam

  • Omeprazole

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.


Other Medical Problems


The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:


  • Alcohol abuse, history of or

  • Drug abuse or dependence, history of—Dependence may be more likely to develop.

  • Angina (severe chest pain), unstable or

  • Heart attack, recent—Use with caution. May cause side effects to become worse.

  • Depression, history of or

  • Hypertension (high blood pressure) or

  • Mania, history of or

  • Psychosis (mental illness), history of—Use with caution. May make these conditions worse.

  • Left ventricular hypertrophy (heart disease), history of or

  • Mitral valve prolapse (heart disease)—Should not be used in patients with these conditions.

  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of Nuvigil


Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.


This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor if you have any questions.


If you have sleep apnea and use a continuous positive airway pressure (CPAP) machine at night, continue using this machine with the medicine.


Take this medicine at the same time each day. Do not change your schedule without talking to your doctor.


You may take this medicine with or without food.


Dosing


The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For oral dosage form (tablets):
    • For narcolepsy or obstructive sleep apnea:
      • Adults and teenagers 17 years of age and older—150 or 250 milligrams (mg) once a day in the morning.

      • Teenagers and children younger than 17 years of age—Use and dose must be determined by your doctor.


    • For shift work sleep disorder:
      • Adults and teenagers 17 years of age and older—150 milligrams (mg) one hour before you begin working.

      • Teenagers and children younger than 17 years of age—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Storage


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Ask your healthcare professional how you should dispose of any medicine you do not use.


Precautions While Using Nuvigil


It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.


This medicine does not take the place of getting enough sleep. It should not be used for occasional sleepiness that has not been diagnosed as narcolepsy, sleep apnea, or a shift work sleep problem. Ask your doctor for advice about good sleep habits.


This medicine may cause serious types of allergic reactions, including anaphylaxis and angioedema. Anaphylaxis can be life-threatening and requires immediate medical attention. Stop taking this medicine and call your doctor right away if you have a skin rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.


Stop taking this medicine and check with your doctor right away if you have more than one of these symptoms: chest pain or discomfort; fever and chills; dark urine; a headache; a rash; stomach pain; unusual bleeding or bruising; unusual tiredness; or yellow eyes or skin. These may be signs of a serious allergic reaction.


Serious skin reactions can occur during treatment with this medicine. Stop using this medicine and check with your doctor right away if you have any of the following symptoms: blistering, peeling, or loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, or white spots in your mouth or lips; or unusual tiredness or weakness.


Hormonal birth control pills, implants, patches, shots, vaginal rings, or IUDs may not work as well while you are using armodafinil. To keep from getting pregnant, use a second form of birth control together with your pills, implant, patch, shot, vaginal ring, or IUD while you are using this medicine. Continue using the second form of birth control for one month after your last dose. Other forms of birth control include condoms, diaphragms, or contraceptive foams or jellies.


If you do become pregnant while you are taking this medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for pregnant patients who are taking this medicine.


Until you know how this medicine affects you, do not drive, use machines, or do anything else that could be dangerous if you are not alert.


Armodafinil may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you notice any of these side effects, tell your doctor right away.


Check with your doctor if you have been taking this medicine for a long time and feel that it is not working as well as before. Do not increase your dose without talking to your doctor. Some people can become mentally or physically dependent on this medicine. If you have questions, talk with your doctor.


Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.


Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


Nuvigil Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor immediately if any of the following side effects occur:


Less common
  • Blistering, burning, crusting, dryness, or flaking of the skin

  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

  • difficult or labored breathing

  • fast, irregular, pounding, or racing heartbeat or pulse

  • fever

  • frequent urination

  • headache, severe and throbbing

  • increased volume of pale, dilute urine

  • itching, scaling, severe redness, soreness, or swelling of the skin

  • rash

  • shakiness in the legs, arms, hands, or feet

  • shortness of breath

  • tightness in the chest

  • trembling or shaking of the hands or feet

  • wheezing

Get emergency help immediately if any of the following symptoms of overdose occur:


Symptoms of overdose
  • Anxiety

  • blurred vision

  • chest pain or discomfort

  • confusion about identity, place, and time

  • diarrhea

  • dry mouth

  • headache

  • hyperventilation

  • irritability

  • lightheadedness, dizziness, or fainting

  • nausea

  • nervousness

  • pounding in the ears

  • restlessness

  • seeing, hearing, or feeling things that are not there

  • sleeplessness

  • slow heartbeat

  • trouble sleeping

  • unable to sleep

  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


Less common
  • Acid or sour stomach

  • belching

  • chills

  • cough

  • depression

  • difficulty having a bowel movement (stool)

  • discouragement

  • feeling sad or empty

  • general feeling of discomfort or illness

  • heartburn

  • indigestion

  • joint pain

  • loss of appetite

  • loss of interest or pleasure

  • mood or mental changes

  • muscle aches and pains

  • runny nose

  • shivering

  • sore throat

  • stomach discomfort, upset, or pain

  • sweating

  • thirst

  • tiredness

  • trouble concentrating

  • vomiting

  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Nuvigil side effects (in more detail)



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More Nuvigil resources


  • Nuvigil Side Effects (in more detail)
  • Nuvigil Dosage
  • Nuvigil Use in Pregnancy & Breastfeeding
  • Nuvigil Drug Interactions
  • Nuvigil Support Group
  • 132 Reviews for Nuvigil - Add your own review/rating


  • Nuvigil Prescribing Information (FDA)

  • Nuvigil Consumer Overview

  • Nuvigil Monograph (AHFS DI)

  • Nuvigil MedFacts Consumer Leaflet (Wolters Kluwer)

  • Armodafinil Professional Patient Advice (Wolters Kluwer)



Compare Nuvigil with other medications


  • Bipolar Disorder
  • Chronic Fatigue Syndrome
  • Depression
  • Fibromyalgia
  • Hypersomnia
  • Jet Lag
  • Narcolepsy
  • Obstructive Sleep Apnea/Hypopnea Syndrome
  • Shift Work Sleep Disorder

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