The Medical Letter on Drugs and Therapeutics
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Armodafinil (Nuvigil) for Wakefulness

Armodafinil (Nuvigil – Cephalon), the R-enantiomer of the non-amphetamine stimulant modafinil (Provigil – Cephalon; Alertec – Shire in Canada), is being promoted directly to the public for treatment of excessive daytime sleepiness associated with shift work.

BACKGROUND — Both modafinil and armodafinil are benzhydryl sulfinyl acetamides. Modafinil was first approved by the FDA in 1998 for treatment of excessive daytime sleepiness associated with narcolepsy.1 In 2004, it was also approved for excessive sleepiness due to obstructive sleep apnea/hypopnea syndrome (OSAHS) and shift work sleep disorder (SWSD).2

MECHANISM OF ACTION — The mechanism of action of armodafinil or modafinil in promoting wakefulness is unknown.

PHARMACOKINETICS — As with modafinil, plasma concentrations of armodafinil reach a ... more      

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