armodafinil

General information

• Class: Adjunctive therapy
• Common US brands: Nuvigil
• Typical dose range: Narcolepsy or OSA: 150–250 mg once daily in the morning (label).
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2025-12-30

Dosing & forms

• Forms/strengths: Tablets: 50 mg, 150 mg, 200 mg, and 250 mg (label).
• Frequency: Narcolepsy or OSA: 150–250 mg once daily in the morning (label).
• Typical range: Narcolepsy or OSA: 150–250 mg once daily in the morning (label).

Mechanism (brief)

Wakefulness-promoting agent (R-enantiomer of modafinil) indicated for excessive sleepiness in narcolepsy, obstructive sleep apnea (as adjunct to primary therapy), and shift work disorder; Schedule IV with clinically important rash/hypersensitivity warnings and CYP-mediated interaction potential.

Metabolism & Half‑life

• Metabolism: CYP3A4, CYP2C19
• Half‑life: Steady-state mean 15 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Rash and hypersensitivity monitoring, especially early in treatment (label).
• Blood pressure and heart rate monitoring, especially with cardiac risk factors (label/clinical).
• Mood and psychiatric symptom monitoring (anxiety, agitation, mania/psychosis) (label/clinical).
• Sleep disruption monitoring (insomnia, timing effects) (clinical).
• Drug interaction review (CYP3A induction; CYP2C19 inhibition), including contraception counseling (label).

Sources

• NUVIGIL (armodafinil) tablets prescribing information — DailyMed (2025)
• Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline — Journal of Clinical Sleep Medicine (2021)
• Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment — Journal of Clinical Sleep Medicine (2021)
• The efficacy and safety of armodafinil as treatment for adults with excessive sleepiness associated with narcolepsy — Current Medical Research and Opinion (2006)