Modafinilo

Modafinilo is a wakefulness-promoting medication used to treat excessive daytime sleepiness in several sleep-related conditions. It is approved for narcolepsy, shift work sleep disorder, and obstructive sleep apnea/hypopnea syndrome, and is marketed in various countries under different brand names. In some markets the enantiomer of modafinil, armodafinilo, is sold separately as a related wakefulness-promoting drug.

Mechanism of action for modafinilo is not fully understood. It is known to increase wakefulness and attention through effects on multiple neurotransmitter systems, including dopaminergic pathways via the dopamine transporter, as well as orexin (hypocretin), histamine, and noradrenergic systems. This multi-faceted action distinguishes it from classic CNS stimulants and is thought to contribute to its wake-promoting properties with a lower propensity for euphoria and abuse.

Pharmacokinetics and metabolism vary by individual. Modafinilo is taken orally and has a relatively long duration of action, with a half-life generally in the range of about 12 to 15 hours. It is metabolized in the liver and eliminated primarily in the urine, with active and inactive metabolites contributing to its overall effect profile. Dose adjustments may be required in hepatic impairment, and there is potential for interactions with other medications through hepatic enzyme pathways.

Common adverse effects include headache, nausea, nervousness, dizziness, and dry mouth. Rare but serious skin reactions have been reported. Modafinilo can interact with hormonal contraceptives by inducing certain liver enzymes, potentially reducing contraceptive effectiveness. It is classified as a controlled substance in some jurisdictions (for example, Schedule IV in the United States) and generally requires a prescription. Safety considerations include use in pregnancy and in individuals with cardiovascular or hepatic conditions; medical advice should be sought for individual risk assessment.