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Armodafinil

Trade name Nuvigil 

Pregnancy category C

Routes of administration Oral 

US: Schedule IV

Metabolism Liver, including CYP3A4 and other pathways

Elimination half-life 12–15 hours

Excretion Urine, as metabolites.

It is the enantiopure compound of the eugeroic agent modafinil.

It has a longer half-life than modafinil, and may be more effective at improving wakefulness in patients with excessive daytime sleepiness.

Approved to treat excessive daytime sleepiness associated with obstructive sleep apnea, narcolepsy, and shift work disorder.

It is commonly used to treat attention deficit hyperactivity disorder, chronic fatigue syndrome, and major depressive disorder, and has been repurposed as an adjunctive treatment for bipolar disorder.

While It has been shown to improve vigilance in air traffic controllers,[8] prevention medications are not approved by the FAA for civilian controllers or pilots.

It has been repurposed as an adjunctive treatment for acute depression in people with bipolar disorder: quality of evidence  is considered low, 

Patients with schizophrenia treated with armodafinil showfewer of the negative symptoms of schizophrenia.

Adverse effects: headache, xerostomia, nausea, dizziness, and insomnia.

Patients may experience:  depression, anxiety, hallucinations, euphoria, extreme increase in activity and talking, anorexia, tremor, thirst, rash, suicidal thoughts, and aggression. 

Overdose of armodafinil include:  trouble sleeping, restlessness, confusion, disorientation, feeling excited, mania, hallucinations, nausea, diarrhea, severely increased or decreased heart beat, chest pain, and increased blood pressure.

Rashes can develop in rare cases, and require immediate medical attention due to the possibility of Steven’s-Johnson Syndrome, or other hypersensitivities to armodafinil.

Its mechanism of action of armodafinil is unknown. 

Armodafinil has pharmacological properties almost identical to those of modafinil.

It has wake-promoting actions similar to sympathomimetic agents including amphetamine and methylphenidate.

It is an indirect dopamine receptor agonist; it binds to the dopamine transporter (DAT) and inhibits dopamine reuptake. 

Its activity has been associated in vivo with increased extracellular dopamine levels. 

Armodafinil has  psychoactive and euphoric effects, alterations in mood, perception, thinking, and feelings typical of other central nervous system (CNS) stimulants.

Armodafinil exhibits linear time-independent kinetics following single and multiple oral dose administration. 

Steady state for armodafinil was reached within 7 days of dosing. 

Armodafinil is readily absorbed after oral administration. 

Peak plasma concentrations are attained at approximately 2 hours in the fasted state. 

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