Modafinil.txt

CLINICAL USE

Excessive daytime drowsiness associated with narcolepsy, obstructive sleep apnoea and chronic shift work

DOSE IN NORMAL RENAL FUNCTION

200–400 mg daily in 1 or 2 divided dosesChronic shift work disorder: 200 mg taken 1 hour before the start of the shift

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :273.4

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :60

%Excreted unchanged in urine &nbsp &nbsp :

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.9

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :15/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Start at 50% normal dose and increase according to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Ciclosporin: reduced ciclosporin concentration

Oestrogens: metabolism accelerated (reduced contraceptive effect)

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Major metabolite is not pharmacologically activeRecommended that modafinil not be used in patients with left ventricular hypertrophy or ischaemic ECG changes.

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