Modafinil

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 :273.4

%Protein binding :60

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :0.9

half-life – normal/ESRD (hrs) :15/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

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

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

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

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

CAV/VVHD :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

–

Route

Oral

Rate of Administration

–

Comments

–

OTHER INFORMATION

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

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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