Wakefulness-promoting agent
Modafinil
Brand names: Provigil
Adult dose
Dose: 200mg OD in morning (or split into 100mg AM + noon)
Route: PO
Frequency: OD or BD
Clinical pearls
- Narcolepsy with cataplexy; specialist sleep clinic
- Restricted indication — narcolepsy only since EMA review
Contraindications
- Uncontrolled hypertension
- Significant arrhythmia
- Severe anxiety / psychiatric history
- Pregnancy / women of childbearing potential without contraception (MHRA — congenital malformations)
Side effects
- Headache
- Insomnia
- Nausea
- Anxiety
- Hypertension
- Skin reactions (SJS/TEN — rare)
- Psychiatric reactions
Interactions
- Hormonal contraceptives — efficacy reduced (CYP3A4 induction)
- CYP2C19 substrates (raised)
- Warfarin
Monitoring
- BP
- Mental state
Reference: BNF; MHRA Drug Safety Update; SmPC; https://bnf.nice.org.uk/drugs/modafinil/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF