To users of Rx Provigil (Modafinil)

I went to a new (to me) pulmonary specialist yesterday. He said he might suggest Modafinil after he sees the results of a test he prescribed. It is sometimes used for Residual Sleep Apnea (RSA). Apparently, I'm in that 6% who otherwise react satisfactorily to BPAP therapy, but still have RSA. However, he said he was concerned about the side-effects because I have Atrial Fibrillation. The long list of side effects contains the usuals and in a clinical trial, 8% had an adverse experience. It advises not to drive until you know how you are reacting to it. That would create a real problem for me because I MUST drive daily. Just as an aside, it is a Class IV Controlled Substance.

Have any of you used this drug for RSA? Was it useful? Did you have any adverse side effects?

Thanks for any information.

wardmiller wrote:I went to a new (to me) pulmonary specialist yesterday. He said he might suggest Modafinil after he sees the results of a test he prescribed. It is sometimes used for Residual Sleep Apnea (RSA). Apparently, I'm in that 6% who otherwise react satisfactorily to BPAP therapy, but still have RSA. However, he said he was concerned about the side-effects because I have Atrial Fibrillation. The long list of side effects contains the usuals and in a clinical trial, 8% had an adverse experience. It advises not to drive until you know how you are reacting to it. That would create a real problem for me because I MUST drive daily. Just as an aside, it is a Class IV Controlled Substance.

Have any of you used this drug for RSA? Was it useful? Did you have any adverse side effects?

Thanks for any information.

I used it and to be honest, I still felt like crap with brain fog and that achey eye/head fatigue feeling, but I was no longer fighting the urge to sleep and crash. I was able to manage better my functionality and concentration on the drug, although it wasn't superstar 180 degree difference. I've found it also upsets my stomach and it grumbles a lot on it. It's not a miracle pill, so manage your expectations. Also, it works differently for different people, so do your research.

Hello Ward,
I've used it off and on (mostly off) for a few years. I found it to be effective for a time when first starting or restarting. After taking it for some time (couple of weeks or a month) it does not seem to be as effective. I took it for several months a few years ago and I thought it might have had an adverse effect on my blood pressure causing it to rise slightly (could have been coincidence) otherwise, I had no ill effects. I now use it occasionally, once or twice a year, if I'm suffering from RDS in the morning and have something I need to be particularly alert for on that day, like driving!
I'd advise to fill the RX and see how it does for you. I didn't find it to be habit forming. Taking it in the morning, it seems to wear off by night-time and does not seem to have an adverse effect on my sleep.
Jay

Justin & Jay: Just the kind of information I'm looking for. Thank you very much.

You might find it very underwhelming, for all the hype it gets. It leaves you in a state of "physically awake but still mentally tired"--you're not nodding off, but you can feel unnaturally "propped up" (like your brain knows you really ought to be resting it) on days where you're very tired.

I took two doses of it and stopped. I had some kind of weird reaction to it. I had the brain fog and all that others describe, but I also was over emotional, crying all the time and just totally miserable. I tried getting a hold of my doctor after the second dose and when I couldn't, *I* made the decision NOT to take it again. It took me about 48 hours to get over it.

My official records now list it as a drug allergy.

I have used Nuvigil from 2004 till last month of this year, and I miss it. I started out on Provigil and when the price took off, Nuvigil is basically the same drug, just a little different composition, and they had the $50 co-pay deal on their website. I can't afford it now with my new high deductible insurance (thanks Mr, Obama!) because it is $500.00 a month for 30 tablets of 250 mg now. I was splitting the tablets into quarters to try to save some money, so it would last 4 months, but when I ran out last month I couldn't afford it anymore. If you go to Cephalon's website (they make Nuvigil) you can get a coupon that will save you up to $50 a month on it for about a year, if they still have it. Some medical insurance companies require preauthorization for it to be covered, and some don't cover it at all, check your health insurance website. It helps me to stay awake at my desk in a very attention to details job. Wg\hen I first started taking it, it caused mouth ulcers because I kept running my tongue over my teeth, but after about a week, had no other side effects. Yes, it is a Class IV narcotic with potential for abuse and addiction, since has effects similar to amphetamine, and some people who like to take drugs for recreational purposes might try to take too many to get a "speed-like" effect. I had no issues with heart beating faster or BP going up but everybody is different. Cephalon might have a free week trial coupon on their website, you could check if your Dr is going to give you a script for it, so you could try a few without having to buy so many, in case you get a side-effect.

mellabella wrote:You might find it very underwhelming, for all the hype it gets. It leaves you in a state of "physically awake but still mentally tired"--you're not nodding off, but you can feel unnaturally "propped up" (like your brain knows you really ought to be resting it) on days where you're very tired.

This is a good description of how it makes me feel. I use it because I will fall asleep at work without it-and I need my job.

I have found the once in a while doing does nothing for me at all. I have to take it daily.

wardmiller wrote:I went to a new (to me) pulmonary specialist yesterday. He said he might suggest Modafinil after he sees the results of a test he prescribed. It is sometimes used for Residual Sleep Apnea (RSA). Apparently, I'm in that 6% who otherwise react satisfactorily to BPAP therapy, but still have RSA. However, he said he was concerned about the side-effects because I have Atrial Fibrillation. The long list of side effects contains the usuals and in a clinical trial, 8% had an adverse experience. It advises not to drive until you know how you are reacting to it. That would create a real problem for me because I MUST drive daily. Just as an aside, it is a Class IV Controlled Substance.

Have any of you used this drug for RSA? Was it useful? Did you have any adverse side effects?

Thanks for any information.

Ward, you're smart to be cautious about any new drug. I'm in a very similar position; see this thread. A few thoughts about your specific concerns:

Atrial fibrillation: Discuss with your cardiologist.

"It advises not to drive until you know how you are reacting to it": That's a common warning for drugs. Some internet research turns up stories of people who had trouble driving when using modafinil; the drug made them so focused, they had trouble keeping track of the bigger picture of traffic around them.

"I MUST drive daily": Can you go a day or two (maybe on the weekend) with someone driving you? When I try modafinil, I'll take at least one trip where I sit in the front seat, pretend I'm driving, and see how well that works.

(Sleep study results often contain warnings about driving like "avoid activity that requires heightened concentration such as driving ... until effective treatment of the sleep disorder is instituted" or words to that effect. In other words, if you've got Residual Sleep Apnea, you should already be cautious about driving. Good fun, huh?)

"a Class IV Controlled Substance": That means only available by prescription. Specifically it means: "The drug or other substance has a low potential for abuse relative to the drugs or other substances in schedule III. The drug or other substance has a currently accepted medical use in treatment in the United States. Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III."

Internet research also turns up stories of people who've had U.S. Customs find modafinil in their luggage while crossing a border, without having any problems.

Good luck to both of us.

codinqueen wrote:I started out on Provigil and when the price took off, Nuvigil is basically the same drug, just a little different composition, and they had the $50 co-pay deal on their website. I can't afford it now with my new high deductible insurance (thanks Mr, Obama!) because it is $500.00 a month for 30 tablets of 250 mg now. I was splitting the tablets into quarters to try to save some money, so it would last 4 months, but when I ran out last month I couldn't afford it anymore. If you go to Cephalon's website (they make Nuvigil) you can get a coupon that will save you up to $50 a month on it for about a year, if they still have it. Some medical insurance companies require preauthorization for it to be covered, and some don't cover it at all, check your health insurance website.

Agreed about checking with your insurer. Also, shop around. Seven months ago, someone found that generic modafinil is hundreds of dollars cheaper (for 30 pills) at Costco than at CVS, Rite Aid, Walgreens, or Walmart ($375 for 100 mg, $469.23 for 200 mg). Two months ago, someone found even lower costs: "COSTCO now has a generic that is only about $170-270 a month depending on dosage (about $800 cheaper than elsewhere). It's made by Watson labs. As far as I can tell only COSTCO sells it right now."

For what it's worth, Consumer Reports found that prescription drug prices skyrocket in the five years before going out of patent. Brand-name Provigil quadrupled in price ($275 -> $1101) between 2007 and 2012.

When I first started taking it, it caused mouth ulcers because I kept running my tongue over my teeth, but after about a week, had no other side effects.

Other people on the internet have reported similar issues.