Modvigil-200

Modafinil is a wakefulness-promoting medicine for adults with excessive daytime sleepiness. Modvigil-200 is the trade name of a tablet holding 200 mg of the active. Sellers name HAB Pharmaceuticals & Research (India) as the maker and sell it as a strip of 10 tablets,, though one listing names another company, so check the maker's name on your box.

How Modafinil promotes wakefulness is not fully known. In laboratory tests it binds the dopamine transporter and blocks dopamine reuptake (FDA label, 2015).

The original brand is the US product Provigil, whose 200 mg tablet is white, capsule-shaped and scored. No maker's document for Modvigil-200 was found, so rely on what is printed on your box and strip.

The listed uses differ by regulator.

• United States (FDA, original-brand label, 2015) To improve wakefulness in adults with excessive sleepiness from narcolepsy, obstructive sleep apnoea (OSA) or shift work disorder.
• Europe and the UK (EMA and MHRA) Excessive sleepiness from narcolepsy only, after an EMA review concluded in 2010-2011 that the evidence for the other uses was not sufficient.

In OSA the medicine treats the sleepiness only, not the airway blockage, and the US label says CPAP should be tried first where it is the right treatment. Taking it to stay alert without a sleep disorder is not a listed use on any label.

The doses below come from the US original-brand label (2015) and the European Provigil product information (HPRA version, 2011), not from a Modvigil-200 leaflet.

• Narcolepsy and OSA 200 mg once a day, as a single morning dose.
• Shift work disorder 200 mg once, about 1 hour before the shift.
• Above 200 mg The US label says up to 400 mg a day was well tolerated but there is no consistent evidence of extra benefit. The older European text allows 200-400 mg a day.
• Severe liver impairment Halve the dose.
• Older adults Consider a lower dose and close monitoring.

Swallow whole, with or without food. Do not raise the dose by yourself.

In pooled US placebo-controlled trials (934 people on the medicine, 567 on placebo) the most common side effects were:

• Headache in 34% against 23% on placebo.
• Nausea in 11% against 3%.
• Nervousness in 7% against 3%, and anxiety in 5% against 1%.
• Runny nose 7%, back pain 6%, diarrhoea 6% and dizziness 5%.

The label also lists insomnia and indigestion at 5% or more. The 2011 European product information puts headache at about 21%, usually mild and gone within days.

Stop and get medical help at once for a severe rash, blisters, peeling skin or mouth sores; fever with a rash or yellow skin or eyes; swelling of the face, lips, tongue or throat; trouble breathing or swallowing; chest pain or an irregular heartbeat; hallucinations, big mood changes or thoughts of self-harm.

• Serious rash Serious rashes, including Stevens-Johnson syndrome and DRESS, have been reported. Stop at the first sign of rash. The EMA says the risk is higher in children.
• Pregnancy The 2015 US label allows use only if the benefit outweighs the risk, but the MHRA says it should not be used in pregnancy, so the stricter advice applies. Pregnancy follow-up data showed major birth defects in about 14.75% (95% CI 5.85-23.65) against 3%, including heart defects, hypospadias and cleft lip or palate.
• Contraception It can make hormonal contraception less effective. See the next tab.
• Mental health Anxiety, confusion, agitation and depression were reported, and after launch also mania, hallucinations, suicidal thoughts and aggression, mostly in people with a psychiatric history.
• Heart and blood pressure Not recommended with a history of left ventricular hypertrophy or mitral valve prolapse. Extra monitoring is advised after a recent heart attack or unstable angina. New or higher blood pressure medicine was needed by 2.4% of users against 0.7% on placebo.
• Allergy Do not use if allergic to Modafinil or Armodafinil. Swelling of the face, eyes or lips and severe allergic reactions have been reported.
• Dependence risk In the United States Modafinil is a Schedule IV controlled substance, because it has psychoactive and euphoric effects like other central nervous system stimulants. Take care with a history of drug or alcohol misuse.
• Under 18 Safety and effectiveness are not established. It is not known whether it passes into breast milk.

Tell a doctor or pharmacist about every medicine you use. The labels flag these.

• Hormonal contraceptives It induces the CYP3A4 enzyme, so the pill may work less well. The US label advises another or extra method during treatment and for 1 month after stopping. The MHRA says 2 months, and suggests a copper IUD, a levonorgestrel IUS or a progestogen depot injection. Follow the longer, 2 month period.
• Ciclosporin Blood levels fell by about half in one reported case, so monitor and adjust the dose.
• CYP2C19 substrates such as phenytoin, diazepam, propranolol, omeprazole and clomipramine may clear more slowly and may need a dose change.
• Warfarin Check INR more often.
• MAO inhibitors Use with caution.
• Alcohol Use together has not been studied, so avoid it.

The label gives no time in minutes or hours for when wakefulness is felt. It gives only these pharmacokinetic figures from the original-brand label.

• Peak blood level 2-4 hours after a dose.
• Half-life about 15 hours after repeated doses, with steady state reached in 2-4 days.
• Food It does not change the overall amount absorbed, but with a meal the peak may come about 1 hour later.
• Severe cirrhosis Clearance fell by about 60% and steady-state levels doubled.

This is why the US label has a morning dose, and a dose about 1 hour ahead of a shift, rather than a dose when sleepiness starts.

Where Can I Buy Modvigil-200?

Order online at Intimo Life, delivered across Thailand in 1-3 working days. Discreet packaging, with no product name shown on the parcel.