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2D Structure
Also known as: 68693-11-8, Provigil, Modiodal, 2-[(diphenylmethyl)sulfinyl]acetamide, Modafinilum [latin], 2-(benzhydrylsulfinyl)acetamide
Molecular Formula
C15H15NO2S
Molecular Weight
273.4  g/mol
InChI Key
YFGHCGITMMYXAQ-UHFFFAOYSA-N
FDA UNII
R3UK8X3U3D

A benzhydryl acetamide compound, central nervous system stimulant, and CYP3A4 inducing agent that is used in the treatment of NARCOLEPSY and SLEEP WAKE DISORDERS.
Modafinil is a Sympathomimetic-like Agent. The physiologic effect of modafinil is by means of Central Nervous System Stimulation, and Increased Sympathetic Activity.
1 2D Structure

2D Structure

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
2-benzhydrylsulfinylacetamide
2.1.2 InChI
InChI=1S/C15H15NO2S/c16-14(17)11-19(18)15(12-7-3-1-4-8-12)13-9-5-2-6-10-13/h1-10,15H,11H2,(H2,16,17)
2.1.3 InChI Key
YFGHCGITMMYXAQ-UHFFFAOYSA-N
2.1.4 Canonical SMILES
C1=CC=C(C=C1)C(C2=CC=CC=C2)S(=O)CC(=O)N
2.2 Other Identifiers
2.2.1 UNII
R3UK8X3U3D
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 2 Benzhydrylsulfinylacetamide

2. 2-((diphenylmethyl)sulfinyl)acetamide

3. 2-((r)-(diphenylmethyl)sulfinyl)acetamide

4. 2-(benzhydrylsulfinyl)acetamide

5. 2-benzhydrylsulfinylacetamide

6. Alertec

7. Armodafinil

8. Benzhydrylsulfinylacetamide

9. Crl 40476

10. Crl-40476

11. Modiodal

12. Nuvigil

13. Provigil

14. R Modafinil

15. R-modafinil

16. Sparlon

2.3.2 Depositor-Supplied Synonyms

1. 68693-11-8

2. Provigil

3. Modiodal

4. 2-[(diphenylmethyl)sulfinyl]acetamide

5. Modafinilum [latin]

6. 2-(benzhydrylsulfinyl)acetamide

7. 2-benzhydrylsulfinylacetamide

8. Modafinilo [spanish]

9. Crl 40476

10. Modaphonil

11. Alertec

12. R Modafinil

13. Crl-40476

14. 2-((diphenylmethyl)sulfinyl)acetamide

15. Cep 1538

16. Modavigil

17. Modafinil Civ

18. C15h15no2s

19. Cep-1538

20. Nsc-751178

21. Nsc-759110

22. Chembl1373

23. R3uk8x3u3d

24. Acetamide, 2-((diphenylmethyl)sulfinyl)-

25. 112111-49-6

26. Chebi:77585

27. Thn102 Component Modafinil

28. Dep-1538

29. Thn-102 Component Modafinil

30. Crc-40476

31. 2-(diphenyl-methanesulfinyl)-acetamide

32. Ncgc00095176-03

33. Sparlon

34. Dsstox_cid_3329

35. Modafinil [usan:inn]

36. Dsstox_rid_76980

37. Dsstox_gsid_23329

38. (+-)-modafinil

39. Modafinilo

40. Modafinilum

41. Moderateafinil

42. Smr000058957

43. Cas-68693-11-8

44. (+/-)-modafinil

45. Sr-01000759419

46. 152jrg3t0u

47. Nh 02d

48. Nh-02d

49. Unii-r3uk8x3u3d

50. Attenace

51. Modalert

52. Modasomil

53. Crl 40983

54. Crl-40983

55. Dea No. 1680

56. Hsdb 7585

57. Modafinil [usan:usp:inn:ban]

58. Modafinil- Bio-x

59. 2-(diphenylmethyl)sulfinylacetamide

60. Provigil (tn)

61. Mfcd00868082

62. Modafinil [inn]

63. Modafinil [jan]

64. Modafinil [mi]

65. Modafinil [hsdb]

66. Modafinil [usan]

67. Spectrum2_001712

68. Modafinil [vandf]

69. Modafinil [mart.]

70. Modafinil [who-dd]

71. Modafinil (jan/usp/inn)

72. Unii-152jrg3t0u

73. Schembl34488

74. Bspbio_002270

75. Mls000759427

76. Mls001424049

77. Bidd:gt0714

78. Spectrum1505361

79. (-)benzhydrylsulphinylacetamide

80. Spbio_001724

81. Gtpl7555

82. Modafinil [orange Book]

83. Modafinil Civ [usp-rs]

84. Dtxsid0023329

85. Modafinil [ep Monograph]

86. Modafinil, >=98% (hplc)

87. Aft-801

88. Modafinil [usp Monograph]

89. Hms1922f12

90. Hms2051p17

91. Hms2093d15

92. Hms3264i03

93. Hms3393p17

94. Hms3713c12

95. Pharmakon1600-01504283

96. Pharmakon1600-01505361

97. 2-(diphenylmethane)sulfinylacetamide

98. 2-(diphenylmethyl)sulfinylethanamide

99. Bcp28422

100. Tox21_111470

101. Bdbm50156055

102. Ccg-39511

103. Cn 801

104. Cn-801

105. Grl 40476

106. Hy-15201a

107. Nsc751178

108. Nsc751850

109. Nsc758711

110. Nsc759110

111. 2-[di(phenyl)methylsulfinyl]acetamide

112. Modafinil 1.0 Mg/ml In Acetonitrile

113. Akos004118314

114. Tox21_111470_1

115. Ac-1382

116. Db00745

117. Nc00224

118. Nsc 751178

119. Nsc 759110

120. Ncgc00095176-01

121. Ncgc00095176-02

122. Ncgc00095176-04

123. Ncgc00095176-05

124. Ncgc00095176-06

125. Ncgc00095176-08

126. As-17039

127. Bm164601

128. Sbi-0206841.p001

129. Db-116344

130. Am20060710

131. D01832

132. Ab00639993_03

133. Ab00639993_04

134. 693m118

135. A836219

136. L001269

137. Q410441

138. Sr-01000759419-3

139. Sr-01000759419-4

140. Brd-a16332958-001-02-4

141. Brd-a16332958-001-04-0

142. F2173-0797

143. Modafinil, European Pharmacopoeia (ep) Reference Standard

144. Modafinil For System Suitability, European Pharmacopoeia (ep) Reference Standard

145. Modafinil Solution, 1.0 Mg/ml In Acetonitrile, Ampule Of 1 Ml, Certified Reference Material

146. Alertec Pound>> Modavigil Pound>> Modiodal Pound>> Provigil Pound>> Modalert Pound>> Crl-40476

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 273.4 g/mol
Molecular Formula C15H15NO2S
XLogP31.7
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count3
Rotatable Bond Count5
Exact Mass273.08234989 g/mol
Monoisotopic Mass273.08234989 g/mol
Topological Polar Surface Area79.4 Ų
Heavy Atom Count19
Formal Charge0
Complexity302
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count1
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 4  
Drug NameModafinil
PubMed HealthModafinil (By mouth)
Drug ClassesCNS Stimulant
Drug LabelPROVIGIL (modafinil) is a wakefulness-promoting agent for oral administration. Modafinil is a racemic compound. The chemical name for modafinil is 2-[(diphenylmethyl)sulfinyl]acetamide. The molecular formula is C15H15NO2S and the molecular weight is...
Active IngredientModafinil
Dosage FormTablet
Routeoral; Oral
Strength200mg; 100mg
Market StatusTentative Approval; Prescription
CompanyMylan Pharms; Alembic; Apotex; Aurobindo Pharma; Sandoz; Hikma Pharms; Teva Pharms; Caraco; Carlsbad; Orchid Hlthcare; Barr

2 of 4  
Drug NameProvigil
PubMed HealthModafinil (By mouth)
Drug ClassesCNS Stimulant
Drug LabelPROVIGIL (modafinil) is a wakefulness-promoting agent for oral administration. Modafinil is a racemic compound. The chemical name for modafinil is 2-[(diphenylmethyl)sulfinyl]acetamide. The molecular formula is C15H15NO2S and the molecular weight is...
Active IngredientModafinil
Dosage FormTablet
RouteOral
Strength200mg; 100mg
Market StatusPrescription
CompanyCephalon

3 of 4  
Drug NameModafinil
PubMed HealthModafinil (By mouth)
Drug ClassesCNS Stimulant
Drug LabelPROVIGIL (modafinil) is a wakefulness-promoting agent for oral administration. Modafinil is a racemic compound. The chemical name for modafinil is 2-[(diphenylmethyl)sulfinyl]acetamide. The molecular formula is C15H15NO2S and the molecular weight is...
Active IngredientModafinil
Dosage FormTablet
Routeoral; Oral
Strength200mg; 100mg
Market StatusTentative Approval; Prescription
CompanyMylan Pharms; Alembic; Apotex; Aurobindo Pharma; Sandoz; Hikma Pharms; Teva Pharms; Caraco; Carlsbad; Orchid Hlthcare; Barr

4 of 4  
Drug NameProvigil
PubMed HealthModafinil (By mouth)
Drug ClassesCNS Stimulant
Drug LabelPROVIGIL (modafinil) is a wakefulness-promoting agent for oral administration. Modafinil is a racemic compound. The chemical name for modafinil is 2-[(diphenylmethyl)sulfinyl]acetamide. The molecular formula is C15H15NO2S and the molecular weight is...
Active IngredientModafinil
Dosage FormTablet
RouteOral
Strength200mg; 100mg
Market StatusPrescription
CompanyCephalon

4.2 Therapeutic Uses

Modafinil is indicated to improve wakefulness in patients with excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnea/hypopnea (OSAHS), or shift work sleep disorder (SWSD). In OSAHS, modafinil is indicated as an adjunct to standard treatment. Continuing efficacy beyond 9 weeks has not been evaluated in placebo-controlled trials. /Included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 2019


Unlabeled uses: Treatment of fatigue associated with multiple sclerosis.

Novak, K.M. (ed.). Drug Facts and Comparisons 59th Edition 2005. Wolters Kluwer Health. St. Louis, Missouri 2005., p. 1084


Modafinil is a wake-promoting agent shown to improve wakefulness in patients with excessive sleepiness (hypersomnolence) associated with shift work sleep disorder, obstructive sleep apnea, or narcolepsy. Safety and tolerability data from 6 randomized, double-blind, placebo-controlled studies were combined to evaluate modafinil across these different patient populations. One thousand five hundred twenty-nine outpatients received modafinil 200, 300, or 400 mg or placebo once daily for up to 12 weeks. Assessments included recording of adverse events and effects of modafinil on blood pressure/heart rate, electrocardiogram intervals, polysomnography, and clinical laboratory parameters. Two hundred seventy-three patients with shift work sleep disorder, 292 with obstructive sleep apnea, and 369 with narcolepsy received modafinil; 567 received placebo. Modafinil was well tolerated versus placebo, with headache (34% vs 23%, respectively), nausea (11% vs 3%), and infection (10% vs 12%) the most common adverse events. Adverse events were similar across all patient groups. Twenty-seven serious adverse events were reported (modafinil, n = 18; placebo, n = 9). In modafinil-treated patients, clinically significant increases in diastolic or systolic blood pressure were infrequent (n = 9 and n = 1, respectively, < 1% of patients). In the studies, 1 patient in the modafinil group and 1 in the placebo group had a clinically significant increase in heart rate. New clinically meaningful electrocardiogram abnormalities were rare with modafinil (n = 2) and placebo (n = 4). Clinically significant abnormalities in mean laboratory parameters were observed in fewer than 1% of modafinil-treated patients at final visit. Modafinil did not affect sleep architecture in any patient population according to polysomnography. Modafinil is well tolerated in the treatment of excessive sleepiness associated with disorders of sleep and wakefulness and does not affect cardiovascular or sleep parameters.

PMID:17993041 Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2045706 Roth T et al; J Clin Sleep Med 3 (6): 595-602 (2007)


/EXPL THER/: ... a randomized, placebo-controlled crossover trial /was used/ ... to determine if modafinil can improve fatigue in patients with post-polio syndrome. Intervention with modafinil (400 mg/day) and placebo occurred over 6-week periods. Primary endpoint (fatigue) was assessed using the Fatigue Severity Scale as the main outcome measure. Other measures included the Visual Analog Scale for Fatigue and the Fatigue Impact Scale. Secondary endpoint (health-related quality of life) was assessed using the 36-Item Short-Form. Analysis of variance for repeated measures was applied to assess treatment, period, and carryover effects. Thirty-six patients were randomized, 33 of whom (mean age: 61 years) completed required interventions. Treatment with modafinil was safe and well-tolerated. After adjusting for periods and order effects, no difference was observed between treatments. Based on the utilized measures of outcome modafinil was not superior to placebo in alleviating fatigue or improving quality of life in the studied post-polio syndrome population.

PMID:17502549 Vasconcelos OM et al; Neurology 68 (20): 1680-6 (2007)


For more Therapeutic Uses (Complete) data for MODAFINIL (7 total), please visit the HSDB record page.


4.3 Drug Warning

Serious rash, including Stevens-Johnson Syndrome requiring hospitalization and discontinuation of treatment has been reported in adults and children in association with the use of modafinil. ... Rare cases of serious or life-threatening rash, including Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and Drug Rash with Eosinophilia and Systemic Symptoms have been reported in adults and children in worldwide post-marketing experience. The reporting rate of Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome associated with modafinil use, which is generally accepted to be an underestimate due to underreporting, exceeds the background incidence rate. Estimates of the background incidence rate for these serious skin reactions in the general population range between 1 to 2 cases per million-person years. There are no factors that are known to predict the risk of occurrence or the severity of rash associated with modafinil. Nearly all cases of serious rash associated with modafinil occurred within 1 to 5 weeks after treatment initiation. However, isolated cases have been reported after prolonged treatment (e.g., 3 months). Accordingly, duration of therapy cannot be relied upon as a means to predict the potential risk heralded by the first appearance of a rash. Although benign rashes also occur with modafinil, it is not possible to reliably predict which rashes will prove to be serious. Accordingly, modafinil should ordinarily be discontinued at the first sign of rash, unless the rash is clearly not drug-related. Discontinuation of treatment may not prevent a rash from becoming life-threatening or permanently disabling or disfiguring.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3467


Multi-organ hypersensitivity reactions, including at least one fatality in postmarketing experience, have occurred in close temporal association (median time to detection 13 days: range 4-33) to the initiation of modafinil. Although there have been a limited number of reports, multi-organ hypersensitivity reactions may result in hospitalization or be life-threatening. There are no factors that are known to predict the risk of occurrence or the severity of multi-organ hypersensitivity reactions associated with modafinil. Signs and symptoms of this disorder were diverse; however, patients typically, although not exclusively, presented with fever and rash associated with other organ system involvement. Other associated manifestations included myocarditis, hepatitis, liver function test abnormalities, hematological abnormalities (e.g., eosinophilia, leukopenia, thrombocytopenia), pruritis, and asthenia. Because multi-organ hypersensitivity is variable in its expression, other organ system symptoms and signs, not noted here, may occur.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3468


Psychiatric adverse experiences have been reported in patients treated with modafinil. Postmarketing adverse events associated with the use of modafinil have included mania, delusions, hallucinations, and suicidal ideation, some resulting in hospitalization. Many, but not all, patients had a prior psychiatric history. One healthy male volunteer developed ideas of reference, paranoid delusions, and auditory hallucinations in association with multiple daily 600 mg doses of modafinil and sleep deprivation. There was no evidence of psychosis 36 hours after drug discontinuation.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3468


Although modafinil has not been shown to cause functional impairment, the possibility that the drug, like any other drug affecting the CNS, may alter judgment, thinking, or motor skills should be considered. Patients should be cautioned about operating an automobile or other hazardous machinery until they are reasonably certain that modafinil does not adversely affect their ability to engage in such activities.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2494


For more Drug Warnings (Complete) data for MODAFINIL (20 total), please visit the HSDB record page.


4.4 Drug Indication

To improve wakefulness in patients with excessive daytime sleepiness (EDS) associated with narcolepsy.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Modafinil is a stimulant drug marketed as a 'wakefulness promoting agent' and is one of the stimulants used in the treatment of narcolepsy. Narcolepsy is caused by dysfunction of a family of wakefulness-promoting and sleep-suppressing peptides, the orexins, whose neurons are activated by modafinil. The prexin neuron activation is associated with psychoactivation and euphoria. Modafinil is not indicated for complaints of lack of energy or fatigue; but it appears to be very helpful for some patients. Also, it has been used in the treatment of hypersomnia, a disorder in which patients lack the capacity for meaningful sleep and may require ten or more hours per day. Recent studies have have found that modafinil may help recovering cocaine addicts fight their addiction.


5.2 MeSH Pharmacological Classification

Central Nervous System Stimulants

A loosely defined group of drugs that tend to increase behavioral alertness, agitation, or excitation. They work by a variety of mechanisms, but usually not by direct excitation of neurons. The many drugs that have such actions as side effects to their main therapeutic use are not included here. (See all compounds classified as Central Nervous System Stimulants.)


Cytochrome P-450 CYP3A Inducers

Drugs and compounds that induce the synthesis of CYTOCHROME P-450 CYP3A. (See all compounds classified as Cytochrome P-450 CYP3A Inducers.)


Wakefulness-Promoting Agents

A specific category of drugs that prevent sleepiness by specifically targeting sleep-mechanisms in the brain. They are used to treat DISORDERS OF EXCESSIVE SOMNOLENCE such as NARCOLEPSY. Note that this drug category does not include broadly-acting central nervous system stimulants such as AMPHETAMINES. (See all compounds classified as Wakefulness-Promoting Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
MODAFINIL
5.3.2 FDA UNII
R3UK8X3U3D
5.3.3 Pharmacological Classes
Increased Sympathetic Activity [PE]; Sympathomimetic-like Agent [EPC]; Central Nervous System Stimulation [PE]
5.4 ATC Code

N06BA07

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


N - Nervous system

N06 - Psychoanaleptics

N06B - Psychostimulants, agents used for adhd and nootropics

N06BA - Centrally acting sympathomimetics

N06BA07 - Modafinil


5.5 Absorption, Distribution and Excretion

Absorption

Rapid following oral administration.


Route of Elimination

The major route of elimination is metabolism (~90%), primarily by the liver, with subsequent renal elimination of the metabolites.


Volume of Distribution

0.9 L/kg


An open-label, single-center, single-dose, parallel-group study was performed in healthy young males and females as well as healthy elderly males to examine the influence of age and gender on the pharmacokinetics of modafinil following administration of a single 200 mg oral dose. Twelve subjects were enrolled in each of the following three groups: young males, young females, and elderly males. Each fasted (overnight) subject received 2 x 100 mg modafinil tablets. Blood and urine samples were collected at various times up to 72 hours postdose for the determination of plasma and urine levels of modafinil as well as the acid and sulfone metabolites. The plasma concentrations of the individual isomers, d- and l-modafinil, were also determined. Pharmacokinetic parameters were determined by noncompartmental methods. ... Modafinil was rapidly absorbed after oral dosing and slowly cleared (half life approximately 11-14 hr) from the body. Modafinil acid was the major urinary metabolite, which accounted for 35% to 60% of the dose. Results from this study indicated that there were age and gender effects on modafinil clearance processes. In this regard, the clearance rate of modafinil in males decreased with age while young females cleared modafinil at a faster rate than young males. Stereospecific pharmacokinetics of modafinil were also demonstrated. The d-modafinil was eliminated three times faster than the l-modafinil.

PMID:10073328 Wong YN et al; J Clin Pharmacol 39 (3): 281-8 (1999)


It is not known whether modafinil or its metabolites are distributed into milk.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2495


Modafinil is well distributed in body tissue with an apparent volume of distribution (approximately 0.9 L/kg) larger than the volume of total body water (0.6 L/kg). In human plasma, in vitro, modafinil is moderately bound to plasma protein (approximately 60%, mainly to albumin). At serum concentrations obtained at steady state after doses of 200 mg/day, modafinil exhibits no displacement of protein binding of warfarin, diazepam or propranolol. Even at much larger concentrations (1000uM; > 25 times the Cmax of 40uM at steady state at 400 mg/day), modafinil has no effect on warfarin binding. Modafinil acid at concentrations >500 uM decreases the extent of warfarin binding, but these concentrations are >35 times those achieved therapeutically.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3466


Absorption of Provigil tablets is rapid, with peak plasma concentrations occurring at 2-4 hours. The bioavailability of Provigil tablets is approximately equal to that of an aqueous suspension. The absolute oral bioavailability was not determined due to the aqueous insolubility (<1 mg/mL) of modafinil, which precluded intravenous administration. Food has no effect on overall Provigil bioavailability; however, its absorption (tmax) may be delayed by approximately one hour if taken with food.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3466


Modafinil is a racemic compound, whose enantiomers have different pharmacokinetics (e.g., the half-life of the l-isomer is approximately 3 times that of the d-isomer in humans). The enantiomers do not interconvert. At steady state, total exposure to the l-isomer is approximately 3 times that for the d-isomer. The trough concentration (Cmin ss) of circulating modafinil after once daily dosing consists of 90% of the l-isomer and 10% of the d-isomer.

Novak, K.M. (ed.). Drug Facts and Comparisons 59th Edition 2005. Wolters Kluwer Health. St. Louis, Missouri 2005., p. 1085


5.6 Metabolism/Metabolites

Hepatic


The major route of elimination is metabolism (approximately 90%), primarily by the liver, with subsequent renal elimination of the metabolites. Urine alkalinization has no effect on the elimination of modafinil. Metabolism occurs through hydrolytic deamidation, S-oxidation, aromatic ring hydroxylation, and glucuronide conjugation. Less than 10% of an administered dose is excreted as the parent compound. In a clinical study using radiolabeled modafinil, a total of 81% of the administered radioactivity was recovered in 11 days post-dose, predominantly in the urine (80% vs. 1.0% in the feces). The largest fraction of the drug in urine was modafinil acid but at least six other metabolites were present in lower concentrations. Only two metabolites reach appreciable concentrations in plasma, i.e., modafinil acid and modafinil sulfone. In preclinical models, modafinil acid, modafinil sulfone, 2-((diphenylmethyl)sulfonyl)acetic acid and 4-hydroxy modafinil, were inactive or did not appear to mediate the arousal effects of modafinil.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3466


Based on in vitro data, modafinil is metabolized partially by the 3A isoform subfamily of hepatic cytochrome P450 (CYP3A4).

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3466


5.7 Biological Half-Life

23-215 hours


Elimination: Effectively, about 15 hours after multiple dosing; the elimination half life of the levo-isomer is about three times that of the dextro-isomer.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2007., p. 2020


... Modafinil was rapidly absorbed after oral dosing and slowly cleared (half life approximately 11-14 hr) from the body.

PMID:10073328 Wong YN et al; J Clin Pharmacol 39 (3): 281-8 (1999)


5.8 Mechanism of Action

The exact mechanism of action is unclear, although in vitro studies have shown it to inhibit the reuptake of dopamine by binding to the dopamine reuptake pump, and lead to an increase in extracellular dopamine. Modafinil activates glutamatergic circuits while inhibiting GABA. Modafinil is thought to have less potential for abuse than other stimulants due to the absence of any significant euphoric or pleasurable effects. It is possible that modafinil acts by a synergistic combination of mechanisms including direct inhibition of dopamine reuptake, indirect inhibition of noradrenalin reuptake in the VLPO and orexin activation. Modafinil has partial alpha 1B-adrenergic agonist effects by directly stimulating the receptors.


The precise mechanism(s) through which modafinil promotes wakefulness is unknown. Modafinil has wake-promoting actions similar to sympathomimetic agents like amphetamine and methylphenidate, although the pharmacologic profile is not identical to that of sympathomimetic amines. Modafinil has weak to negligible interactions with receptors for norepinephrine, serotonin, dopamine, GABA, adenosine, histamine-3, melatonin, and benzodiazepines. Modafinil also does not inhibit the activities of MAO-B or phosphodiesterases II-V. Modafinil-induced wakefulness can be attenuated by the 1-adrenergic receptor antagonist prazosin; however, modafinil is inactive in other in vitro assay systems known to be responsive to -adrenergic agonists, such as the rat vas deferens preparation. Modafinil is not a direct- or indirect-acting dopamine receptor agonist. However, in vitro, modafinil binds to the dopamine transporter and inhibits dopamine reuptake. This activity has been associated in vivo with increased extracellular dopamine levels in some brain regions of animals. In genetically engineered mice lacking the dopamine transporter (DAT), modafinil lacked wake-promoting activity, suggesting that this activity was DAT-dependent. However, the wake-promoting effects of modafinil, unlike those of amphetamine, were not antagonized by the dopamine receptor antagonist haloperidol in rats. In addition, alpha-methyl-p-tyrosine, a dopamine synthesis inhibitor, blocks the action of amphetamine, but does not block locomotor activity induced by modafinil.

Thomson Health Care Inc.; Physicians' Desk Reference 62 ed., Montvale, NJ 2008, p. 3466


Modafinil is a well-tolerated medication for excessive sleepiness, attention-deficit disorder, cocaine dependence and as an adjunct to antidepressants with low propensity for abuse. ... The modafinil action on identified dopaminergic and GABAergic neurons in the ventral tegmental area (VTA) and substantia nigra (SN) of rat brain slices /was examined/. Modafinil (20 microM) inhibited the firing of dopaminergic, but not GABAergic neurons. This inhibition was maintained in the presence of tetrodotoxin and was accompanied by hyperpolarization. Sulpiride (10 microM), a D2-receptor antagonist, but not prazosine (20 microM, an alpha1-adrenoreceptor blocker) abolished the modafinil action. Inhibition of dopamine reuptake with a low dose of nomifensine (1 microM) reduced the firing of DA neurons in a sulpiride-dependent manner and blunted the effect of modafinil. On acutely isolated neurons, modafinil evoked D2-receptor-mediated outward currents in tyrosine-hydroxylase positive cells, identified by single-cell RT-PCR, which reversed polarity near the K(+) equilibrium potential and were unchanged in the presence of nomifensine. Thus modafinil directly inhibits DA neurons through D2 receptors.

PMID:17070873 Korotkova TM et al; Neuropharmacology 52 (2): 626-33 (2007)


Modafinil is a wakefulness-promoting drug that improves the alertness levels in narcolepsy; however, the molecular mechanism of action remains to be elucidated. We found that after a single icv injection of modafinil (10 ug/5 uL) the extracellular levels of dopamine (DA) and l-DOPA collected from the nucleus accumbens were increased and decreased, respectively. Separately, the icv administration of modafinil (10 microg/5 uL) to rats enhanced wakefulness (W) whereas diminished sleep during 4hr. Lastly, the alertness induced by modafinil was partially antagonized by the sleep-inducing endocannabinoid anandamide (ANA). We conclude that modafinil enhances the extracellular levels of DA, promotes W and its effects on sleep are partially blocked by ANA.

PMID:17098298 Murillo-Rodriguez E et al; Behav Brain Res 176 (2): 353-7 (2007)


Modafinil is an increasingly popular wake-promoting drug used for the treatment of narcolepsy, but its precise mechanism of action is unknown. To determine potential pathways via which modafinil acts, we administered a range of doses of modafinil to rats, recorded sleep/wake activity, and studied the pattern of neuronal activation using Fos immunohistochemistry. To contrast modafinil-induced wakefulness with spontaneous wakefulness, we administered modafinil at midnight, during the normal waking period of rats. To determine the influence of circadian phase or ambient light, we also injected modafinil at noon on a normal light/dark cycle or in constant darkness. We found that 75 mg/kg modafinil increased Fos immunoreactivity in the tuberomammillary nucleus (TMN) and in orexin (hypocretin) neurons of the perifornical area, two cell groups implicated in the regulation of wakefulness. This low dose of modafinil also increased the number of Fos-immunoreactive (Fos-IR) neurons in the lateral subdivision of the central nucleus of the amygdala. Higher doses increased the number of Fos-IR neurons in the striatum and cingulate cortex. In contrast to previous studies, modafinil did not produce statistically significant increases in Fos expression in either the suprachiasmatic nucleus or the anterior hypothalamic area. These observations suggest that modafinil may promote waking via activation of TMN and orexin neurons, two regions implicated in the promotion of normal wakefulness. Selective pharmacological activation of these hypothalamic regions may represent a novel approach to inducing wakefulness.

PMID:11069971 Scammell TE et al; J Neurosci 20 (22): 8620-8 (2000)


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