Armodafinil vs. Modafinil: Which Is Better? (2024)

Nuvigil (armodafinil) and Provigil (modafinil) are prescription medications. They belong to a drug class known as stimulants.

Healthcare providers prescribe these drugs to help keep individuals awake if they:

• Have sleep-related disorders that cause them to fall asleep during the day.
• Need to be alert.

Keep reading to learn about both armodafinil and modafinil, when each medication may be prescribed, and the critical differences between the two medication options.

What Is Modafinil?

Provigil (modafinil) is a stimulant drug, which means it activates the nervous system. Provigil was approved by U.S. the Food and Drug Administration (FDA) in 1998. The drug is approved to help promote wakefulness in adults with the following sleep disorders:

• Narcolepsy, or excessive sleepiness throughout the day
• Sleep apnea, a condition that frequently interrupts breathing during sleep
• Shift-work sleep disorder, a sleep disorder that can affect individuals who work overnight shifts or rotating shifts, which impacts their sleep/wake schedule

The FDA has not approved modafinil for use in children. So, whether this medication would be safe or effective for people younger than 18 is unknown.

Modafinil comes as an oral tablet with two strengths: 100 milligrams (mg) and 200 mg. The recommended dose and frequency depend on the reason for use as follows:

• Typical dosage for narcolepsy and sleep apnea: 200 mg once daily in the morning
• Typical dosage for shift-work sleep disorder: 200 mg taken one hour prior to the start of the work shift

Healthcare professionals may prescribe a lower dose of 100 mg for older adults or individuals with liver problems.

Some healthcare professionals choose to prescribe modafinil for other conditions that the FDA does not explicitly approve, which is called off-label prescribing. In fact, one study from 2013 found that nearly 90% of individuals taking modafinil were prescribed the drug off-label. Examples of off-label uses for modafinil include the following:

• Multiple sclerosis
• Depression
• Attention-deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Parkinson’s disease
• Chronic fatigue syndrome
  

What Is Armodafinil?

Nuvigil (armodafinil) is very similar to modafinil. The FDA approved Nuvigil in 2007 to prevent excessive sleepiness in adults with the following sleep-related disorders:

• Narcolepsy
• Sleep apnea
• Shift-work disorder

Armodafinil is not approved for use in children. The drug comes as an oral tablet with four different strengths available: 50 mg, 150 mg, 200 mg, and 250 mg. The recommended dosage varies with the condition treated:

• Typical dosage for narcolepsy and sleep apnea: 150 mg to 250 mg once daily in the morning.
• Typical dosage for shift-work sleep disorder: 150 mg taken one hour prior to the start of the work shift

As with modafinil, lower doses (50 mg to 150 mg) are typically recommended for people with liver problems or older adults.

Armodafinil is utilized for many of the same off-label purposes as modafinil. Healthcare providers may prescribe armodafinil off-label for combating fatigue and sleepiness associated with the following:

• Multiple sclerosis
• Parkinson’s disease
• Chronic fatigue syndrome
• Cancer-related exhaustion
  

How Are Armodafinil and Modafinil Different?

Armodafinil and modafinil are very similar medications.

Armodafinil was developed by making a slight change to the formulation of modafinil.

As a result, the main differences are related to their recommended dosages, relative potency (the strength required for a drug to produce an effect), and how long their effect lasts.

On a milligram-per-milligram basis, the stimulant effect of modafinil wears off more quickly than armodafinil.

Even though armodafinil and modafinil have similar half-lives of around 15 hours, the levels of armodafinil in the blood remain higher for a more extended period when both drugs are administered in the same amount.

This is a critical consideration for treating shift-work sleep disorder. If taken an hour before a night shift, the wakefulness-promoting effect of modafinil may wear off during the last third of the shift.

This means the drug's effectiveness in keeping individuals awake diminishes as the night shift progresses toward the early morning hours. This increases the risk of accidents if the individual becomes excessively sleepy while commuting home.

In one study comparing the two medications for shift-work sleep disorder, researchers found that taking 150 mg of armodafinil provides the same safe and effective reduction in sleepiness that 200 mg of modafinil does.

Is Armodafinil or Modafinil Safer?

For most individuals, armodafinil and modafinil are safe medication options for reducing excessive sleepiness due to narcolepsy, sleep apnea, or shift-work sleep disorder.

Given their similarity, both medications are associated with the same side effects discussed below.

One review of multiple studies found no significant safety or side effect differences between the two drugs.

Side Effects

Armodafinil and modafinil can cause similar side effects. Mild side effects commonly include the following:

• Headache
• Nausea
• Nervousness
• Nasal congestion or runny nose
• Diarrhea
• Anxiety
• Insomnia
• Dizziness
• Upset stomach

These side effects may be more likely to occur at higher doses but may ease up or go away after your body adjusts to the medication.

Less commonly, armodafinil or modafinil may result in severe side effects, such as:

• Serious skin reactions. Symptoms may include rash, itching, blistering, or peeling.
• Severe allergic reactions. Symptoms can include hives, trouble breathing, or the swelling of your tongue, throat, or lips.
• Worsening heart problems. Symptoms may include chest pains, heart palpitations, or shortness of breath.
• Psychiatric or mental health changes. Symptoms can include increased aggression, delusions, or hallucinations.

If side effects from either drug don’t go away, contact a healthcare provider for advice.

If your symptoms seem severe, call 911 or go to a hospital emergency department right away.

Precautions

Armodafinil and modafinil have the same contraindications and precautions, as summarized in the table below.