Modafinil
A tablet that keeps people awake when a sleep disorder won’t let them. Not a brain booster, and not a substitute for sleep.
Quick answer: Modafinil is a prescription tablet that reduces daytime sleepiness in narcolepsy, sleep apnoea despite CPAP, and shift work disorder. Its most common side effects are headache and nausea. It makes hormonal contraception less effective, and it’s not approved for boosting study or work performance. Any rash, especially with blistering or fever, means stop and seek help the same day.
At a glance
- For
- Narcolepsy, sleepiness in sleep apnoea despite CPAP, shift work disorder
- Works
- Reduces daytime sleepiness for most people, though usually not back to normal
- Cost
- $25 a script on the PBS for narcolepsy only, with an authority ($7.70 concession); other uses are private and cost more, varying by brand and pharmacy
- Kicks in
- 1–2 hours; lasts most of the day
- Taken for
- Long term for narcolepsy; on work days for shift work
- Watch for
- Headache, nausea, nervousness, trouble sleeping, faster pulse
It hides sleepiness; it doesn’t repay sleep debt. And it quietly sabotages hormonal contraception.
Brand names
- Modavigil, and generic modafinil brands
How it works
Exactly how modafinil works isn’t fully known. It raises dopamine by blocking its reuptake and boosts other wake-promoting signals, with less of a “high” than amphetamines.
Used for
- Narcolepsy (TGA-approved)
- Sleepiness in obstructive sleep apnoea despite CPAP, alongside CPAP (TGA-approved)
- Moderate to severe shift work disorder, when other measures haven’t worked (TGA-approved)
- Off-label (specialist use): e.g. fatigue in multiple sclerosis. Not approved for boosting study or work performance
Side effects
Most common: headache and nausea. Nervousness or anxiety, trouble sleeping, dizziness, a fast heartbeat, dry mouth, less appetite and tummy upsets are also common. Serious skin rashes are rare, so any rash needs checking the same day.
Full side-effect list (from the product information)
How often, from the official product information. Bold = serious.
Very common more than 1 in 10
- Headache
- Nausea
Common 1 in 10 to 1 in 100
- Nervousness or anxiety
- Trouble sleeping
- Dizziness or sleepiness
- Low mood
- Pins and needles
- Back pain
- Runny nose, sore throat or flu-like symptoms
- Diarrhoea, constipation, indigestion or dry mouth
- Less appetite
- Fast heartbeat, palpitations or flushing
- Raised blood pressure
- Chest pain
- Abnormal liver tests
Rare 1 in 1,000 to 1 in 10,000
- Agitation, aggression, psychosis, mania or suicidal thoughts
- Tremor or unusual movements
- Rash, acne, eczema or itch
Very rare fewer than 1 in 10,000
- Serious skin reactions (SJS, TEN, DRESS)
- Anaphylaxis or angioedema
- Multi-organ allergic reaction, seizures
- Heart rhythm problems or reduced heart blood flow
- Sweating, swelling
Get help urgently if
- Any rash, especially with blistering, peeling, mouth sores or fever: stop and seek help the same day
- Swelling of the face or throat, or trouble breathing. Call 000
- Chest pain, a racing heartbeat, hallucinations or thoughts of self-harm
Good to know
- Makes hormonal contraception less effective (pill, implant, injection, hormonal IUD). Use another method during treatment and for 2 months after stopping.
- Not for use in pregnancy.
- Interacts with some medicines (e.g. ciclosporin, warfarin). Check with your pharmacist.
- Doesn’t replace sleep or CPAP. Don’t drive while sleepy. Can be habit-forming in some people.
Common questions
What is modafinil approved for?
Narcolepsy, sleepiness in obstructive sleep apnoea despite CPAP, and moderate to severe shift work disorder. It’s on the PBS for narcolepsy only. It’s not approved for boosting study or work performance.
Does modafinil affect contraception?
Yes. It makes hormonal contraception (pill, implant, injection, hormonal IUD) less effective. Use another method during treatment and for 2 months after stopping.
What are the side effects of modafinil?
Headache and nausea are very common. Nervousness or anxiety, trouble sleeping, dizziness, a fast heartbeat, dry mouth and less appetite are common. Any rash, especially with blistering, peeling, mouth sores or fever, needs you to stop and seek help the same day.
Information only. Not a recommendation or endorsement of any product. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist. In an emergency, call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.
More information
maladywise.com/medicines/modafinil/