Provigil (modafinil) is a brand-name tablet prescribed for excessive sleepiness. Provigil contains the active ingredient modafinil and belongs to the stimulant drug class.

Specifically, the Food and Drug Administration (FDA) has approved Provigil to treat excessive sleepiness caused by narcolepsy, obstructive sleep apnea, and shift work sleep disorder.

Drug details

You’ll find key information about Provigil below.

  • Drug form: oral tablet
  • Generic available? yes
  • Prescription required? yes
  • Controlled substance? yes
  • Year of FDA approval: 1998

Provigil is available in a generic form called modafinil. A generic drug is an exact copy of the active ingredient in a brand-name medication.

Generic drugs are often less expensive than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Provigil can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Provigil. This list does not include all possible side effects.

For more information on the possible side effects of Provigil,or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Note: The FDA tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Provigil, you can do so through MedWatch.

More common side effects

The more common side effects of Provigil can include:

  • headache
  • nausea
  • feelings of nervousness
  • anxiety
  • trouble sleeping
  • loss of appetite
  • dry mouth
  • dizziness
  • runny nose
  • diarrhea
  • upset stomach
  • back pain
  • chest pain

Some people may also experience less frequent side effects, such as:

Serious side effects

Serious side effects from Provigil aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms are described in the following sections.

Severe rash

Provigil can cause a severe rash within the first few weeks of taking it, but this is rare. The rash may occur along with vomiting and fever, and may lead to problems with the liver, lungs, kidneys, and heart.

If you develop a rash while taking Provigil, call your doctor right away. If the rash is related to Provigil, you’ll likely need to stop taking the drug.

Serious allergic reaction

Rarely, people who take Provigil may have an allergic reaction. Symptoms can include:

  • severe rash or hives
  • trouble breathing or swallowing
  • swelling of your lips, tongue, or face
  • rapid heartbeat

Heart effects

Heart-related side effects are more likely to happen in people with a heart condition or high blood pressure, but can occur in people without heart conditions. Symptoms can include:

  • chest pain
  • palpitations
  • trouble breathing
  • high blood pressure requiring treatment with medication

If you have these side effects, talk to your doctor right away. They may check you for heart conditions or monitor your heart rate and blood pressure.

Mental health effects

Some people who take Provigil can experience mood or mental health-related side effects, such as:

  • anxiety
  • depression
  • feelings of nervousness
  • confusion
  • irritability

Sometimes, these side effects can become severe. Although rare, some people have had thoughts of suicide, symptoms of psychosis (such as delusions or hallucinations), mania, and aggression. These side effects are more likely to happen in people who have had mental health problems in the past.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Long-term side effects

Taking Provigil long term may increase the risk of developing psychological and physical dependence. However, this side effect seems to be rare, and may be more likely when Provigil is taken in high doses or if it’s misused. (With dependence, you need the drug in order to feel and function like usual. With misuse, the drug is taken differently than how it’s prescribed.)

Provigil misuse is not common. It’s more likely to occur in people who have a history of alcohol or drug dependence.

There have been no reports of people having withdrawal symptoms after stopping Provigil treatment. Withdrawal symptoms are effects that can occur when you stop taking a drug that you’ve become dependent on.

Driving warning

Before you drive while taking Provigil, wait until you know how the drug will affect you. If you feel lightheaded, confused, or sleepy after taking it, don’t drive or use dangerous equipment.

Although Provigil helps reduce sleepiness in people with narcolepsy or other conditions, it may not provide full wakefulness. In addition, Provigil might cause certain side effects, such as dizziness or confusion, that may impair your ability to drive.

As with all medications, Provigil’s price can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks for price estimates of Provigil. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance: If you need financial support to pay for Provigil, or if you need help understanding your insurance coverage, help is available.

Generic version: Provigil is available in a generic form called modafinil. A generic drug is an exact copy of the active ingredient in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of generic modafinil compares to the cost of Provigil, talk with your doctor or pharmacist.

Learn more about saving money on prescriptions.

The Food and Drug Administration (FDA) approves drugs such as Provigil to treat certain conditions.

Approved uses for Provigil

Provigil is FDA-approved for improving wakefulness in people who have excessive sleepiness caused by:

If you take Provigil for OSA, it’s important to note that Provigil does not treat the cause of OSA. Your doctor will likely have you try CPAP treatment before or during Provigil treatment.

Studies show that Provigil increases the ability to stay awake compared to a placebo. It’s considered a first-choice medication option for decreasing sleepiness in people with these conditions.

You can learn more about these conditions in our science of sleep hub.

Uses that are not approved

Provigil may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Provigil for ADHD

Provigil is used off-label to treat attention deficit-hyperactivity disorder (ADHD). However, it’s not considered a first-choice medication for this purpose.

Although some research shows that Provigil can reduce symptoms of ADHD, other research shows no benefit.

Provigil for depression

Provigil is used off-label for depression when antidepressants alone aren’t enough to manage the condition. Taking Provigil along with antidepressants has been shown to reduce symptoms of fatigue and excessive tiredness in people who have depression.

Provigil for MS

Provigil is sometimes prescribed off-label to treat symptoms of fatigue caused by conditions such as multiple sclerosis (MS). An analysis of clinical studies showed that Provigil can reduce symptoms of fatigue in people with MS.

Provigil for anxiety

Provigil is not usually prescribed off-label for treating anxiety. However, some people say that Provigil gives them more focus, calm, and confidence in social or stressful situations. Because of this, some people might misuse Provigil for treating social anxiety or performance anxiety. (With misuse, the drug is taken differently than how it’s prescribed.)

Other people who take Provigil say that it causes more anxiety, or worsens anxiety symptoms.

If you have anxiety, talk with your doctor about what treatment options that might reduce your symptoms. And be sure to take Provigil exactly as your doctor prescribes it.

Provigil for weight loss

Provigil can cause loss of appetite in some people. Because of this side effect, some people might misuse Provigil as a weight loss aid.

Don’t take Provigil unless your doctor has prescribed it for you. Misusing this drug could lead to dependence. (With dependence, you need the drug in order to feel and function like usual.)

The Provigil dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Provigil to treat
  • your age
  • other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Dosage for narcolepsy and sleep apnea

For daytime sleepiness caused by narcolepsy or obstructive sleep apnea (OSA), the typical Provigil dosage is 200 milligrams (mg) once per day in the morning.

Higher doses are sometimes prescribed, up to 400 mg daily. However, these doses may not be any more effective than 200 mg daily.

Dosage for shift work sleep disorder

For excessive sleepiness due to shift work sleep disorder, the typical dosage is 200 mg taken about 1 hour before the start of your work shift.

Dosage for people with liver problems

If you have severe liver problems, your doctor will likely prescribe a lower Provigil dosage than usual. The recommended dosage for people with severe liver problems is typically 100 mg daily.

Dosage for older adults

Older adults may be more sensitive to the effects of Provigil, especially side effects. If you’re over age 65, your doctor may prescribe a lower dosage than usual.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. Remember that Provigil will keep you awake, so don’t take it unless you plan to be awake for several hours. If it’s close to your bedtime, skip the missed dose and take it the next day at the normal time.

Never try to catch up by taking two doses at a time. This can cause dangerous side effects.

Will I need to use this drug long-term?

Yes, Provigil is usually taken long term by people with narcolepsy or sleep apnea. These are chronic conditions that often require long-term treatment to improve symptoms of daytime sleepiness.

How you take Provigil may depend on what you’re taking it for.

Timing

If you’re taking Provigil to reduce daytime sleepiness due to narcolepsy or obstructive sleep apnea (OSA), you’ll take it in the morning.

If you’re taking Provigil for shift work sleep disorder, you’ll likely take it one hour before your work shift.

You shouldn’t take Provigil too close to your bedtime, because it can make it harder to sleep.

Taking Provigil with food

You can take Provigil with or without food. If the drug upsets your stomach, taking it with food might reduce this side effect. However, if you take it with food, Provigil might take slightly longer to start working.

Can Provigil be crushed?

Provigil tablets should not be crushed or split. If you’re having trouble taking Provigil, talk to your doctor or pharmacist about options that can make swallowing the tablet easier.

You may wonder how Provigil compares with other medications that are prescribed for similar uses. You can find out how Provigil compares to Nuvigil.

Urine drug screening tests usually don’t detect Provigil in the urine.

Although Provigil is a stimulant, its chemical makeup is different from the makeup of other stimulants, such as amphetamines. Therefore, it probably wouldn’t cause a false positive test result for amphetamines. However, there’s very little scientific information available about this.

Although Provigil may not appear in a drug test, if you’re an athlete, it’s important to know that stimulants are often prohibited. This includes Provigil.

For instance, the National Collegiate Athletic Association lists stimulants such as Provigil (modafinil) as prohibited during sports. Be sure to talk with your coach if you’re taking Provigil for a medical condition.

Provigil can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Provigil and other medications

The following list highlights some medications that can interact with Provigil. This list does not contain all drugs that may interact with Provigil.

Before taking Provigil, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that change the effects of Provigil

Several medications can lessen the activity of an enzyme called cytochrome P450 3A4 in your body. Taking these drugs with Provigil can cause your body to get rid of Provigil more slowly. This can cause more Provigil side effects.

Examples of these medications include:

  • antiviral medications, such as:
    • cobicistat (Tybost)
    • darunavir (Prezista)
    • ritonavir (Norvir)
    • dasabuvir, ombitasvir, paritaprevir, ritonavir (Viekira Pak, Viekira XR)
  • antifungal medications, such as:
    • fluconazole (Diflucan)
    • itraconazole (Sporanox, Onmel)
    • ketoconazole
  • antibiotic medications, such as:
    • clarithromycin (Biaxin)
    • erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin)
  • heart disease medications, such as:
    • amiodarone (Pacerone, Nexterone)
    • diltiazem (Cardizem, Cartia XT, Diltzac, Taztia XT, Tiazac, others)
    • verapamil (Calan, Verelan)

Drugs that may be affected by Provigil

Provigil can increase the activity of an enzyme called cytochrome P450 3A4 in your body. This can cause your body to get rid of certain medications more quickly. As a result, these medications may become less effective.

Examples of these medications include:

  • certain oral contraceptives (consider using a backup method of birth control while taking Provigil, and for one month after stopping it)
  • cyclosporine (Neoral, Sandimmune)
  • midazolam
  • triazolam (Halcion)

Provigil can reduce the activity of enzymes called cytochrome P450 2C19 in your body. This can cause your body to get rid of certain medications more slowly. This may cause more medication side effects.

Examples of these medications include:

  • clomipramine (Anafranil)
  • diazepam (Valium)
  • omeprazole (Prilosec)
  • phenytoin (Dilantin, Phenytek)
  • propranolol (Inderal LA, Inderal XL, InnoPran XL)

Many other medications may be affected when taken with Provigil. If you take other medications, talk to your doctor and pharmacist about how to avoid potential interactions.

Monoamine oxidase inhibitors (MOAIs)

Taking Provigil with MAOIs might lead to dangerous side effects, such as very high blood pressure, chest pain, severe headache, and increased body temperature. Provigil should not be taken within 14 days of using an MAOI.

Examples of MAOIs include:

  • isocarboxazid (Marplan)
  • linezolid (Zyvox)
  • phenelzine (Nardil)
  • selegiline (Eldepryl)
  • tranylcypromine (Parnate)

Warfarin

Taking Provigil with warfarin (Jantoven) may make your body get rid of warfarin more slowly. This may increase the effects of warfarin and increase your risk of side effects, such as bleeding.

Provigil and herbs and supplements

Provigil may interact with certain supplements or herbal products you may be taking. Examples of these include:

  • acacia rigidula
  • bitter orange
  • green tea
  • guarana
  • hordenine
  • Indian snakeroot
  • octodrine
  • St. John’s wort
  • yohimbe

Cannabis

Taking Provigil with cannabis might change how cannabis affects you. Provigil alters enzymes in your body that control how quickly the body gets rid of cannabis chemicals that cause you to get high. This might increase or decrease the effects and side effects of cannabis.

Provigil and foods

Provigil may interact with certain foods:

  • Fruit juices. Drinking certain fruit juices, such as grapefruit juice, while taking Provigil might change how your body handles the drug. This could increase the amount of Provigil in your body and increase your risk of side effects.
  • Foods and beverages that contain caffeine. Caffeine in foods and beverages might add to the stimulant effects of Provigil. This can increase the risk of stimulant-related side effects, such as anxiety, nervousness, trouble sleeping, and others. Examples of foods and drinks that contain caffeine include:
    • coffee
    • chocolate
    • soda
    • tea (such as black, green, and oolong)

If you consume a lot of fruit juice or caffeine, talk with your doctor about this. They may recommend decreasing your intake during Provigil treatment.

You should avoid drinking alcohol while you take Provigil.

Alcohol can make you feel tired and sleepy. This can decrease the effects of Provigil, which is typically used to help you feel less tired and sleepy.

Some people who take Provigil can have changes in mood or thinking that makes them feel more focused and more confident. Although not common, some people may also experience feelings of euphoria or a “high.”

This effect can lead to misuse (also called abuse) of Provigil for nonmedical uses. Misuse refers to taking a drug differently than how it’s prescribed, such as for a different use or in a different amount. Misuse is more likely to occur in people who have misused alcohol or drugs in the past.

Taking too much Provigil can be life threatening (see the “Provigil overdose” section). Be sure to take Provigil only as prescribed by your doctor. If you have difficulty taking Provigil as instructed, discuss this with your doctor.

Provigil is a controlled substance due to its risk of misuse. It’s classified as a schedule IV prescription drug. This means it has an accepted medical use but may also cause physical or psychological dependence and has the potential for misuse. There are strict regulations for how doctors and pharmacists prescribe and dispense controlled medications. Your doctor or pharmacist can tell you more.

Other drugs are available that can treat your condition. Some may be better suited for you than others. If you’re interested in finding an alternative to Provigil, talk to your doctor to learn more about other medications that may work well for you.

Examples of other medications that can be used to reduce excessive sleepiness in people with narcolepsy, sleep apnea, or shift work sleep disorder include:

Note: Some of the drugs listed here are used off-label to treat these specific conditions.

You may wonder how Provigil compares to certain drugs such as Vyvanse (lisdexamfetamine). Provigil and Vyvanse are both stimulant medications. As a result, they have several similar side effects. But they affect the brain in slightly different ways.

Provigil increases wakefulness and alertness. Vyvanse can cause wakefulness and, in people with attention deficit hyperactivity disorder (ADHD), can also produce feelings of calm and focus.

Provigil is FDA-approved for excessive sleepiness caused by narcolepsy, sleep apnea, and shift work sleep disorder. Vyvanse may be prescribed off-label for these uses. Vyvanse is FDA-approved to treat ADHD and binge eating disorder. Provigil may be prescribed off-label for these uses.

Provigil comes as an oral tablet that’s usually taken once daily. Vyvanse comes as a capsule and a chewable tablet, each of which is taken once daily.

How Provigil works (its mechanism of action) to help increase wakefulness and decrease sleepiness isn’t clear. The drug works in the brain to increase amounts of certain chemical messengers such as dopamine. It also seems to affect the messenger glutamate in certain areas of the brain.

These actions may result in stimulation of brain activities, which could make you feel less tired.

How long does it take to work?

Provigil begins to work within 30 to 60 minutes after you take it. If you take it with food, the drug might take slightly longer to start working.

There haven’t been enough studies done in humans to be sure how Provigil might affect pregnancy. Some animal studies have shown negative effects to a fetus when Provigil was given during pregnancy. However, animal studies don’t always predict what can happen in humans.

Slowed fetal growth and pregnancy loss have occurred in people who took Provigil while pregnant. However, it’s not clear whether Provigil was the cause.

Talk with your doctor if you’re pregnant or planning to become pregnant. This medication should only be used during pregnancy if the benefit justifies the potential risk.

It’s not known if Provigil passes into breast milk. If you’re breastfeeding your child, talk to your doctor. You may need to decide whether to stop breastfeeding or stop taking this medication.

Provigil may make certain hormonal birth control methods less effective. Examples include:

While you take Provigil and for at least 1 month after stopping Provigil, your doctor will recommend switching to a different birth control method or using a backup method, such as condoms.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Provigil.

Here are answers to some frequently asked questions about Provigil.

What is Provigil’s half-life? How long does Provigil stay in your system?

Provigil’s half-life is about 15 hours. (A drug’s half-life is the time it takes for your body to remove half a dose of the drug.)

It usually takes about 5 half-lives for the body to clear a drug from its system. So, Provigil typically stays in your body for just over 3 days (about 75 hours) after your last dose.

Is Provigil a stimulant?

Yes. Provigil is classified as a central nervous system stimulant because it helps you stay awake by affecting certain chemical messengers in the brain. See the “How Provigil works” section for details.

How long does it take Provigil to work?

For most people, it usually takes 30 to 60 minutes to start working. If you take Provigil with food, it might take slightly longer.

What’s the difference between Modalert and Provigil?

Modalert is another name for Provigil. Both drugs contain the same active ingredient, modafinil. This form of Provigil is sold in countries outside of North America. Modalert isn’t sold in the United States, and is not interchangeable with Provigil.

What if Provigil stops working?

For most people who take Provigil as prescribed by their doctor, the drug continues to work even when taken for long periods of time.

However, if you feel that it’s no longer working for you, talk with your doctor. They may need to increase your dosage or consider a different medication.

Taking too much Provigil can increase your risk of severe side effects.

Overdose symptoms

Symptoms of overdose of Provigil can include:

  • irritability
  • anxiety
  • agitation
  • confusion
  • nervousness
  • trouble sleeping
  • nausea
  • vomiting
  • diarrhea
  • hallucinations
  • increased blood pressure
  • rapid heartbeat
  • chest pain

An overdose of Provigil can be serious and, in rare cases, fatal. Fatal overdoses have been reported when Provigil was taken alone or with other drugs.

What to do in case of overdose

If you think you or your child has taken too much of this drug, call your doctor or seek guidance from America’s Poison Centers at 800-222-1222 or through its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Before taking Provigil, talk with your doctor about your health history. Provigil may not be right for you if you have certain medical conditions. Be sure to talk with your doctor if any of the following apply to you:

  • mental health conditions
  • heart conditions
  • previous allergic reaction to this or a similar drug
  • pregnancy
  • breastfeeding

Note: For more information about the potential negative effects of Provigil, see the “Provigil side effects” section.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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