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Provigil and Nuvigil are related drugs that are used in treating the excessive sleepiness associated with narcolepsy, shift-work sleep disorder, and obstructive sleep apnea/hypopnea syndrome. The chemical and generic names of these drugs are Modafinil (Provigil) and Armodafinil (Nuvigil).
In addition to their approved uses for sleep disorders, there are many popular off-label uses of these two stimulating drugs. Because they are capable of providing long-lasting mental energy, both of these drugs are considered to be “Smart Drugs.”
They have been observed to improve brain performance and factors related to intelligence. Users are better able to focus and have increased acuity and memory scores in tests administered during clinical trials. They also have been seen to improve focus and concentration, which make them useful for reducing symptoms of ADHD.
What are the key differences between Provigil and Nuvigil in terms of their effects, side effects, dosages, and cost?
Alertness
Mental Acuity
Focus- Stimulates wakefulness in the brain
- Promotes mental acuity & processing
- Enhances focus, motivation & energy
History and Clinical Uses of Modafinil
Related Topics
- What is Modafinil? (Provigil)
- How Does Provigil Work?
- Effects and Benefits
- User Reviews
- Typical Experiences
- Recommended Dosages
- How to Take
- Provigil Uses
- Use for ADHD
- Effects on Weight Loss
- Negative Side Effects
- Abuse Warnings & Dangers
- Comparison to Adrafinil
- Comparison to Armodafinil
- Comparison to Adderall
- Where to Buy
- Generic Modafinil Brands
- Is Modafinil Legal?
- How to Get Modafinil
- Review of Online Sources
Modafinil was first discovered because of testing done on another related compound, Adrafinil. Adrafinil is a benzhydryl sulfinyl compound that was discovered in 1974 at the French pharmaceutical company Lafon Laboratories (later bought in 2001 by Cephalon).
Modafinil was discovered two years later in 1976 during testing to determine Adrafinil’s mechanism of action in the body. It was seen that Adrafinil was metabolized in the liver into its component parts, the inactive modafinilic acid, and its primary active compound, Modafinil.
In animal testing, Adrafinil and Modafinil were seen to have stimulating effects, causing increased locomotion and vigilance. To see how these effects would translate in humans, the first human trials for both drugs were for the sleep disorder narcolepsy.
Narcolepsy is a neurological sleep disorder that affects the ability to maintain wakefulness, causing excessive daytime sleepiness and random sleeping bouts throughout the day. In multiple double-blind placebo-controlled clinical trials, when compared to a placebo, Modafinil is able to significantly improve scores on a variety of sleep tests including the Multiple Sleep Latency test, the Maintenance of Wakefulness test, and the patient-administered Epworth Sleepiness Scale.
Adrafinil was first approved as a treatment for narcolepsy in France in 1986. When Modafinil was able to be produced on its own without conversion from Adrafinil, and after sufficient testing, it replaced Adrafinil, as Modafinil is a more potent and faster-acting drug.
Modafinil was approved as a treatment for narcolepsy in France in 1994, and in the United States in 1998. Production of Adrafinil slowed, and eventually Lafon ceased production (although today it is produced by other manufacturers).
Modafinil has been tested for and approved for a few other serious sleep disorders in the United States: shift-work sleep disorder and obstructive sleep apnea/hypopnea syndrome. It is also an approved treatment for hypersomnia (a condition similar to narcolepsy, but often less severe) in some countries around the world.
Shift-work sleep disorder (SWSD) is a condition that can happen in people who are awake at night during to late night or overnight work shifts and sleep during the day. Due to the disruption of the normal circadian rhythm, the condition causes excessive sleepiness while awake, and can cause insomnia when trying to sleep.
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a medical condition that involves the partial or complete blockage of the upper airway by the tongue, soft palate, and/or uvula, leading to labored breathing (hypopnea), or the temporary stopping of breathing (apnea).
These breathing episodes lead to poor sleep quality and excessive daytime sleepiness. Even with traditional treatment with a CPAP machine at night, some patients still experience residual sleepiness during the day.
While the root cause is different in both conditions, excessive sleepiness is a common symptom. As seen previously in narcolepsy trials, studies using Modafinil for SWSD and OSAHS have shown that the drug significantly improves wakefulness and decreases excessive sleepiness compared to a placebo.
Patients with SWSD have been observed to have improved work performance and decreased attention lapses when taking Modafinil. When used as an adjunct treatment for OSAHS, Modafinil has been seen to improve Epworth Sleepiness Scale scores significantly from baseline compared to changes on placebo.
Similarities of Modafinil and Armodafinil
Let’s first consider the ways in which these drugs are similar. Both are analeptic compounds meaning they stimulate the central nervous system. For this reason, both are effective and used currently in the treatment of sleep disorders such as narcolepsy, sleep apnea and shift work disorder.
However, neither of these drugs are considered traditional stimulants because they do not carry the side effects that one associated with stimulating drugs.
For example, Provigil and Nuvigil do not increase the heart rate nor do they raise blood pressure levels. They both do increase the release of norepinephrine and dopamine from synaptic terminals, but to a lesser degree than drugs such as Adderall or amphetamines.
The primary effects of these smart drugs are said to be eugeroic, increasing wakefulness and alertness by affecting the histaminergic system in the brain. This is the system that regulates your arousal level so you have energy in the day and can sleep at night.
Provigil vs Nuvigil
The pharmaceuticals Provigil and Nuvigil are manufactured by the same company, Cephalon (a subsidiary of Teva Pharmaceutical Industries), and are viewed by many physicians as interchangeable.
As described previously, Provigil is the US trade name for the compound Modafinil which has been heavily researched since the 1970’s. In 1998, the FDA first approved Modafinil as a Schedule IV prescription drug for use in the United States as a treatment for narcolepsy. It was later approved as a treatment for shift-work sleep disorder and as an adjunct treatment for obstructive sleep apnea/hypopnea syndrome.
Nuvigil is the brand name for the drug Armodafinil which is a modified version of the Modafinil molecule. Modafinil is comprised of two copies of the same molecular compound, R-Modafinil and S-Modafinil. These two forms are mirror images of each other (much like a right and left hand), making them enantiomers, or non-superposable stereoisomers. Modafinil is a racemic compound, meaning it contains both enantiomers in equal proportion.
In terms of its chemical make-up, Nuvigil is a single-enantiomer form of Modafinil. It is the R-enantiomer alone, hence its name, Armodafinil – for R-Modafinil. Research has determined that the R-enantiomer is the more potent, longer-acting, and metabolically stable enantiomer in Modafinil.
This makes Armodafinil slightly more concentrated in its effects since the enatiopure form acts differently within the body. As a result, Nuvigil’s effects do differ slightly from those of Modafinil and there are also slightly different side effects to consider.
Armodafinil was first approved by the FDA in 2007 as a Schedule IV prescription drug for the same uses as Modafinil before it, narcolepsy, SWSD, and OSAHS.
- Increases energy, wakefulness and motivation
- Boosts mental performance and focus
- Supports memory and cognition
Reviews and Uses
As a result, individuals who take Provigil or Nuvigil generally feel a strong sense of alertness, clarity of thought and mental energy. You may feel like your brain is “firing on all cylinders” and you can focus or work intently for long periods of time without experiencing fatigue or cognitive strain. These drugs allow users to overcome sleep disorders and function normally during the day with greater purpose, productivity and enjoyment.
The diverse mechanisms of action for Provigil have led to several off-label uses for this drug in the United States. The FDA has only approved its use for sleep dysfunctions, but doctors are free to prescribe it for other conditions they believe that it can offer benefits for.
Well over 75% of Modafinil prescriptions in the USA are believed to be off-label, treating conditions such as attention-deficit hyperactivity disorder (ADHD), mood disorders, fatigue, depersonalization disorder, cocaine addiction, and for weight loss.
Nuvigil’s use for ADHD and other conditions is growing, however Modafinil remains more popular. It has gained favor among doctors as an alternative treatment for ADHD because it offers stimulant-like effects with fewer side effects than traditional amphetamine or methylphenidate based stimulants.
The drugs have been considered as treatments for jet lag, depression, and schizophrenia but have failed to receive FDA approval for these applications. However, they can still be used clinically for these and other conditions if the prescribing doctor is willing to write a prescription for it off-label.
One of the most popular off-label uses of Provigil and Nuvigil are as nootropic “smart drugs.” People take these drugs to help improve concentration, focus, memory, motivation, and learning ability.
There has been some research done in this area, using Modafinil as a cognitive enhancer. In one literature review, a general trend emerged from the research studies showing that Modafinil may improve memory, specifically working memory and episodic memory. Another literature review found that Modafinil may improve executive function (higher level mental processes like time management, organization, reasoning, etc) while planning and executing complex and difficult tests and tasks.
Provigil Versus Nuvigil Dosages
In comparing dosages for Provigil Modafinil vs Nuvigil Armodafinil, we find that Nuvigil is slightly more concentrated than its predecessor.
When taken as a medication for narcolepsy and obstructive sleep apnea (OSA), the proper dosage of Provigil is a single dose of 200mg in the morning.
If used for shift work disorder, a single 200 mg tablet should be administered approximately one hour before the start of the shift.
For off-label use as a smart drug for ADHD, it is common to take between 100 mg and 200 mg again in a single dosage in the morning.
Nuvigil is more commonly found in a 150 mg tablet, though there are also pills sold that contain 250mg of active ingredient. Like Modafinil, it should be taken as a single dose in the morning for excessive daytime fatigue or an hour before shift work commences.
The lower dosage is a sign of the increased potency that Armodafinil possess over Modafinil because it is an enatiopure form. But one should not assume that Nuvigil will as a result be stronger in its effects than Provigil: when they two were compared to each other in wakefulness studies, there was no difference reported in the efficacy of Nuvigil vs. Provigil.
How to Take
Both of these drugs are to be taken by mouth with a glass of water. Simply follow your prescription label and take your doses at regular intervals. Do not take this medicine more often than directed, continue taking it until your doctor advises you to stop. With every prescription refill a pharmacist will give you a med guide, be sure to carefully study it each time.
If you miss your daily dose, take it as soon as you can, but if it’s almost time for your next dose, do not take the missed one. Only take one, do not take extra or double doses, under no circumstances. Keep these drugs out of reach of children and store at room temperature. Throw away any left over, or unused medicine after the expiration date.
Comparison of Side Effects and Safety
The common side effects for Provigil include: back pain, nausea, headache, stuffy nose, diarrhea, nervousness, anxiety, dizziness, upset stomach, and trouble sleeping. Common side effects for Nuvigil are: headache, nausea, trouble sleeping, and dizziness.
These side effects present in less than 5% of patients and have equal prevalence among both drugs. There are some research trials that indicate Nuvigil may have a higher rate of side effects occurring, but no definitive studies have show this so far.
Some times people’s bodies need some time to adjust to taking a new medication, and side effects can be likely after first beginning treatment. These side effects typically subside after the first few weeks; speak with your doctor if you are still experiencing side effects after this time.
One common side effect of both medications is trouble falling and staying sleeping, or insomnia. This side effect is most commonly not truly a negative effect, but is just a case of taking the drug at the wrong time. Both drugs have very similar half-lives of around 12-15 hours, meaning they can be active in the body for a long time.
If you take Modafinil or Armodafinil too late in the day, then you may have sleep disturbances when trying to sleep. It is recommended to take your dosage in the morning, before noon, to avoid any sleep issues. If a later dosage is taken near noon or after, then it is reasonable to expect to still feel the stimulating effects of these drugs late into the evening/night.
Both of these drugs are seen as very safe for adults to use and much safer than ADHD or ADD drugs like Ritalin and Adderall. There are few serious side effects and none of the typical adverse reactions seen with stimulant drugs including cardiovascular effects.
However, there have been some rare serious side effects reported with both Provigil and Nuvigil, including the skin reactions Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms.
Symptoms of these conditions can include: serious rash, hives, mouth sores, blistering and/or peeling of the skin, swelling of the lips, tongue, mouth, eyes, legs or throat, fever, shortness of breath, dark urine, yellowing of the skin or whites of the eyes, allergic reaction involving the liver or blood cells and trouble swallowing.
These side effects are extremely rare for individuals taking Provigil or Nuvigil. Research studies have shown strong evidence that certain people may be born with a genetic predisposition that makes them more susceptible to developing these conditions if they are taking certain medication, including Provigil or Nuvigil.
If you do experience any of these issues, please contact a medical specialist as soon as possible. Neither of these drugs have been approved by the FDA for pediatric use, though some doctors may prescribe them to older children or teenagers.
Since both of these drugs require a prescription in the United States they should only be used under the guidance of a qualified physician. In clinical studies, no symptoms of withdrawal were noted with either Armodafinil or Modafinil, though sleepiness did return when intake of either of the drugs was stopped.
Nuvigil vs. Provigil Cost
Nuvigil is a newer version of Provigil and carries a higher price tag. However, both are extremely expensive if you do not have insurance or a drug plan to cover some of the cost.
A single month supply of 200 mg Provigil tablets will cost between $300 to $600 while the same month-long supply of 150 mg Nuvigil pills will cost $500 – $800. Generics may be able to save you some money, though in the USA they still average between $10 to $15 per pill.
Do you need to spend the money on the more expensive Nuvigil to get better results? Not necessarily. In fact, many prefer Modafinil’s effects over those of Armodafinil and many more say they notice no difference between the two.
There are some skeptics who argue the sole reason Nuvigil was created was due to Provigil’s patent coming close to its expiry date. By manufacturing an enatiomeric version of this drug, the patent holder Lafon was able to retain its monopoly so that prices for the drug could stay high.
Buying Nuvigil and Provigil Online
Provigil and Nuvigil are both very expensive medications. From common pharmacies (CVS, Rite Aid, Walgreens) Provigil averages $1400 for 30 day supply of 200 mg pills, and Nuvigil averages $700 for a 30 day supply of 150 mg pills.
Using generic Modafinil and Armodafinil is definitely a way to save money. With free coupons available from places like GoodRX.com it is possible to get generic versions of these drugs for a fraction of the cost of the name brand. Ask your doctor to write on your prescription that generic substitution is allowed to be able to use generic Modafinil or Armodafinil.
Another way that some people will save money is to buy Armodafinil or Modafinil from an online pharmacy instead of a physical store. Online pharmacies can offer significant savings. Any legitimate online pharmacy will require proof of a prescription, just like a physical pharmacy. Do your research to find a reliable source.
Some people who are unable to get a doctor’s prescription for either of these drugs or in the United States will order Modafinil and Armodafinil pills from online pharmacies based in other countries. However, these online pharmacies that do not require a prescription are the ones to be most wary of and avoid. It is strongly not recommended to buy from these sources, as there are poor quality control standards in place in many of these countries such as India or Mexico.
If you import Provigil or Nuvigil generics from these offshore pharmacies, you run the risk of buying a contaminated product. Additionally, you risk having your order seized as the border by customs officials if you are unable to provide proof of a prescription. In these cases, it is often impossible to get a refund for your purchase.
Non-Prescription Alternatives
Because getting a prescription can be very difficult, and buying without a prescription from international online pharmacies can be risky, one alternative that has become popular among smart drug users is to purchase Adrafinil – a significantly cheaper pro-drug to Modafinil.
Adrafinil is available without a prescription in the USA and can cost as little as $0.50 per dosage. As described previously, Adrafinil is converted by the body into Modafinil and produces almost identical effects.
Due to the processing that occurs in the liver, there is the possibility of a buildup of toxic liver enzymes if Adrafinil is used on a regular basis. It is recommended that this compound only be used on an as needed basis.
Another non-prescription alternative to consider is one of the Racetam class of compound. This group is based off of the original nootropic, Piracetam. Piracetam has been seen to have positive effects on Acetylcholine in the brain, which can help increase cognition and memory.
The other Racetams are all more powerful derivatives of the parent compound Piracetam, and have additional benefits of their own. For example, Phenylpiracetam is estimated to be between 50-60 times as potent as Piracetam, and has been seen to significantly increase mental energy and alertness, making it an ideal substitute for Modafinil or Armodafinil as a nootropic.
Adrafinil and the Racetams are unregulated, unscheduled compounds in the United States. While FDA laws limit the sales of these compound, they are entirely legal to buy, own, and use. They are available from many specialized online nootropic vendors.
While Adrafinil or the Racetams may not be appropriate for everyone’s needs, they are certainly much cheaper than either Nuvigil or Provigil. Consider them as non-prescription alternative nootropic options instead of risking buying Provigil and Nuvigil or generic Modafinil or Armodafinil on gray market online pharmacies.
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Article last updated on: April 17th, 2018 by Nootriment
8 Comments
FOR THOSE who are not covered by Prescription Insurance, price can be a deterent to having access to a “quality of productive life”. Withe all the billions$ Generated by pharmacy manufacturers we need to re Institute the “CELLING PRICE LEGISLATION” OF THE 1970’s plus. The FRA is approving pharmaceuticals with known high sued effect potential because.of “Corporate CLOUT!”. SENIOR and others with marginal incomes can not afford these life restoring meds. How sad to see our Politicians enjoying the best of what the 21st C. offers while their constituency suffers.
I called to see how much my Provigil prescription would be because my insurance was temporarily not active. For 60 200 mg pills the out of pocket cost is $2772!!! This is crazy! There has to be something that can be done. If I do not have medicine I can not work, if I can’t work, I can not pay for my medication. Right now, I am temporarily on Medicaid (my husband left and I go to school full time as well as have three part time jobs, but none that offer insurance), I checked into getting insurance at one of my jobs if I went full time, It was between $600 and $800 a month and after my deductible my medication is in the top tier so it would be $80 to $150 a month, for only one of my scripts. If I went to work full time, I would have to pay for day care, insurance and medication. This would cost an average of $1650 a month. This translates into approximately $9.75 an hour just to pay for my med, insurance and daycare ($200/wk, which is cheap) and that is after tax. If I add in mortgage, utilities, gas, food and Unless my job paid at least $4000 pretax a month then maybe I could pay for my basic bills. I am hoping to get a great job with reasonable insurance costs once I graduate from school. If not, I will basically be limited to working a minimal amount of hours in order to still qualify for medical assistance. There has to be a better way to break this cycle.
My mobile word recognition system has changed my comment.
1. Pharmaceutical, not pharmacy.
2. “1940’s” not 1970’s
3. “FDA”, not FRA
4. “side effectct”, not sued effect
Dr Dragonas,
It’s tempting to paint drug companies as villians, as the prices of these drugs are quite high. But it’s these prices that allow companies to develop these new therapies in the first place. Only one in a thousand drug candidates are approved, and clinical trials and other development costs routinely exceed $1 billion. Preventing drug companies from recovering these costs from our insurance providers means that much less effort goes into developing the next generation of therapies.
And as a practical matter, consumers end up bearing little of the cost of these drugs. Between my insurance and the Nuvigil savings card, I spend $10 a month for a therapy that allows me to function at a normal level.
Without insurance my Provigil costs $2772 a month how is this reasonable? I explained more in my other comment, but for all of the insurances that I have ever had, I never paid less than $50 a month with the insurance.
This is the governments and natures way of telling us we are living to long.
I get Modafinil for ADD – and for me 100mg works perfectly. I use it only when I need it – like when I have work on a project that requires sustained focus. Unfortunately, my insurance won’t cover it and I was paying $25 per 200mg oil at Target (and CVS) l… until I went to a local Costco pharmacy. Their price (I’m not making this up)… $1.25 pill. In other words cheaper than a co-pay if I could find insurance to cover it.
You can get a 30 day supply of Modafinil from Costco’s pharmacy for about $30.00 with a prescription. That is without insurance paying cash. You don’t have to be s Costco member to use their pharmacy either. I think Nuvigil is about $50.00 as well. Just an FYI.