[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/) › Modafinil

# Modafinil

## Wake-promoting agents and narcolepsy drugs?

Wake-promoting agents and narcolepsy drugs

A wake-promoting drug for excessive sleepiness in narcolepsy, sleep apnoea and shift work. It blocks dopamine reuptake; serious rashes are rare but dangerous.

Updated Nov 1, 2026

## Quick facts

**Group**
[Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/)

**Target**
Dopamine transporter (DAT)

**Used for**
Excessive sleepiness in narcolepsy

**Key effects**
Headache · Nausea · Nervousness and anxiety

**Monitor**
Daytime sleepiness and safety to drive · Skin rash

**ATC**
N06BA07

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Its exact mechanism is not known. Modafinil binds the dopamine transporter and blocks dopamine reuptake, so dopamine stays longer in the synapse in wake-promoting circuits; it is not a direct dopamine receptor agonist.

- Binds the dopamine transporter (DAT)
- Less dopamine is taken back into the neuron
- Wake-promoting signalling increases; daytime sleepiness falls

## Indications

- Excessive sleepiness in narcolepsy [Narcolepsy →](https://durgical.com/en/conditions/narcolepsy/)
- Residual sleepiness in obstructive sleep apnoea (with airway treatment) [Obstructive sleep apnoea →](https://durgical.com/en/conditions/obstructive-sleep-apnoea/)
- Shift work disorder

## Adverse effects

### Common

- Headache
- Nausea
- Nervousness and anxiety
- Insomnia
- Dizziness and rhinitis

### Serious (rare, important)

- Stevens-Johnson syndrome, toxic epidermal necrolysis and DRESS
- Angioedema and anaphylaxis
- Mania, hallucinations and suicidal thoughts
- Persistent sleepiness that still impairs driving

## Contraindications

- Known hypersensitivity to modafinil or armodafinil

## Key interactions

**Hormonal contraceptives**
Less effective; another method is used during treatment and for one month after stopping

**Cyclosporine**
Lower cyclosporine levels

**CYP2C19 substrates (phenytoin, diazepam, omeprazole)**
Higher levels of these drugs

## What is monitored

- Daytime sleepiness and safety to drive
- Skin rash, mood and psychiatric symptoms
- Heart rate and blood pressure in heart disease

## Administration and safety

- Given by mouth in the morning, or before the shift in shift work disorder
- Controlled medicine (Schedule IV in the United States)

## Pregnancy and breastfeeding

Animal data suggest possible fetal harm; it also makes hormonal contraception unreliable.

## Nursing care

- Teach to stop the drug and seek care at the first rash, blisters or mouth sores
- Counsel on a non-hormonal or added contraceptive method
- Ask about psychosis, depression, mania and heart disease
- Remind that it does not replace CPAP in sleep apnoea

## Pharmacokinetics

**Metabolism**
Mostly in the liver (about 90%); it induces CYP3A4 and inhibits CYP2C19

**Elimination**
Metabolites in the urine; less than 10% as unchanged drug

**Half-life**
About 15 hours after repeated doses

## Memory aid

Modafinil: «Mo' dopamine, no hormones» – DAT block for wakefulness; the pill fails and rashes kill.

## Test yourself

Think of the answer, then tap the question to see it.

## Which transporter does modafinil block?

The dopamine transporter (DAT).

## Why is contraception counselling part of modafinil treatment?

It lowers the effectiveness of hormonal contraceptives, during treatment and for a month after.

## Does modafinil treat the airway in obstructive sleep apnoea?

No. It treats the residual sleepiness; the airway treatment continues.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/modafinil/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 4

- [Armodafinil](https://durgical.com/en/pharmacology/armodafinil/)
- [Solriamfetol](https://durgical.com/en/pharmacology/solriamfetol/)
- [Pitolisant](https://durgical.com/en/pharmacology/pitolisant/)
- [Methylphenidate](https://durgical.com/en/pharmacology/methylphenidate/)

## Related conditions 2

- [Narcolepsy](https://durgical.com/en/conditions/narcolepsy/)
- [Obstructive sleep apnoea](https://durgical.com/en/conditions/obstructive-sleep-apnoea/)

[← Back to the class: Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - MODAFINIL tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=944daf47-49a6-93ca-e348-4a0f1b6d937e) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N06BA07) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/modafinil/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/modafinil/