4.4.1 Narcolepsy

ChoiceDrugDosage

1st choice

For information

Specialist initiation only

Modafinil tablets 100mg

Dose:
Initially 200mg daily either in 2 divided doses morning and at noon or as a single dose in the morning, dose adjusted according to response to 200-400mg daily in 2 divided doses or as a single dose;
elderly initiate at 100mg daily

Prescribing Notes

  • Modafinil is an amber list drug and should be initiated by a specialist – see IPNSM red/amber lists.
  • Supervision should remain the responsibility of hospital staff for the first three months or until objective evidence of effectiveness has been provided.
  • Dependence with long-term use of modafinil cannot be excluded.
  • Dexamfetamine sulphate or methylphenidate hydrochloride may be prescribed by specialists when modafinil is ineffective.

Cautions

  • Modafinil potentially increases the risk of congenital malformations when used in pregnancy. Modafinil should not be used during pregnancy and women of childbearing potential must use effective contraception during treatment and for 2 months after stopping modafinil. See MHRA