Nuvigil (armodafinil) is used to improve wakefulness in adults with excessive sleepiness linked to obstructive sleep apnea, narcolepsy, and shift-work disorder. It is a derivative of Provigil (modafinil), which some people with multiple sclerosis take to combat MS-related fatigue. Though not approved by the U.S. Food and Drug Administration to treat fatigue in people with MS, Nuvigil is sometimes used off-label for this purpose.
The scientific evidence backing Nuvigil as a treatment for fatigue in MS is weak and, at present, inconclusive. Since it is reported to work for some people, though, your doctor may recommend it for you—especially if other treatments aren't working.
Treating fatigue often requires a delicate combination of interventions that may include exercise, proper sleep, addressing other health issues that may be impacting fatigue, and medication.
Nuvigil is considered a derivative of Provigil because it is made by using only the right isomer of the molecule that makes up the drug. This is thought to be a way to get more benefits with fewer side effects, which seem to correspond to Provigil's left isomer. Despite this, Nuvigil may end up causing the same sorts of issues as Provigil.
One of the most serious side effects of using the drug is a life-threatening skin rash or a serious allergic reaction. If you develop any signs of a rash or allergic reaction, it's important to seek emergency medical help right away.
It's important to contact your doctor if you experience any persistent or bothersome side effects, including the ones above or any that aren't listed.
Due to Nuvigil's potential to interact with other medications, be sure to inform your doctor of all your medical problems and all the medications you are taking, including prescriptions, herbals, supplements, vitamins, and over-the-counter medications.
In particular, Nuvigil may interact with and/or lower the effectiveness of certain medications like hormonal birth control methods (pills, shots, implants, patches, rings, and IUDs). This means that a woman may have an increased chance of becoming pregnant while taking Nuvigil and for one month after going off of it.
Be sure to use non-hormonal forms of birth control, such as condoms, to prevent unwanted pregnancy while taking Nuvigil.
Your Nuvigil dosage will be different than your Provigil dosage, so if you're switching from one to the other, be sure you're taking the amount prescribed by your doctor.
Your insurance may not cover Nuvigil at the same level it covers Provigil, so your out-of-pocket expenses may be higher than expected. It's a good idea to check with your insurance company and/or pharmacist about what the cost will be before you get your prescription filled.
To decide whether Nuvigil is right for you, make sure to talk it over with your doctor, consider all your conditions and treatments, and weigh the pros and cons. Keep pushing to find effective treatments. Fatigue is a difficult symptom to live with and you deserve to feel better.
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Braley TJ, Chervin RD. Fatigue in multiple sclerosis: Mechanisms, evaluation, and treatment. Sleep. 2010 Aug 1;33(8):1061-67.
Bruce J, Hancock L, Roberg B, Brown A, Henkelman E, Lynch S. Impact of armodafinil on cognition in multiple sclerosis: a randomized, double-blind crossover pilot study. Cogn Behav Neurol. 2012 Sep;25(3):107-14. doi: 10.1097/WNN.0b013e31826df7fd.