Generic Modafinil, Provigil (brand) Or Nuvigil Experiences
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Hey all, 1. Anyone tried varying generics of Modafinil? Which ones, and did they work? Anyone tried brand Provigil (super pricey!) as well and can compare the two? 2. Anyone try Modafinil or Provigil and also tried the considerably cheaper brand Nuvigil (or even generic Nuvigil; please specify which generic). Did they affect you differently? How so, especially in terms of mood, motivation, energy, wakefulness, and task initiation (the latter for ADHD people). How long did it last, and how much longer than Modafinil/Provigil? Please include what doses were optimal! The full story: I have severe ADHD and severe excessive daytime sleepiness since childhood and adolescence, respectively. Perfect physical health otherwise. ADHD meds help many of my ADHD symptoms, but do nothing for my fatigue and lack of energy. On the contrary, they (paradoxically) relax my hyperactive and impulsive brain so much that they may even contribute to my fatigue! My psychiatrist suggested trying Modafinil (Provigil) or Armodafinil (Nuvigil) for the EDS and since it is also used off-label for ADHD, she thought it might also help the few symptoms my ADHD meds aren't helping: procrastination and low motivation. I thought this was very promising, as a few years ago I was on a road trip and getting very tired and a friend gave me a pill to wake me up that she told me was "an energy supplement, but not caffeine" (caffeine makes me jittery, drops my blood sugar too low and does not wake me up much). Turns out it was adrafinil, the no-prescription-needed cousin to Moda, sold as a dietary supplement. It is weaker than Moda and, as I learned later, is tougher on the liver and takes longer to kick in/lasts long enough to impede sleep, so it's definitely not recommended! But I found it did keep me awake, and also made me feel more motivated to accomplish tasks. The issue is this: I have always had issues with various generics and never with brand names of psychotropic drugs. Since my state does electronic scripts only, I cannot ask around what pharmacies have what generics, and truth be told I'm tired of generic roulette. So I have my Dr mark "brand only". The problem here is that the cost of brand Provigil is ASTRONOMICAL. The cost of brand name Nuvigil is a lot less, but it only has the R-antinomer of modafinil (and therefore the generic is called armodafinil) while Provigil has both R and S entianomers. Since I responded to Adrafinil, which breaks down to Modafinil in the liver, I worry that I might need both R and S for therapeutic efficacy re: both wakefulness and motivation, so Nuvigil might not work as well. Another concern is I believe Nuvigil lasts longer (how much so if true?) and I do like a regular sleep schedule. My other option is just taking the generic Modafinil offered by Aurobindo, a generic I have had problems with in terms of generic Adderall IR. The only other common generic around here is Teva (whose generic Adderall IR, generic dextroamphetamine IR, AND generic Zolpidem didn't work for me either!) I have heard one person online, though, say that generic Aurobindo Modafinil was fine, but I'd like more than a sample size of one! Please let me know what doses worked/didn't work/caused side effects. My doctor told me that sometimes less is more for this drug! Thank you so much! My appointment is soon, and once I have enough information to go on, I can make a choice and hopefully it will be the right one and won't spend half my daytime hours napping!

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Re: Hop (# 7) Expand Referenced Message

The 80% as effective thing you mention is a rumor based on the misunderstanding of statistical bioequivalence. The short explanation is the comparison is based on the blood concentration in the same person of the control drug to the generic being tested. And most of the time the blood concentration is within +/- 2.5 to 3.5% of the control. Rarely it can go up to 5% difference. The problem is, that bioequivalence assumes therapeutic equivalence, but therapeutic equivalence is not actually tested. The issue is most likely the excipients (inactive ingredients) which may help or hinder the actual medication and at times often have their own slight drug profiles. So, blood concentrations can be the same, but very greatly as far as how well a generic has a psychoactive effect. My theory on Aurobindo brand generic Adderall is that the excipients hinder the absorption through the blood brain barrier compared to good brands like Teva or Sandoz. Which is why people often refer to it as "all levo" since the levoamphetamine in it affects the heart much more than dextro, which is therapeutic in the brain. For me Aurobindo adderall was less than 35% as therapeutic as Teva or Sandoz.

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16

@MostlySaneCatGentleman It has been many years, but hopefully you will read this.
You mention that Adderall relaxes your hyperactivity and impulsiveness and theorize it may contribute to your fatigue, based on it relaxing those symptoms. That is not correct. Adderall symptoms are due to under stimulation of the brain. When they are "relaxing" your ADHD symptoms, it is because they are stimulating the parts of the brain that mitigates those symptoms and results in better focus and attention.

You may want to do some research on something called Sluggish Cognitive Tempo. It is not in the current DSM-V (Book psychiatrists use as a guide to aid in diagnosis and treatment) It was in the last 2 years of the DSM-IV as ADHD type Inattentive (Restrictive) but a ton more is known about it now. There may be other reasons for daytime sleepiness but SCT is found to be 30 to 60% comorbid with ADHD inattentive types, and a lesser percent with combination and hyperactive types.

Some studies have shown that stimulant medications relieve ADHD symptoms, but don't do as well for the daytime sleepiness of SCT. Conversely, medications that target wakefulness so not do as well for ADHD symptoms. Modafinil is often suggested as the most likely best medication for SCT. But that additional ADHD medication may be needed for ADHD symptoms in some people. Modafinil is recognized by the FDA now as an ADHD treatment so less hassle from insurance companies.

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15

I don't think Adrafinil is available anymore as a supplement. I think the FDA had cracked down on that due to its relationship to its metabolites being the drugs Modafinil and Armodafinil.

As mentioned Modafinil is the racemic mix of R and S isomers which are about equal in effectiveness. Difference being half life of S isomer is only 1/4 to 1/3 as long as the R isomer. So by the afternoon, only the R isomer is really doing anything since the S isomer has mostly wore off.

Armodafinil being only the R isomer should be a little under twice as effective in the afternoon if dosing was the same. Armodafinil also has more potential incidents of side effects. Modafinil would most likely kick in a little sooner and be a little strong in the beginning since the dosage for it is higher. But, since the S isomer wears off a lot faster, there would be less active ingredient left in the blood at bedtime so may be easier for some to fall asleep.

In one post someone mentioned generics being within 20% of the brand name. That is a common mistake people make. It is not at all accurate. Instead of the long explanation on how bioequivalence works I'll just say this. The vast majority of generics are found to be within 2.5 to 3.5% of the brand name. And rarely go up to 5% variation of the active ingredient. And that variation is based on blood concentration of the active ingredient over a time span.

What makes them therapeutically different is usually the excipients, i.e. inactive ingredients. Which may have their own drug profile some of which can help or hinder the effects of the active ingredient. Or just have their own separate effects. Some active ingredients are not that well absorbed. So some excipients may help with absorption and first pass metabolism. So in theory, it is possible to have a generic with excipients that help absorption and first pass metabolism of the active ingredient and have 1/4 of the active ingredient and fail the bioequivalence test because it results in to high of a blood concentration of the active ingredient. Or have a generic with double the active ingredient but less bioavailable formulation that fails the bioequivalence test because blood concentrations are too low.

Or have a psychoactive generic drug that passes bioequivalence but is ineffective therapeutically because it does not pass the blood brain barrier well enough compared to the name brand. (my theory on why aurobindo brand generic adderall IR is useless in so many people)

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Re: Hop63 (# 2) Expand Referenced Message

The generic by Teva is exactly the same, even stamped PROVIGIL.

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Re: Hop (# 12) Expand Referenced Message
I realize that everyone is different and what works for one person may not work for another but give it a try it has worked for me.

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Re: w john (# 3) Expand Referenced Message

Thanks for recommending to split dosage between morning and afternoon. I tried in the past and found it to be less effective overall but my lifestyle has changed since then. Maybe it will keep me awake and alert longer if I take 100 mg 2 times a day.

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11

Very sorry to read about your dilemma. Contending with the same ailments for the better part of my life and all too familiar with the pervasive and inferior quality of generic psychotropic medications, I too have had no choice but to rely on brand versions (i.e. Lexapro, Strattera, Klonopin, etc.). I DID NOT find Nuvigil to be effective. Since Provigil is now made by Teva (originally produced by Cephalon which was bought out by Teva) I do not know if Teva quality is same as Cephalon quality. If you have not already tried, then I recommend contacting Patient Help Network in Toledo, OH or GoodRx. These are companies that assist patients who cannot afford their medications. Also, seek out pharmaceutical company manufacturers and inquire if they have a patient assistance program. By googling "provigil/original manufacturer" I was able to discover a list of Modafinil producers.

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10

I have taken brand Provigil and Teva (authorized generic of Provigil). They are exactly the same, except the price. I only take 100mg, so I split a 200mg and have 30 doses for $50.00. I don’t take it daily. Tried Nuvigil also, it didn’t work for me.

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There are many videos on YouTube that explain the difference between Provigil and Nuvigil. The maximum size Provigil pill is 200 mg. The maximum size Nuvigil is 250mg. I have taken BOTH and do not understand why Nuvigil is way less than Provigil. If my information is correct the only difference between Provigil and Nuvigil is that the manufacturer changed ONE of the enantiomers in the Nuvigil so they could get a new patent. There is basically little to no difference in the two. There are many explanations on YouTube and the internet. Please keep in mind that what works one way for a person may not work that way for another person. The videos that state that either of these two substances works wonders is not true for ME.

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Re: Hop63 (# 2) Expand Referenced Message
I was under the impression that when a medication lost its patent that it would be allowed to be manufactured by other manufacturers and would become way cheaper. For some reason the generic Modafanil made by other manufacturers is almost as expensive as the name brand. I was given the name brand one month when my Pharmacy did not have enough of the generic Modafanil to fill my script. Personally, I did not notice much difference between the name brand and the generic. Medications affect people differently and I know this but the name brand Provigil and the generic Modafanil worked equally as well FOR ME.

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7

I stared provigil 200 mg daily in 2008. I was falling asleep without warning even at stoplights. It was a miracle drug for me. Then the generics came out. They are no where near as effective. There is a round pill and an oval pill by different manufacturers. The round one is about 50% as effective as the brand name I started on. The oval is about 75% as effective. I cannot post the name of the manufacturers as I am not home right now. A generic only has to be 80% as effective as brand name according to FDA guidelines. The fillers and binders also can reduce the effectiveness as well.

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Re: Marilyn (# 4) Expand Referenced Message
I have never had any side effects from Modafanil or the generic in 4 years.

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5

Just a short reply from one that has taken BOTH Provigil generic and Nuvigil. The Provigil comes in a 200 mg size and the Nuvigil comes in a 250 mg size. I have taken BOTH and notice no difference between the two. There are videos on YouTube that explain the difference and it is according to the videos, my Pharmacist, and my experience little difference. This is my personal experience of over 4 years. Substances work differently on different people. I have taken the generic and once, because they had no generic available, I was given the name brand Modafanil. I have taken generics by Cephalon, Milan, and Alembic. I have found very little difference between them. MY UNDERSTANDING is that the main difference between Provigil and Nuvigil is one of the enantiomers. This was done so that, as the patent ran out on the Modafanil, the manufacturer changed the formulation so that they could apply and get a new patent. The new formulation has made very little difference TO ME. I was initially offered, what my Doctor said, was an adrenaline drug. I was unfamiliar with the term and found out that it was like pharmaceutical speed. I said no thank you and got qualified for the Modafanil. I do not know if any of this information helps anyone.

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4

My dr prescribed modafinil for chronic fatigue and daytime drowsiness. I’m having side effects, nausea. Insomnia, dizziness. Will these fade away when my body adapts?

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Re: Hop63 (# 2) Expand Referenced Message

I have been on Modafanil for over 3 years. We discussed what my Doctor described as the "adrenalin drugs" i.e. Ritalin, and other amphetamine based drugs. My Doctor (and the research I read) said, that while the amphetamine based drugs is tantamount to pharmaceutical speed, Modafanil and/or Provigil is not addictive. That is a big plus to me. I do NOT want to become addicted to pharmaceutical speed. For that one reason alone Modafanil is my choice. I have stopped taking this medication for up to three weeks at a time with no withdrawal whatsoever. Anyone that takes any pharmaceutical speed for any length of time wil lbecome AT LEAST dependent on the medication. Modafanil and/or Provigil can be stopped immediately without any withdrawals. As far as brands go I have only tried two brands--Mylan and Cephalon. I prefer the Cephalon brand. if you like the "speed" high and rush you will not like Modafanil because, while Modafanil will keep you awake, it will not give you any "high" or "rush". I PERSONALLY find it better to take 200 mg--100 mg in the morning and 100 mg in the early afternoon. Taken too late in the day for ME will keep me up too long. This is my PERSONAL experience of over 3 years. I hope it helps. Btw, before this Modafanil was prescribed I had to go to TWO overnight sleep studies two weeks apart AND under go CPAP therapy which I am still on.

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2

I take modafinil generic. I liked Provigil much better. I have narcolepsy. I have been taking it since 2008. It does work but there is a difference between the Provigil and generic modafinil. I think there are differences among the different generic brands I have received. My insurance won’t pay for the brand name. Must take whatever generic is given to me. I have not had any side effects.

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I know I personally went through all the amphetamine meds and Adderall ir prob worked the best but that was years ago when the generic s were better quality. I tried nuvigil hoping maybe it would have less side effects and be better. It felt ok for like an hour than I got really depressed and the rest of the day I felt awful. So never again as far as those. I since went back on Adderall ir and the only one that I can tolerate is the teva but it's not the same as it was years ago even. I guess you could try more of those generic modafinil products if you like the effects better but I found them to have less positive effects than Adderall or dextro and more negative personally. Good luck

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