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Nifedical XL and Nuvigil

Determining the interaction of Nifedical XL and Nuvigil and the possibility of their joint administration.

Check result:

Nifedical XL <> Nuvigil

Relevance: 06.09.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Armodafinil may reduce the blood levels and effects of NIFEdipine. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with modafinil (the racemate) or armodafinil (the R-enantiomer) may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. Modafinil and armodafinil are modest inducers of CYP450 3A4, and pharmacokinetic studies suggest that their effects may be primarily intestinal rather than hepatic. Thus, clinically significant interactions would most likely be expected with drugs that have low oral bioavailability due to significant intestinal CYP450 3A4-mediated first-pass metabolism (e.g., buspirone, cyclosporine, lovastatin, midazolam, saquinavir, simvastatin, sirolimus, tacrolimus, triazolam, calcium channel blockers). Chronic administration of 250 mg doses of armodafinil has been shown to reduce midazolam systemic exposure (AUC) by 32% and 17% after single oral (5 mg) and intravenous (2 mg) doses, respectively. Similar reductions in plasma concentrations were also observed for cyclosporine, ethinyl estradiol, and triazolam during coadministration of modafinil.

MANAGEMENT: Pharmacologic response to these drugs may be altered and should be monitored more closely whenever modafinil or armodafinil is added to or withdrawn from therapy. Dosage adjustments may be required if an interaction is suspected.

References

Robertson P, Decory HH, Madan A, Parkinson A "In vitro inhibition and induction of human hepatic cytochrome P450 enzymes by modafinil." Drug Metab Dispos 28 (2000): 664-71
Doherty MM, Charman WN "The mucosa of the small intestine: how clinically relevant as an organ of drug metabolism?" Clin Pharmacokinet 41 (2002): 235-53
Cerner Multum, Inc. "Australian Product Information." O 0
"Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
"Product Information. Nuvigil (armodafinil)." Cephalon Inc, West Chester, PA.
Robertson P Jr, Hellriegel ET, Arora S, Nelson M "Effect of modafinil on the pharmacokinetics of ethinyl estradiol and triazolam in healthy volunteers." Clin Pharmacol Ther 71 (2002): 46-56

Nifedical XL

Generic Name: nifedipine

Brand name: Adalat CC, Afeditab CR, Nifediac CC, Nifedical XL, Procardia, Procardia XL, Adalat

Synonyms: Nifedical XL (Oral)

What is Nifedical XL?

Nuvigil

Generic Name: armodafinil

Brand name: Nuvigil

Synonyms: n.a.

What is Nuvigil?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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