Vilafinil is a high-purity pharmaceutical-grade cognitive enhancer indicated for the management of excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. Its primary mechanism of action involves selective agonism of wakefulness-promoting neuropathways, offering sustained alertness without the peripheral stimulatory effects typical of traditional psychostimulants. Clinically, it demonstrates a favorable pharmacokinetic profile characterized by rapid onset, extended duration of action, and minimal rebound hypersomnolence. It is formulated to support neurocognitive function in eligible patient populations under professional supervision.

Features

• Active ingredient: Modafinil 200 mg
• Pharmaceutical grade, manufactured under GMP conditions
• Rapid onset of action, typically within 30–60 minutes
• Extended half-life of approximately 12–15 hours
• Minimal impact on cardiovascular parameters at therapeutic doses
• Low abuse potential relative to Schedule II stimulants
• Bioavailability of approximately 80% under fasting conditions

Benefits

• Promotes sustained wakefulness and alertness during waking hours
• Enhances cognitive functions including memory, focus, and executive function
• Reduces subjective fatigue without significant jitteriness or euphoria
• Supports occupational and social functioning in individuals with sleep-wake disorders
• May improve quality of life by mitigating excessive daytime sleepiness
• Generally well-tolerated with a lower incidence of adverse effects compared to amphetamine-based agents

Common use

Vilafinil is primarily prescribed for the treatment of narcolepsy, obstructive sleep apnea (with residual sleepiness despite CPAP therapy), and shift work sleep disorder. Off-label, it is sometimes used under medical guidance to address fatigue and cognitive impairment associated with conditions such as multiple sclerosis, depression, and ADHD, though such uses are not formally approved and require careful risk-benefit assessment.

Dosage and direction

The standard recommended dosage for adults is 200 mg taken orally once daily, preferably in the morning. For shift work sleep disorder, the dose should be taken approximately one hour prior to the start of the work shift. Dosage adjustment may be necessary in elderly patients or those with severe hepatic impairment. Do not crush, chew, or split the tablet. Administration with or without food is acceptable, though high-fat meals may delay absorption.

Precautions

Patients should be advised to avoid activities requiring mental alertness, such as driving or operating machinery, until they know how Vilafinil affects them. Use with caution in those with a history of psychosis, depression, mania, or cardiovascular disease. Regular monitoring of blood pressure and heart rate is recommended during treatment. Not recommended during pregnancy or breastfeeding unless potential benefits outweigh risks. Discontinuation should be gradual under medical supervision to avoid withdrawal effects.

Contraindications

Vilafinil is contraindicated in patients with known hypersensitivity to modafinil or armodafinil, or any component of the formulation. It should not be used in individuals with a history of left ventricular hypertrophy, ischemic ECG changes, chest pain, or mitral valve prolapse associated with stimulant use. Concomitant use with monoamine oxidase inhibitors (MAOIs) is contraindicated due to the risk of hypertensive crisis.

Possible side effects

Common adverse reactions (≥5%) include headache, nausea, nervousness, anxiety, insomnia, dizziness, and dry mouth. Less frequently reported effects include palpitations, diarrhea, hypertension, and blurred vision. Serious but rare side effects may include Stevens-Johnson syndrome, angioedema, multiorgan hypersensitivity reactions, and psychiatric symptoms such as aggression or hallucinations. Patients should seek immediate medical attention if severe reactions occur.

Drug interactions

Vilafinil is a moderate inducer of CYP3A4 and may reduce the efficacy of substrates such as oral contraceptives, cyclosporine, midazolam, and certain antiepileptics. Conversely, strong CYP3A4 inhibitors (e.g., ketoconazole) may increase modafinil concentrations. Concurrent use with other CNS stimulants may exacerbate sympathetic effects. Caution is advised when co-administering with warfarin, tricyclic antidepressants, or clozapine due to potential interactions.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is close to the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include agitation, insomnia, tachycardia, hypertension, anxiety, and confusion. In severe cases, delirium, hallucinations, or ECG changes may occur. Management is supportive and symptomatic; there is no specific antidote. Gastric lavage or activated charcoal may be considered if ingestion was recent. Hemodialysis is not expected to be effective due to high protein binding.

Storage

Store at room temperature (20–25°C or 68–77°F), in a tightly closed container, away from light, moisture, and heat. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes only and does not constitute medical advice. Vilafinil is a prescription medication and should be used only under the supervision of a qualified healthcare provider. Individual response may vary. Always follow your physician’s instructions and read the patient information leaflet provided with the medication.

Reviews

“As a neurologist specializing in sleep disorders, I’ve found Vilafinil to be a reliable option for patients with residual sleepiness. Its clean profile and sustained effect make it a go‐to in my practice.” – Dr. Elena R., MD
“After years of struggling with shift work disorder, Vilafinil has significantly improved my alertness and productivity without the crash I experienced with other agents.” – Mark T., night-shift nurse
“Effective and well-tolerated. My patients appreciate the mental clarity it provides, though we always discuss potential side effects beforehand.” – Dr. Ian K., sleep specialist