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Provigil vs Nuvigil
Does anyone currently take medications to help with excessive sleepiness? I have been on provigil for about 2 months now. I started off with 1/2 of a 100mg pill twice a day. Then I bumped up to taking 200mg a day. I'm currently taking 400mg a day. Still feeling fatigued. My doctor prescribed me Nuvigil (my copay was $45- I'll be looking to get reimbursed). Tomorrow is day one of 250mg of Nuvigil once a day.
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Replies to This Discussion
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Permalink Reply by Fred on
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Provigil and Nuvigil are absolutely prescribed for people with OSA, who are being successfully treated with CPAP but still suffer from excessive daytime sleepiness. I know because I'm one of them.If your doctor doesn't know that he/she needs to look it up, or you need to find a new doctor. I would suggest Provigil first because the patent has expired or will expire soon. That means generics should be available. If that doesn't work, then ask for Nuvigil.
matt_jk said:
Are Provigil or Nuvigil commonly used for sleepiness for OSA? I've got OSA, and when I asked about them, my sleep Dr. told me that those drugs are only used to treat narcolepsy. I would have loved something a couple times a week like Mary.
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Matt,
You're not alone in that experience, as my doctor said the exact same thing. Last I checked, her credentials are legitimate too. So, no need to 'find a new doctor right away'. I'd be wary of any physician who is overzealous to prescribe you anything.
Regards,
Jay
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http://www.amstraussdds.com/oral-systemic-balance.html
While we're all chasing our tails like puppies with these drugs and stimulants, Dr. Arthur Strauss offers a holistic approach towards sleep apnea. He address the structural root causes of Sleep Apnea.
Be well and best in your journey through this difficult condition.
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Permalink Reply by Mary Z on
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I don't take Nuvigil to treat OSA, but hypersomnia. Without this medicine there are days when I would not be able to stay awake to go to appointments, to drive to the store, or even to give my dogs a good walk. My internist, my psychiatrist (who originally prescried Provigil), my sleep doctor (who preferred that I take Nuvigil, and my neurologist (who wrote my last prescription for Nuvigil) all feel that medicine is necessary and ok for me. I do not get "stimulant effects" from it (I've taken it for a couple of years), but it allows me to stay awake and go about the business of my day. It is considered a "wakefullness medicine" I was told by my neurologist; diffeent ffrom ritalin, adderal, and amphetamines.
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Hi,
I just started taking nuvigil myself. I wasn't as tired in the beginning, but it seems to have flamed out also. I stopped taking it everyday to see if it will work when I really need it. I'm glad to know it wan't just me.
Good luck,
Julie
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I have had excessive sleepiness for almost 10 years now, and have been on Provigil 400 mg a day. I would take 200 mg about 6:30 am and the other 200 mg around 11:00. I found taking them apart works better and last me through the day. Here recently it seems like the Provigil isn't working. I went to the doctor and she put me on Nuvigil 250 mg which I've been taking about 3 days. I don't like it as well as the provigil. The Nuvigil makes me shakey in side, gives me headaches, wears off at about 6:00 or so and I also am getting little sores in my mouth.
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Better get the sores checked out. Nasty Stevens-Johnson is rare but extremely serious. Seriously!
Nuvigil gave me a paranoid anxiety attack. Provigil keeps me more awake but sleepy - miserable. Cant work. Caffeine is supposed to be one of the best if not THE best stimulant and it's what I use when I HAVE to be functional.
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I agree with Rose Marie. It may be unrelated and nothing to worry about, but ulcers in the mouth can be the first sign of Stevens-Johnson Syndrome. I would stop the Nuvigil until you get further instructions from your physician. It's not worth taking a chance.
I didn't have any luck with Nuvigil, it just didn't seem to work for me. So I returned to Provigil, that is when I can get some. My insurance doesn't cover it (but will cover Nuvigil). Fortunately, the generic for Provigil should be released this month, as of the last I heard. Has anybody heard anything differently? Or what the generic will cost initially? The first six months of a generic release is always more expensive because one company is given exclusive rights...... I think it was Teva but now Teva owns Cephalon so who knows.
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Karen,
Unfortunately, its not 5 yrs OR 15 yrs. Instead while officially they are good for 20 years (12 years for biologics), the more correct answer is "it all depends". Patents are applied for early during R&D of a new drug and that is when the clock starts ticking on the 20 years. So, the longer it takes for a drug to get approved and to market, the shorter its effective patent life. However, sometimes the Patent Ofiice moves very slowly and in that case, extensions to the patent can be applied for and might be granted. Ditto if there is a lengthy appeals process, though the company is expected to appeal in an expeditious manner. If I recall, orphan drugs are given special consideration so that manufacturers have the necessary extra time to recoup R&D costs. R&D for new drugs, which on average costs about $1 billion, has fallen way off. Between cuts in federal funding, easier profits they can earn on patents for 'almost alike' drugs, and average R&D costs for biologics running 10-20% of other drugs causing more interest in these products, BigPharma has little incentive to make the risky investments in new product development.
In the case of Provigil, I don't understand all the technicalities of international law and patents, but it was released in the US in either 1998 or 1999, after rights were purchased from a French company and the drug had been on the market in Europe for several years. Four generic companies filed suit challenging the patent on Provigil, and looked as if they would begin manufacture in 2006. Cephalon entered into a 'reverse settlement' with all four by paying approx. $200M to NOT manufacture generics until April 2012, so they could enjoy a longer exclusivity period. It has been Cephalon's (now owned by Teva) number one money maker, with sales topping $1 billion annually. This prompted the Federal Trade Commission, several pharmacy retailers, and the European Trade Commission to all file anti-trust lawsuits against Cephalon. Those suits are still in the courts, but the FTC lost a similar suit involving Plavix. In 2004, there were no reverse settlements in the pharmaceutical industry. There had been 21 in 2009 by September. The FTC estimates these settlements cost consumers $3.5 billion each year by missing out on generic equivalents, which can cost 90% less than their brand name counterparts and on average delay entry of generics by 48 months. An amendment was introduced into Congress in 2010 that would allow the FTC to intervene in reverse settlements but our fearless leaders voted against passing it.
Cephalon subsequently released and have heavily promoted Nuvigil, restarting a new patent. Since releasing Nuvigil, at a discounted price (yep, hard to believe but Cephalon considers it discounted), they have more than doubled the price of Provigil in an effort to move people over to their new product. They hope to establish brand loyalty to Nuvigil before the release of generic Provigil. Such sick and twisted games BigPharma plays.
And that is the story of patents, Provigil, and Nuvigil, boys and girls. (I'm in the process of doing more extensive coverage of the Provigil lawsuits for publication.)
Karen Day-Lyon said:It is, unfortunately, not five years, but FIFTEEN for patent drugs. Generics can be made after that date, unless, like the manufacturers of Colchicine recently, they change the formula in a miniscule amount and then apply for a new patent to keep others out of the market.
Joanne Williams, RPSGT said:It is my understanding that meds have name brand pattens for 5yrs; once that period is up it can be made generically. It's kinda like Ambien....when it went to generic, here comes Ambien CR. My Dr Rx Nuvigil to me just last Friday. I went to get it filled and to my surprise it was going to be OVER $300 (I have Rx ins too). Let me just say I had taked Provigil in the past and know it really works, however, as of right now I am not a sell on the New "Nuvigil". I speculate it is all about the all mighty dollar! GRRRRRR......
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As of yesterday, 4/6/12, Provigil is starting to be distributed as a generic by Par Pharmaceuticals. The Nuvigil is the original's drug company's effort to have essentially the same product, a breakdown of the provigil, remain a brand name for pharmaceutical profits. Studies do not substanciate a benefit of Nuvigil over Provigil. That said, individuals vary. It's interesting that one thought the Nuvigil lasted longer. Still under most insurance plans, such as mine, brand names cost four times what the generic costs. Knowing this, Nuvigil has a co-pay card that you probably can print out from the web.
I think it's more important to study your CPAP data to lower the AHI and improve sleep quality. Some even use a Zeo to note the sleep stage disruptions that create the constant awakenings contributing to fatigue. Somehow taking magnesium in the evening seem to decrease the restlessness. Taking on a multiple approach has helped my husband half his dose, with the goal of discontinuing after a year of CPAP.
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What about your multiple approach will enable him to discontinue cpap?
I don't understand. He halved his dose of Provigil/Nuvigil. Is the reasoning that if he no longer needs the drug to stay awake his sleep apnea will be cured?
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Mary, I don't think K.S. mean't discontinuing CPAP, she mean't discontinuing Provigil/Nuvigil, which is a good thing if he can.
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