Armodafinil Side Effects | Short-Term, Long-Term, Interactions, and More

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Armodafinil

Like any other pharmaceutical drugs, there’s a risk you’ll experience Armodafinil side effects when you use this smart drug.

So what are these side effects and how will they affect you? Is Armodafinil safe to use?

One of our favorite things about Armodafinil is how minor the side effects are compared to some of our other favorite smart drugs. We rarely experience Armodafinil side effects, and when we do, it’s usually because we’ve gone over the recommended dose or forgotten to drink lots of water.

Even then, the effects are not severe.

But don’t take our word for it. You’re a savvy nootropic user, so make sure you get information on the side effects of Armodafinil based on a thorough review of the research.

We’ve provided a summary of the research literature here so you have everything you need.

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This is not legal or medical advice. This article was strictly created for your entertainment. Please consult with your primary care physician or a medical professional with close working knowledge of your health -- before consuming pharmaceutical drugs or nootropics, like Modafinil. Please read my disclaimer.

What is Armodafinil?

Before we explain the side effects, let’s have a quick refresher about what Armodafinil is.

Armodafinil, like Modafinil, is a prescription medication that is used to treat excessive daytime sleepiness. It was developed in 2007 by the same French pharmaceutical company that developed Modafinil and was originally sold under the brand name Nuvigil.

Armodafinil is essentially Modafinil’s little cousin. The only reason the drug was developed was to ensure the pharmaceutical company had a patent when Modafinil’s patent expired.

The difference between Armodafinil and Modafinil is very slight: Armodafinil’s structure features only one enantiomer, whereas Modafinil has two. This slimmed-down design is why many consider Armodafinil to be a more “pure” smart drug and may also be why Armodafinil side effects tend to be fairly minor.

Armodafinil is generally used for individuals that have sleep disorders, like [1]:

  • Narcolepsy
  • Obstructive sleep apnea
  • Shift work disorder

Occasionally, it’s also prescribed for off-label uses like treating ADHD, chronic fatigue syndrome, and depression.

The stuff works: it’s not only been found to improve alertness in sleep-deprived individuals like it was intended [2, 3], but it’s also been found to have a number of cognitive effects. For example, studies have found that Armodafinil can significantly improve:

  • Memory [4]
  • Alertness [4, 5]
  • Productivity [4]

Armodafinil Side Effects | Short-Term

So, now that you know what it is, let’s dive into Armodafinil’s side effects.

To be clear, it’s important to emphasize that most people do not experience any side effects when they take Armodafinil. We’re going to list the most common ones here, but even though these are the most common of the side effects experienced by research participants, they were still rather rare.

The research on Armodafinil says that it is safe and well-tolerated by most individuals [6].

Still, let’s dig in…

Headaches

The most common Armodafinil side effect is a headache. In randomized control trials, about 17% of participants experienced a headache. Remember, this means that 83% of individuals did not experience this side effect.

In our experience, headaches occur more often when we’re dehydrated.

The best way to combat a potential Armodafinil headache? Drink lots of water and electrolytes and stick to a 150 mg dose—not more.

Nausea

Nausea is the next most commonly reported side effect of Armodafinil [7]. In research studies, this affected about 6% of participants [6].

Like headaches, we’ve experienced this side effect too. In our experience, eating a full meal before taking Armodafinil can help avoid nausea and other stomach issues. It also tends to go away by the next morning. And, we notice that the nausea side effect of Modafinil vs. Armodafinil is much better.

Insomnia

This one shouldn’t be much of a surprise to you. Armodafinil, after all, is a wakefulness agent. So, ya, it causes wakefulness. If you take it too close to bedtime, you could definitely have trouble sleeping.

We make sure that we take it early in the morning—always before 10:00 am. That way, we get a large, full workday out of it without it affecting night-time sleep. While some research has listed insomnia as a side effect, other research finds that—when used properly—Armodafinil doesn’t affect night-time sleep [4].

Dizziness

Dizziness is experienced by between 5% [6] and 8% [4] of patients. It usually does not last long and is usually not severe.

Anxiety

Some participants in clinical trials reported feeling some anxiety after taking Armodafinil. In one study, this was reported by about 5% of participants [6].

Blood pressure

Some research suggests that Armodafinil may make small changes to blood pressure [8], and this is consistent with what we know about Modafinil and blood pressure [9, 10].

But other research didn’t find any meaningful changes in systolic or diastolic blood pressure, in heart rate, or in any other factors as assessed by an electrocardiogram or physical exams [6]. It’s likely that any blood pressure changes, if they occur at all, would probably be quite small.

Diarrhea and Indigestion

Some research has also found that participants report increased instances of diarrhea as a side effect of Armodafinil [11].

Again, we actually have had experience with this side effect. We find that you can reduce the issue if you remember to eat a big meal before taking it. Again, comparing Modafinil vs. Armodafinil, Armodafinil gives us less of this side effect.

In clinical trials, this Armodafinil side effect affected about 2% of participants [4]. 

Decreased Appetite

This is another reason you have to remember to eat: one side effect of Armodafinil is that, in our experience, it can reduce your appetite considerably [4].

In one study, about 3% of participants reported feeling decreased appetite [4].

Dry Mouth

A last relatively common side effect of Armodafinil is becoming dehydrated. This can often take the form of an uncomfortably dry mouth. This seems to occur in about 2.5% of participants and is more common among females, older individuals, and those who have been taking Armodafinil for less than a month [12].

In our experience, dehydration is especially likely when we’re so focused on work that we forget to drink. We address this by making sure we have a large water bottle near us at all times.

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Armodafinil Side Effects | Long-Term

As you can see, the short-term side effects of Armodafinil are quite mild and uncommon. But what about long-term side effects?

Possible Weight Loss

Some individuals may experience some weight loss as a long-term side effect of Armodafinil [13]. But it’s important to keep in mind why this is.

The first reason is that one of the most common reasons for prescribing Armodafinil is to treat daytime sleepiness associated with obstructive sleep apnea. Obstructive sleep apnea is much more common in individuals who are overweight and obese. Therefore, the population prescribed this drug are likely those for whom there is a lot of extra weight to lose.

The second reason is that Armodafinil decreases sleepiness, so its users are more active. It’s likely the increase in activity that is actually causing the weight loss—not the drug itself.

So, if you are quite overweight and not very active in part because you’re so tired from not sleeping well, sure, Armodafinil could help you lose weight. But it’s not a “get thin quick” pill. In individuals that already have a healthy weight, there is no evidence that it will lead to reduced weight.

Stevens-Johnson Syndrome

Stevens-Johnson Syndrome (SJS), is a condition in which a person experiences a severe allergic reaction in the skin. The person with SJS may experience symptoms that are flu-like, including, fever, burning eyes, sore throat, and body aches. It can also feel like the skin is burning.

SJS is listed on the manufacturer’s drug information for side effects of Armodafinil, although the research literature, in general, has not reported this side effect. However, there have been rare but occasional case reports of SJS associated with both Armodafinil [14] and its cousin Modafinil [15].

This is one reason that it’s always important to start with small doses—of any new drug. Give yourself some time to see what effect it will have on your body. If you experience any skin symptoms or allergic reactions, see your doctor.

Mania

It’s well acknowledged that Armodafinil can boost mood. But in at least one case in a person that had been diagnosed with schizophrenia, it was found to result in mania [16].

Mania is an abnormal and persistent elevation in mood. It can be a bad thing because people experiencing mania may take excessive risks or engage in behavior that is not adaptive.

Again, while this is a rare side effect even for people with preexisting psychological disorders, healthy individuals may be at even less risk of experiencing it. Still, you should know about the possibility.

Dependence and Addiction

Long-term research on Armodafinil is limited; however, the research that does exist suggests that the potential to become physically dependent on Armodafinil is very low [4, 6].

However, there has been at least one case report of an individual that became dependent on it [17]. Note that this individual also had addictions issues with other substances.

In our community, we haven’t had any issues with addiction or dependence. But we also are careful not to use it every day. We use it between 1 to 3 times a week and that seems to present no issues.

Armodafinil Side Effects | Rare

Now, there are some more serious side effects of Armodafinil.

While these issues are incredibly rare, you should pay attention and potentially seek medical help if you experience any of the following [18]:

  • Fever
  • Sore throat
  • Skin rash
  • Chest pain
  • Bruising
  • Bleeding
  • Psychosis
  • Angioedema

Again, these are exceptionally rare and not something you should be overly concerned about.

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How Armodafinil Affects the Liver

There isn’t much evidence that Armodafinil affects the liver. In clinical trials, some very small increases in chemicals (aminotransferase and alkaline phosphatase) were observed, suggesting very mild changes in liver function. But the changes were less than 1% concentration [19].

However, because the metabolism of Armodafinil occurs primarily through the liver [20], it’s worth some consideration.

Our own review of the research showed very little evidence for significant adverse impacts on the liver, but we did find one case study where an individual seemed to have liver issues after taking armodafinil [21]. In particular, he had a higher than normal concentration of iron in the liver.

However, upon closer inspection, it appeared that he had a genetic predisposition for higher iron levels [21]. The iron concentrations went back to normal after stopping Armodafinil.

So it appears that Armodafinil may only be an issue for your liver if you have a particular (and rare) genetic predisposition.

Researchers conclude that [19]:

There have not been reports of clinically apparent liver injury due to modafinil or armodafinil… Likelihood score: E (unlikely causes of clinically apparent liver injury).

Armodafinil Interactions?

You might be wondering if there are any Armodafinil interactions—drugs that it could interact with that change the way either of them works.

Armodafinil is broken down by a few particular enzymes in healthy subjects: cytochrome P450 enzymes 1A2, 3A4 and 2C19.

Some researchers suggest that drugs that are also broken down by these enzymes may interact with Armodafinil, but this hasn’t actually been found in real subjects [22].

Still, it’s advised to be extra careful and consult with a doctor for potential Armodafinil interactions if you are:

  • Pregnant
  • Taking risperidone for bipolar I disorder [23]
  • Taking Carbamazepine for bipolar I disorder [24]
  • Taking Steroidal contraceptives [25]
  • Taking Cyclosporine [25]
  • Taking CYP2C19 substrates, such as omeprazole, phenytoin, and diazepam [25]

You MUST pay attention to these warnings and interactions when taking Armodafinil. Interactions are generally higher risk than any common side effects of the nootropic.

Is Armodafinil Safe?

So, at the end of all that, is Armodafinil safe?

Well, we’re not doctors, but we are researchers. And the research consistently shows that Armodafinil, like Modafinil, is well-tolerated and generally considered safe to consume for the majority of individuals [4, 20].

While there are some Armodafinil side effects, these are usually short term, affect less than about 17% of people, and are not severe. The side effects stop after taking the drug.

Best of all, you can avoid the side effects if you’re smart. Here’s how:

  • Don’t take massive doses. Stick to our Armodafinil dosage guide: take a maximum of 150 mg in a single day.
  • Take it early in the morning. Armodafinil lasts a long time. If you want to sleep well at night, take your Armodafinil before 10:00 am.
  • Make sure you eat. You can avoid some of the indigestion and nausea if you take it with food. We like to have a huge breakfast with ours.
  • Make sure you drink. Water is your friend. Drink lots of water to avoid headaches. Take electrolytes with it too.

As of writing this piece, there have been zero reported deaths as a result of Modafinil overdose or even taking Armodafinil.

Simply put, these drugs are not stimulants. Armodafinil has no addictive properties. You won’t get addicted to Armodafinil. You won’t want to take more and more of it after each use.

What does the nootropic do? Armodafinil will increase cognition and help you focus. Taking a higher dose rarely adds benefit. Thus, you won’t feel the need to take more than 150 mg of Armodafinil each day.

Personally, we’ve found Armodafinil side effects to be incredibly minor, and you probably will too.

Modafinil vs. Armodafinil

What about the side effects of Modafinil vs. Armodafinil? How do they compare?

Honestly, the side effects of Armodafinil are milder than those for Modafinil. We love Modafinil, but it really can lead to stomach cramps and headaches if you’re not careful.

We find that Armodafinil has a much milder effect.

Armodafinil is great for those days where you just need to pump out 10 hours of work and then have a good sleep. It’s perfect for that and has fewer side effects.

Modafinil is better for those days when you’re going to be working 15 hours or you need to pull an allnighter. You might have some indigestion, but you can manage it by taking food and drinking lots of water.

Side Effects of Armodafinil | The Verdict

Is Armodafinil safe? Yes. Does it have side effects? Also yes.

Are they severe or common? 

No, they are not. Most people find Armodafinil side effects are not as strong as Modafinil side effects.

We like Armodafinil best on days when we want to get to sleep at a decent hour and not have to worry about diarrhea and stomach cramps.

Don’t get us wrong. Modafinil side effects certainly aren’t that bad. At the very worst, you’ll stay up until 3 AM and have diarrhea the next morning. A small price to pay for 12 hours of your best work. However, with Armodafinil, you generally won’t need to deal with those minor inconveniences, either.

Overall, Armodafinil is a great alternative to Modafinil on days when you need 8-11+ hours of great focus and productivity compared to 12-14+ with Modafinil. Armodafinil isn’t as strong, but neither are the Armodafinil side effects.

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References

  1. Drugs.com (2020). Armodafinil. https://www.drugs.com/cdi/armodafinil.html
  2. Hirshkowitz, M., Black, J. E., Wesnes, K., Niebler, G., Arora, S., & Roth, T. (2007). Adjunct armodafinil improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome. Respiratory Medicine, 101(3), 616-627.
  3. Nishino, S., & Okuro, M. (2008). Armodafinil for excessive daytime sleepiness. Drugs Today, 44(6), 395-414.
  4. Harsh, J. R., Hayduk, R., Rosenberg, R., Wesnes, K. A., Walsh, J. K., Arora, S., … & Roth, T. (2006). The efficacy and safety of armodafinil as treatment for adults with excessive sleepiness associated with narcolepsy. Current Medical Research and Opinion, 22(4), 761-774.
  5. Czeisler, C. A., Walsh, J. K., Wesnes, K. A., Roth, T., & Arora, S. (2009, November). Armodafinil for treatment of excessive sleepiness associated with shift work disorder: A randomized controlled study. Mayo Clinic Proceedings 84(11), 958-972
  6. Roth, T., Rippon, G. A., & Arora, S. (2008). Armodafinil improves wakefulness and long-term episodic memory in nCPAP-adherent patients with excessive sleepiness associated with obstructive sleep apnea. Sleep and Breathing, 12(1), 53-62.
  7. Brown, J. N., & Wilson, D. T. (2011). Safety and efficacy of armodafinil in the treatment of excessive sleepiness. Clinical Medicine Insights: Therapeutics, 3, CMT-S5124.
  8. Black, J. E., Hull, S. G., Tiller, J., Yang, R., & Harsh, J. R. (2010). The long-term tolerability and efficacy of armodafinil in patients with excessive sleepiness associated with treated obstructive sleep apnea, shift work disorder, or narcolepsy: an open-label extension study. Journal of Clinical Sleep Medicine, 6(5), 458-466.
  9. Turner, D. C., Robbins, T. W., Clark, L., Aron, A. R., Dowson, J., & Sahakian, B. J. (2003). Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology, 165(3), 260-269.
  10. Taneja, I., Diedrich, A., Black, B. K., Byrne, D. W., Paranjape, S. Y., & Robertson, D. (2005). Modafinil elicits sympathomedullary activation. Hypertension, 45(4), 612-618
  11. Calabrese, J. R., Frye, M. A., Yang, R., & Ketter, T. A. (2014). Efficacy and safety of adjunctive armodafinil in adults with major depressive episodes associated with bipolar I disorder: a randomized, double-blind, placebo-controlled, multicenter trial. The Journal of clinical psychiatry, 75(10), 1054-1061.
  12. eHealthMe.com (n.d.). Will you have Dehydration with Armodafinil?https://www.ehealthme.com/ds/armodafinil/dehydration/
  13. Chapman, J. L., Cayanan, E. A., Hoyos, C. M., Serinel, Y., Comas, M., Yee, B. J., … & Marshall, N. S. (2018). Does armodafinil improve driving task performance and weight loss in sleep apnea? A randomized trial. American Journal of Respiratory and Critical Care Medicine, 198(7), 941-950.
  14. Holfinger, S., Roy, A., & Schmidt, M. (2018). Stevens-Johnson syndrome after armodafinil use. Journal of Clinical Sleep Medicine, 14(5), 885-887.
  15. Prince, V., Philippidou, M., Walsh, S., & Creamer, D. (2018). Stevens-Johnson syndrome induced by modafinil. Clinical and Experimental Dermatology, 43(2), 191.
  16. Bavle, A., & Phatak, A. (2014). Armodafinil induced mania in schizophrenia. Australian & New Zealand Journal of Psychiatry, 48(4), 381-381.
  17. Jerry, J. M., Shirvani, N., & Dale, R. (2016). Addiction to armodafinil and modafinil presenting with paranoia. Journal of Clinical Psychopharmacology, 36(1), 98-100.
  18. eMedicineHealth (n.d.). Nuvigil (Armodafinil). https://www.emedicinehealth.com/drug-armodafanil/article_em.htm
  19. National Institute of Diabetes and Digestive and Kidney Diseases (2017). LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. https://www.ncbi.nlm.nih.gov/books/NBK548274/
  20. Bogan, R. K. (2010). Armodafinil in the treatment of excessive sleepiness. Expert Opinion on Pharmacotherapy, 11(6), 993-1002.
  21. Gangireddy, V., Talla, S., Abdulla, H., Chamberlain, S., & Sridhar, S. (2014). Armodafinil, not so silent as it appears. American Journal of Gastroenterology, 109, S379-S380.
  22. Robertson, P., & Hellriegel, E. T. (2003). Clinical pharmacokinetic profile of modafinil. Clinical Pharmacokinetics, 42(2), 123-137.
  23. Darwish, M., Bond, M., Yang, R., Hellriegel, E. T., & Robertson, P. (2015). Evaluation of potential pharmacokinetic drug-drug interaction between armodafinil and risperidone in healthy adults. Clinical Drug Investigation, 35(11), 725-733.
  24. Bond, M., Yang, R., Hellregel, E. T., Robertson, P. (2013). Evaluation of Potential Drug Interactions Between Armodafinil and Carbamazepine in Healthy Adult Males. https://www.psychcongress.com/posters/evaluation-potential-drug-interactions-between-armodafinil-and-carbamazepine-healthy-adult
  25. Ceaphlon (2007). Armodafinil Prescribing Information. https://web.archive.org/web/20180107165205/http://www.nuvigil.com/PDF/Full_Prescribing_Information.pdf

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