From the FDA Drug Label
DOSAGE AND ADMINISTRATION See Full Prescribing Information for complete dosing instructions (2.1-2.7). Dosage for Adult Patients with Narcolepsy • Initiate dosage at 4.5 g per night orally, divided into two doses (2.1). • Titrate to effect in increments of up to 1.5 g per night per week (2.1). • Recommended dosage range: 6 g to 9 g per night orally, divided into two doses (2.1).
The recommended dosage range for adult patients with narcolepsy is 6 g to 9 g per night, divided into two doses, with a starting dosage of 4.5 g per night. The dosage may be titrated in increments of up to 1.5 g per night per week 1.
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From the Research
Narcolepsy treatment typically involves medications tailored to the individual's symptoms and severity, with modafinil (Provigil) often prescribed at 200-400mg once daily in the morning, or armodafinil (Nuvigil) at 150-250mg daily, as supported by recent studies 2, 3, 4.
Treatment Options
- For excessive daytime sleepiness, stimulants like methylphenidate may be used at 10-60mg daily in divided doses, or amphetamine salts (Adderall) at 5-60mg daily divided 2, 5.
- For cataplexy, sodium oxybate (Xyrem) is effective at 2.25-4.5g taken twice nightly (second dose 2.5-4 hours after the first), or antidepressants like venlafaxine (37.5-225mg daily) or fluoxetine (20-60mg daily) may help 2, 6.
- Pitolisant (Wakix), a newer option, is dosed at 17.8-35.6mg once daily in the morning, as approved by the European Medicines Agency and the FDA for the treatment of excessive daytime sleepiness in adult narcolepsy patients 3, 4.
Lifestyle Modifications
- Lifestyle modifications like scheduled naps and regular sleep patterns complement medication therapy, and are essential for managing narcolepsy symptoms 2, 4.
- Treatment should start at lower doses and gradually increase to minimize side effects, with dosages individualized based on symptom control, tolerability, and potential drug interactions, requiring regular follow-up with a sleep specialist 2, 5, 4.