Can Solriamfetol (Sunosi) be combined with Modafinil?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

Combining Sunosi (solriamfetol) with modafinil is not recommended without medical supervision due to the potential for increased side effects and excessive stimulation of the central nervous system. Both medications are wakefulness-promoting agents that work on similar neurotransmitter systems in the brain, particularly affecting dopamine. Using them together could potentially increase the risk of side effects such as increased blood pressure, heart rate, anxiety, insomnia, and other stimulant-related adverse effects. According to the American Academy of Sleep Medicine clinical practice guideline 1, solriamfetol and modafinil are both recommended for the treatment of narcolepsy in adults, but there is no guidance on combining these medications.

Key Considerations

  • The combination of Sunosi and modafinil may lead to excessive stimulation of the central nervous system, increasing the risk of adverse effects.
  • Potential drug interactions with other medications should be considered before combining these two medications.
  • Adjusting the dosage of the current medication or switching to a different treatment approach may be more appropriate than combining these two medications.

Recommendations

  • Consult with a healthcare provider before combining Sunosi and modafinil to evaluate the specific situation and determine the best course of treatment.
  • Never adjust the medication regimen without professional medical guidance, as this can lead to serious health consequences.
  • The American Academy of Sleep Medicine clinical practice guideline 1 provides recommendations for the treatment of narcolepsy, but it is essential to consider the individual patient's needs and medical history when making treatment decisions.

From the Research

Combination of Sunosi and Modafinil

There is no direct evidence in the provided studies that specifically addresses the combination of Sunosi (Solriamfetol) and Modafinil.

  • The studies primarily focus on the efficacy and safety of Solriamfetol in treating excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea, often comparing it to Modafinil in terms of wake-promoting effects and side effects 2, 3, 4, 5, 6.
  • Solriamfetol is shown to be effective in improving wakefulness and reducing sleepiness in patients with obstructive sleep apnea or narcolepsy, with a favorable safety profile 3, 5, 6.
  • Modafinil is also recognized for its wake-promoting effects but is compared and contrasted with Solriamfetol in terms of efficacy, side effects, and mechanisms of action 2, 4.
  • One study suggests that Solriamfetol can be used as initial therapy or as replacement therapy in patients who fail treatment or experience unacceptable side effects with Modafinil, among other treatments 6.
  • However, there is no explicit discussion on the combination therapy of Sunosi and Modafinil, indicating a lack of direct research evidence on this specific topic within the provided studies.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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