From the FDA Drug Label
Blood pressure monitoring in short term (≤3 months) controlled trials showed no clinically significant changes in mean systolic and diastolic blood pressure in patients receiving modafinil tablets as compared to placebo However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on modafinil tablets required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%).
- The exact amount of increase in blood pressure is not specified in the label.
- Modafinil may increase blood pressure in some patients, as evidenced by the increased need for antihypertensive medications 1.
- It is recommended to exercise caution when prescribing modafinil to patients with known cardiovascular disease and to consider increased monitoring of heart rate and blood pressure.
From the Research
Modafinil typically causes modest increases in blood pressure, with average elevations of 1.93 mmHg in systolic pressure and 1.84 mmHg in diastolic pressure, as evidenced by the most recent and highest quality study 2.
Key Points
- The effects of modafinil on blood pressure are generally considered clinically insignificant for most healthy individuals.
- However, people with pre-existing hypertension, cardiovascular disease, or those taking other medications that affect blood pressure should use modafinil with caution.
- The blood pressure effects are dose-dependent, with higher doses potentially causing greater increases.
- Modafinil's stimulant properties work by affecting neurotransmitters like dopamine, norepinephrine, and histamine, which can lead to these cardiovascular effects.
- Blood pressure typically returns to baseline after the medication wears off.
Recommendations
- If you're prescribed modafinil, regular blood pressure monitoring is advisable, especially when starting treatment or adjusting dosage.
- If you experience symptoms like severe headache, chest pain, or significantly elevated blood pressure readings while taking modafinil, seek medical attention promptly.
Considerations
- The study 2 found that daily oral amphetamines, which have similar effects to modafinil, increase blood pressure, heart rate, and withdrawals due to adverse effects, with these effects observed across all time points.
- Future trials should measure blood pressure using 24-hour ambulatory monitoring and assess the effect of long-term use.
- It is essential to weigh the benefits and risks of modafinil use, particularly in individuals with pre-existing cardiovascular conditions or those taking other medications that affect blood pressure.