Can Modafinil Be Crushed?
The provided evidence does not address whether modafinil tablets can be crushed or altered for administration in patients with swallowing difficulties, and no FDA labeling or guideline information is available on this specific question.
What the Evidence Does NOT Tell Us
The available guidelines and drug information focus exclusively on:
- Dosing schedules and maximum daily doses 1, 2
- Pharmacokinetics and absorption characteristics 3, 4
- Safety profiles and adverse events 5, 6
- Clinical efficacy across various conditions 5
Critically, none of these sources provide information about tablet formulation, crushing, or alternative administration methods for patients with dysphagia.
Clinical Considerations in the Absence of Evidence
What We Know About Modafinil Formulation
- Modafinil is readily absorbed after oral administration, reaching peak plasma concentrations at 2-4 hours 3, 4
- The drug has dose-independent pharmacokinetics between 200-600 mg/day 4
- Absorption is not significantly affected by food intake 3
Important Contrast: Controlled-Release Formulations
The evidence does specify that zolpidem controlled-release tablets must be "swallowed whole, not divided, crushed or chewed" 5, demonstrating that when crushing is contraindicated, guidelines explicitly state this restriction.
The absence of any such warning for standard modafinil tablets in the available evidence is notable but not definitive.
Recommended Approach
Without specific manufacturer guidance or FDA labeling information about crushing modafinil tablets:
- Contact the pharmacist or manufacturer directly to obtain official guidance on whether the specific formulation can be crushed
- Review the actual FDA prescribing information for modafinil (Provigil) to check for any tablet integrity warnings
- Consider alternative formulations or medications if crushing is contraindicated and the patient cannot swallow tablets
Common Pitfalls to Avoid
- Do not assume that absence of crushing warnings means crushing is safe
- Do not crush any medication without verifying the formulation type (immediate-release vs. extended-release)
- Be aware that crushing may affect absorption kinetics even if not explicitly contraindicated
The evidence provided is insufficient to answer this question definitively. Direct consultation with pharmaceutical resources is required.