Can Modafinil Be Crushed?
Modafinil tablets should not be crushed without first consulting the FDA prescribing information, as crushing may affect absorption kinetics and there is no explicit safety data confirming this practice is safe for patients with swallowing difficulties. 1
Primary Recommendation
The American Academy of Sleep Medicine explicitly recommends reviewing the actual FDA prescribing information for modafinil (Provigil) to check for any tablet integrity warnings before considering crushing. 1 You should not assume that the absence of crushing warnings means crushing is safe. 1
Key Considerations Before Crushing
Verify the formulation type (immediate-release vs. extended-release) before crushing any medication, as this critically affects whether crushing is appropriate. 1
Be aware that crushing may affect absorption kinetics even if not explicitly contraindicated in the labeling, potentially altering the drug's 15-hour half-life and time to peak concentration (normally 2-4 hours). 1, 2
Modafinil is primarily metabolized in the liver through amide hydrolysis and cytochrome P450 pathways, and any alteration in absorption could affect its clinical efficacy. 3
Alternative Approaches
If crushing is contraindicated and the patient cannot swallow tablets, consider alternative formulations or medications entirely. 1 This is the safest approach when tablet integrity must be maintained.
Clinical Pitfall to Avoid
The most common error is assuming that because modafinil is an immediate-release formulation (based on its pharmacokinetic profile showing peak levels at 2-4 hours), it is automatically safe to crush. 1, 3 However, without explicit manufacturer guidance, this assumption could compromise drug delivery or patient safety.