Nuvigil for Multiple Sclerosis Fatigue

What to Know About Taking This Medication

In This Article

Nuvigil (armodafinil) is used to improve wakefulness in adults with excessive sleepiness linked to obstructive sleep apnea, narcolepsy, and shift-work disorder. It is a derivative of Provigil (modafinil), which some people with multiple sclerosis take to combat MS-related fatigue. Though not approved by the U.S. Food and Drug Administration to treat fatigue in people with MS, Nuvigil is sometimes used off-label for this purpose.


The scientific evidence backing Nuvigil as a treatment for fatigue in MS is weak and, at present, inconclusive. Since it is reported to work for some people, though, your doctor may recommend it for you—especially if other treatments aren't working.

Treating fatigue often requires a delicate combination of interventions that may include exercise, proper sleep, addressing other health issues that may be impacting fatigue, and medication.

Side Effects

Nuvigil is considered a derivative of Provigil because it is made by using only the right isomer of the molecule that makes up the drug. This is thought to be a way to get more benefits with fewer side effects, which seem to correspond to Provigil's left isomer. Despite this, Nuvigil may end up causing the same sorts of issues as Provigil.

Less serious side effects include:

  • Headache
  • Nausea
  • Dizziness
  • Problems sleeping

One of the most serious side effects of using the drug is a life-threatening skin rash or a serious allergic reaction. If you develop any signs of a rash or allergic reaction, it's important to seek emergency medical help right away.

Some symptoms of an allergic reaction include:

  • Skin rash, hives, blistering and/or peeling of the skin, sores in the mouth
  • Swelling of the face, eyes, lips, tongue, or throat
  • Problems swallowing or breathing
  • Fever
  • Swelling of the legs
  • Yellowing of the eyes and/or dark-colored urine

Potentially serious psychiatric side effects of using Nuvigil include:

  • Depression
  • Anxiety
  • Hallucinations
  • Mania
  • Aggressive behavior
  • Suicidal thoughts

Nuvigil may also cause problems with the heart that warrant immediate medical attention, such as:

  • Chest pain
  • Problems breathing
  • Abnormal heart beat

It's important to contact your doctor if you experience any persistent or bothersome side effects, including the ones above or any that aren't listed.


Due to Nuvigil's potential to interact with other medications, be sure to inform your doctor of all your medical problems and all the medications you are taking, including prescriptions, herbals, supplements, vitamins, and over-the-counter medications.

In particular, Nuvigil may interact with and/or lower the effectiveness of certain medications like hormonal birth control methods (pills, shots, implants, patches, rings, and IUDs). This means that a woman may have an increased chance of becoming pregnant while taking Nuvigil and for one month after going off of it.

Be sure to use non-hormonal forms of birth control, such as condoms, to prevent unwanted pregnancy while taking Nuvigil.

Special Considerations

Because of the drug's similarity to Provigil, a couple of other points bear mentioning:

Dosage Differences

Your Nuvigil dosage will be different than your Provigil dosage, so if you're switching from one to the other, be sure you're taking the amount prescribed by your doctor.

Insurance Coverage

Your insurance may not cover Nuvigil at the same level it covers Provigil, so your out-of-pocket expenses may be higher than expected. It's a good idea to check with your insurance company and/or pharmacist about what the cost will be before you get your prescription filled.

A Word From Verywell

To decide whether Nuvigil is right for you, make sure to talk it over with your doctor, consider all your conditions and treatments, and weigh the pros and cons. Keep pushing to find effective treatments. Fatigue is a difficult symptom to live with and you deserve to feel better. Our Doctor Discussion Guide below can help you start that conversation with a healthcare professional to find the best approach.

Multiple Sclerosis Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman
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