Should you switch from Provigil to Nuvigil?
Ever wonder which drug 
makes more sense for you to purchase from online pharmacies? Well, the Wall Street Journal reports that the drug company Cephalon Inc. has launched a marketing campaign to encourage users of its its best-selling drug, Provigil, to switch to a new and improved version of the drug, called Nuvigil.
Provigil (modafinil) is prescribed for the treatment of narcolepsy, shift work sleep disorder (SWSD), and daytime sleepiness associated with sleep apnea.
According to the Journal:
Nuvigil is chemically similar to Provigil, but Cephalon says its effects are longer-lasting than Provigil. The drugs weren’t tested head-to-head in clinical efficacy trials, but Cephalon says the drugs were compared in terms of concentrations in plasma.
To encourage people to switch to Nuvigil, Cephalon is selling it at an 11% discount to Provigil, or an average of $8.98 per pill, said Mike Derkacz, vice president of the central-nervous system therapeutic business at Cephalon.
In addition, Cephalon is offering a prescription savings program for Nuvigil. Under the program, Cephalon will pay for up to $50 in monthly out-of-pocket costs for Nuvigil, bringing the cost down to a floor of $10. For many patients, with an average co-pay of roughly $40, this will lower monthly copays to $10.
Those sound like pretty good reasons to try out Nuvigil. But is switching from Provigil to Nuvigil the best option for you — either financially or from a health standpoint?
It’s important to keep in mind the drug company’s self-interested motives for introducing these incentives.
Nuvigil has patent protection through 2023, while Provigil will face generic competition in the United States beginning in 2012. From a business standpoint, the “new and improved” drug is a means for Cephalon to extend monopoly pricing for another nine years.
Let’s look at the numbers. Nuvigil could well cost $8.98 or more per pill for the next decade. Generic versions of Provigil, on the other hand, will likely cost a tiny fraction of that when they become available in less than three years.
Dr. Ed Zimney, for one, doesn’t seem to think Nuvigil is worth the higher price. He explains:
When a drug company has a successful product, they get very concerned when it gets close to the time for patent expiration because it means that cheap generic equivalents will soon appear. There are any number of strategies that companies use to protect their interests in this situation, and one of the most common is to take a look at the drug’s chemistry to see if there’s anything there to exploit. One possibility is to reformulate the product into something that lasts longer than the original, so you’ll see things like extended-release or controlled-release formulations being developed. Another typical strategy is to look at the drug’s chemical forms, called isomers.
Without getting too deeply into it, many chemicals have two isomers and in many cases only one of them is actually active. So a common strategy is to see whether a new drug can be created that contains only the active isomer. You’ve probably heard of Nexium (”the purple pill”), which is the active isomer of what was previously sold as Prilosec. There are many other examples.
So the people at Cephalon were starting to worry about their patent on Provigil because there were a number of lawsuits pending from generic drug manufacturers eager to get the rights to sell it. And it turns out that Provigil does have two isomers. In this particular case, they are both active, but one is eliminated from the body much more quickly than the other, so essentially the activity really comes from one isomer. Hence the development of Nuvigil, the longer-acting isomer formulation of Provigil.
I should emphasize that the evidence that Nuvigil is “longer-acting” than Provigil is not cut and dry. As the Journal noted, the drugs were never tested against each other in clinical efficacy trials.
But the FDA doesn’t require Cephalon to show that Nuvigil is “new and improved” — only that it’s different and safe. In terms of safety, Nuvigil did well in clinical trials. The most common side effects included headache, anxiety and dizziness. Additionally, in some cases, Nuvigil caused serious rashes and/or allergic reactions.
So, that’s the story of Provigil and Nuvigil. We’ll leave it to you and your doctor to decide which drug (and which price) makes sense for you to purchase.
“We Guarantee Every Online Pharmacy In Our Network Is at Least 50% Cheaper Than Your Local Drugstore or Your Membership Is FREE!”
Start saving money with your first order! 
This patient assistance program provides brand name medications (Provigil and Nuvigil) at no or low cost – better than a coupon! Hope this helps guys…let me know how this works out  |
|
| Pharmaceutical Company | CephalonCares Foundation |
| Program Name | CephalonCares Foundation Patient Assistance Program |
| Program Address | 6900 College Blvd., Ste 1000 Overland park, KS 66211 |
| Phone Number | 877-237-4881 |
| Fax Number | 877-438-4404 |
| Medications on Program | Provigil 1 (modafinil) |
| Application Forms | Click here for the Provigil & Nuvigil patient assistance application form from the CephalonCares Foundation.
You can download the same application here as well: http://cephalon.com/cephaloncares-foundation/download-application/ |
| On-line Application |
No on-line application available at this time |
| Web Site | Click to go to program’s web site |
| Eligibility Guidelines and Notes | The patient can have no public or private prescription insurance and have an income at or below 300% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must be a US citizen or legal resident. If patient is eligible for Medicare but did not enroll, then they are not eligible for this program. A 30 day supply voucher for Fentora is sent to the patient. |
| Application Process | Anyone can call to get an application faxed out. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back. |
| Application Requirements | The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income. |
| Program Details | Up to a 90-day supply is sent to the patient’s home. |
| Last Updated | November 20, 2009 |
June 7th, 2009 at 8:12 pm
[...] Online Pharmacy Medicine Blog « Should you switch from Provigil to Nuvigil? [...]
June 30th, 2009 at 4:35 pm
THAT A LIE!!!!! WITH PROVIGIL I HAVE TO PAY OUT OF POCKET OVER 1,000.00 A MONTH IT’S NOT COVERED AND I WOULD HAVE TO CUT THEN UP AND TRY TO SAVE THEM,,, AND I JUST GOT A MED SLIP FOR THE NUVIGIL TO TRY IT OUT,, IT’S NOT 10.00 FOR ME ITS 100.00 OUT OF POCKET , ONE OF THE REASONS I LOST MY HOME TO A SHORT SELL IS I HAD TO PAY THE MEDS 1,000.00 SO I CAN WORK OR NO MEDS AND PAY THE MORG/ AT 1400.00 A MONTH AND GET FIRED FOR COMING IN LATE ALL THE TIME HUMMMMM U PICK …. SO I HAVE TO TAKE ADDREALL THAT WILL DAMAGE MY HEART IN THE LONG RUN, AS AN OFFICER I NEED TO RESPOND TO CALLS AND SHOW UP RUNNING AT TIMES BUT NOT HOLDING MY CHEST CAUSE OF THE ADDRALL ,,,HUMMM WHICH ONE WAIT I GOT IT!! CANT PAY FOR ANYTHING SO IT WOULD BE EASYER TO JUST LOSE EVERYTHING. THAT WAY I CAN SAVE WHAT MONEY I DO HAVE AS A WIDOW TO FEED MY KIDS ,,,, U GUYS MAKE ME SICK !!!!!!!
July 1st, 2009 at 6:51 pm
HOW CAN WE GET A DISCOUNT, THANKS PHONE NUMBER 925 689 6624,
July 10th, 2009 at 9:47 am
I have tried both and I would like to know if anyone else has had the same effect. Which is I take then and go right to sleep. I have not lied down after taking thinking that may help. I feel like I’m taking a sleeping pill.
July 10th, 2009 at 4:30 pm
I believe the expression should be “cut and dried.” A common mistake. Thanks for the great article.
July 14th, 2009 at 4:29 pm
I have taken both, the provigil and the nuvigil. I prefer the nuvigil. I am not taking it for narcolepsy, I am taking it due to diseases and illness, chronic fatique.
I can take 1-nuvil 250 mg. every other day. And that’s how it works best for me.
The company has a form you can fill out to get the nuvigil or provigil for free. I am thinking about filling out that form to see if I qualify. Call Cephalon cares foundation @ 1-877-237-4881 and they’ll tell you how to access the forms that your doctor needs to fill out. For example if there are 3 people in your home you can’t make more than $54,930.00 a year to qualify.
Provigil did make me feel tired. Nuvigil works best for me.
July 14th, 2009 at 11:33 pm
Pat, I also have tried both Provigil & “Nuvigil” (before it was named). Neither acts to make me sleepy. However, since my big issue is that I can’t awaken in the mornings to actually TAKE the medication (wish they made a time released version), I have occasionally taken them right before bed. This has helped me awaken in the mornings, but not disturbed my sleep significantly.
I don’t recall at the moment with certainty (check with your pharmacologist or physician), but I think the way these medications work, it is still possible to sleep, but just reduce the impact of a sleep deficit. I’ve never seen official documentation describing this, but it has been my personal experience (as well as something at least one other patient I’ve heard about from a doctor has tried).
I have more than one sleep issue, but Delayed Sleep Phase Syndrome is one piece of the pie.
July 17th, 2009 at 6:32 am
I would like to see a Rep in My office. I am in Ringoes NJ, near Flemington. Do you have a contact number? Thank you
July 20th, 2009 at 4:44 pm
i was taking provigil 200 mg. 3x a day with good results. when Nuvigil was released, my Dr. and I thought we found something better. the Nuvigil has been a nightmare i feel sleepy all the time, i take 150 mg. 2x a day. i am going back to provigil regarless of price! i think this NU is a sham!
July 21st, 2009 at 12:39 pm
I have taken 200mg. of provigil 2 times per day for 6 years this medication gives me life. I was told that the maximum dose was 400 mg per day but I read that someone was taking 200mg 3 times per day. Is this possible? I would like to try to take the nuvigil but I would not give up my provigil untill I knew for sure it worked for me. What dose of nuvigil do you think I would need?
August 14th, 2009 at 7:51 am
I agree Lisa! Thanks for your post! I’ve been taking provigil, which doesn’t work great for me, so I started nuvigil. First day at 150mg, 2nd day I took 2(300mg) and went to sleep. I’ve been back on the provigil now. By 5pm I’m ready for bed…I need something else.
August 21st, 2009 at 11:24 am
This article doesn't mention another option that's available.
My doctor is switching his patients to Nuvigil so that we can take advantage of the prescription savings program. Then when a generic version of Modafanil comes on the market he'll start prescribing that instead.
August 31st, 2009 at 10:36 am
My doctor told me 250mg Nuvigil equals 200 mg Provigil. If correct, Lisa Incognito wasn’t taking an equivalent amount of Nuvigil to replace her Progivil. Perhaps the Nuvigil isomer stays in the body longer, but it sounds like it isn’t as effective if you need a larger dose.
September 6th, 2009 at 1:38 pm
Just so you know, Nuvigil doesn’t work right away (at least it didn’t for me), so if you feel like it’s not working after the first few days, wait a full week. It’s supposed to take effect after 7 days. I have been taking Provigil for 3.5 years and switched to Nuvigil just because of the price (I have to pay out of pocket). At first, I thought it wasn’t as good, but now, after 2 weeks of taking it, I feel even better than I did on Provigil. I can take a lower dose and don’t even feel like I need it every single day like I did with Provigil. If it hasn’t worked for you right away, I’d suggest trying a little longer. You may find, like I did, that it’s the better choice.
September 8th, 2009 at 10:48 am
It is my understanding that 250mg NuVigil is = to 600mg Provigil. Any Comments?
September 8th, 2009 at 11:05 am
I’ve taken Provigil 100mg twice daily for M.S. related fatigue for six months….and have been able to actually enjoy my life once again. The effects slowly started wearing off so my neuro. switched me to 250mg Nuvigil once daily – which is not working at all for me. I can sit here right now and fall asleep and I have no energy for anything. I am going to request to go back to the Provigil…a little energy and “get up and go” is better than absolutely none!
September 15th, 2009 at 6:38 am
I’ve been taking 200mg of provigil twice daily. It works OK but not as good as I had hoped. My MD gave me samples of nuvigil taking one 250mg in the morning made a world of differance,I even had comments from friends about my how much better I seemed. My MD gave me a script for it,but my insurance co. Medco rejected it I challanged them and they still rejected it.I think it all comes down to the long term cost when provigil’s patent is up.
September 22nd, 2009 at 12:33 pm
I strongly recommend that you do NOT go to Nuvigil. This is a stunt to wean Provigil users to another drug with longer patent protection. Note the lack of a study directly comparing the two drugs.
My curiosity was piqued when I found the discount offers. It would be cheaper than Provigil! I became disappointed and a bit angry when I read up on the details.
The Cephalon patent on Provigil was extended with orphan drug exclusivity until late 2005. So why are we waiting until 2012 for generics? Profits and the lawyers that wring out profits got involved.
Source:
http://www.prescriptionaccess.org/lawsuitssettlements/current_lawsuits?id=0024
“Despite the strength of their arguments, in late 2005 and early 2006, all four generic companies settled their cases with Cephalon. Under these settlement agreements, each generic company agreed to keep their generic versions of Provigil off the market until 2011 or 2012. The settlement agreements also provided the generic companies with cash payments, supposedly in exchange for certain licensing and supply/inventory agreements. The three payments to Teva, Ranbaxy and Barr alone totaled up to $136 million.”
I know that these companies serve their investors first and their customer second, but they have already served their investors with the EXTENDED exclusivity that went until 2005. This is pure greed and disregard for their customers.
Cephalon SUED the generics manufacturers and paid them millions of dollars in order to extend their manufacturing exclusivity. The plaintiff sued in court and then paid the defendant in an agreement.
In reality, Cephalon didn’t pay the generics manufacturers millions of dollars. We did. We’re also paying Cephalon’s investors a premium on top of that to keep it this way.
Our insurance premiums are higher. The poor souls that pay out of pocket are seeing no relief. I cannot get more than one 200mg pill per day because of insurance coverage limitations. I also have to jump through pre-authorization hoops and pay top tier prices. I’m lucky to have insurance yet I’m still left wanting.
The generics manufacturers are also taking part in this. They’re getting paid to NOT produce a heavily discounted generic version. Cephalon and their lawyers made it more profitable to take a payment instead of going to market.
Will these agreements affect the generics supply in 2012? Does this agreement continue from 2012 and limit how much generics can be manufactured so that the supply/demand imbalance continues? I sure hope not.
My obvious bias created my belief that it was an illegal conspiracy to keep low-cost generics off of the market. The linked lawsuit is with the FTC. They lawyers have been dragging this out for three years and counting.
Can I start a manufacturing company for generic Provigil and get paid off by Cephalon too? This is unethical. If you were able to get the medication you need so that you would be more awake, you’d be more pissed.
Go to Nuvigil and you’ll be paying a premium until 2023, only to risk having the generics manufacturers be paid off again. They got seven years with Provigil, so a good estimate will be 2030.
September 23rd, 2009 at 10:19 am
I just started taking 150mg nuvigil yesterday. I was never on provigil. The md prescribed it for fatigue. It made me alert right away but after a few hours of taking it I had the worst headache in the world. I went to bed and when I woke up the headache was still there. Do you know if the headache is just an inital side effect that will go away after my body adjusts to the drug? Or should I stop it. I can handle it for a little while if I know it will go away, but the pain is really bad.
October 1st, 2009 at 1:36 pm
Iv taken provigil 200mg twice a day for 4 years and switched to Nuvigil 250mg once a day to save money seeing as I pay out of pocket for then and its worked out ok . the Nuvigil wears off towards the end of the day but thats good it doesent mess up my sleep as much . but I seem to have really bad dry mouth even more so than normal and my toungh turns all white and nasty I gotta hope it will go away or Ill be paying more for the provigil…
October 5th, 2009 at 1:40 pm
I HAVE BEEN ON PROVIGIL FOR AWHILE, MY DOSE IS 200MGS. 5X
A DAY…I AM GUESSING FROM THE POSTS THAT I SHOULD JUST STAY ON THE PROVIGIL. IS THE NUVIGIL RELLY THAT BAD ?
IS IT WORTH TRYING ? CAN ANYONE LET ME KNOW.
THANK YOU.
October 8th, 2009 at 8:40 am
After reading all the comments it is clear that individual response to drugs vary tremendously, so I will try Nuvigil and see if it works as well as Provigil, which I have been taking for about 5 yrs. Provigil has been a life-changer for me and I’m very happy with it, but not with the cost.
I will use the free trial and discount card for Nuvigil, and when the generics come on the market, I’ll switch back. I’m hopin the Nuvigil will be as helpful for me as the Provigil has been.
I recommend that each person make their decision based on their own needs, not just on the responses of others. Your response may be entirely different!
October 15th, 2009 at 7:10 pm
I have been a new man since I tried Viagra!! I feel 18 again. I think my wife is hiding from me, but I’ll find her!!
October 22nd, 2009 at 8:37 am
GUDLAUG PETERSON,
To the left of the A key is a key labelled “caps lock”. Please press it once, then promptly remove it from your keyboard. Also, there is never a case in English where you would use more than one comma in a row. When you say you are a police officer, I really hope you are lying.
November 3rd, 2009 at 11:52 pm
I have been taking Provigil to treat my narcolepsy for years with good results. After finding out that my copay is going to double in 2010, I decided to try Nuvigil and take advantage of the discounts offerred. If you have the same idea, make sure you read the fine print. I don’t qualify for the discount because I have Medicare; the fact that my copay will be well over $150 dollars isn’t taken into consideration.
My doctor gave me samples of Nuvigil and although it works, I will be going back to Provigil. I am able to stay awake for a longer amount of time on Nuvigil, but I am more tired overall. I would rather have the higher level of alertness on Provigil even though it means I need a nap sooner.
November 12th, 2009 at 10:00 am
I’m currently on Alertec (a canadian version of provigil) for excessive daytime sleepiness.
To be honest, I don’t really feel it’s working at all. There are times when I would feel awake, but maybe it’s because of the coffee?
Other times I’m still yawning and manage to get in 1-2 naps during the day.
Does anyone know if Nuvigil is available in Canada?
November 15th, 2009 at 10:33 pm
I have been taking 2 200mg provigil a day for over four years. In order for me to drive, I have to take this. Recently my insurance changed and I cannot afford it. I know they have been saying that provigil is coming generic soon, but they first sayed this back in 11/2007, so I haven’t really heald my breath. Nuvigil is just a way for cephalon to continue over charging us. This is a horrible way to live, being tired all the time!
November 18th, 2009 at 4:16 pm
First of all, I don’t think that Nuvigil will appear to be very effective for those people who have become conditioned to using nerve jangling caffeine and its herbal cousins, especially where ever increasing doses have become involved. This drug just doesn’t act in the same way, so it may give an appearance of not being very effective. If you recondition your body by not taking caffeine I think you will, in time, find that your system is far better balanced and better able to benefit from the drug’s actions.
Secondly, with respect to the discount card, it affords no relief to those who would most benefit from it, the cash paying customer. The greed involved here is just amazing. How the previously honorable and well respected medical professionals including the drug companies (who once carried out a considerable amount of work for free on behalf of those who could not pay as a matter of conscience) could have sunk to such a pitiful low is just amazing. Enjoy your blood money because that is exactly what it is.
December 16th, 2009 at 3:28 pm
I think it is disgrace the way Cephalon has taken advantage of all of us who need this miracle drug to function properly. I have been taking 200mg of Provigil twice a day for almost a year, and the impact on my life has been tremendous. I can drive without falling asleep, I can concentrate at work and finish projects without losing focus and fighting constant fatigue, I’m less irritable and depressed – I could go on and on, and my husband is joyous at the difference this has made for me. Unfortunately, my insurance doesn’t cover this, and at a cost of over $400 a month, I couldn’t continue to afford to purchase it. I have tried generic modafinil from the internet, but the effect is far from satisfatory and leaves me still sleepy and fatigued, even if I double the dosage. I am considering switching to Nuvigil until Provigil goes generic (if that ever happens). I think there ought to be a way for the consumers, who have suffered from the sneaky, underhanded tactics that Cephalon has taken to keep us from obtaining generic versions of this, to initiate a class action lawsuit against the company for forcing us to continue to pay outrageously overinflated prices for this life changing drug. Most insurance companies refused to cover it, and most of us are left to pay out of pocket for something we need just to live a normal life. Cephalon is no better than blood-sucking leeches living off the lives of desperately ill patients. They should be sued for all the profits they have made off our backs!
January 7th, 2010 at 10:28 pm
My doctor just prescribed Nuvigil today. Provigil didn’t do much for me, but they say this is new and improved and lasts a while. I look forward to the benefits. Thank you all for your posts.
January 8th, 2010 at 11:18 am
So glad I found this. I am on my second week of samples of Nuvigil. I have severe sleepiness (unknown) so I was given samples of the medication. It has barely helped at all. I have even had chest pain and tachycardia.
Anyway, feel so much better after reading others experiences.
I find it funny package insert states it is a class 4 drug as it can be abused and it can cause feelings of euphoria. I feel nothing on this medication.
January 13th, 2010 at 4:33 am
I take 50 mg of Provigil a day for symtoms to Adult ADD. It works really great for me. Yesterday my Dr. gave me a FREE 30 day coupon for Nuvigil. For me this is a 120 day supply.
My insurance doesn’t pay for either Provigil or Nuvigil so this is a big savings for me right now.
Ask your Dr to get you a 30 day FREE script coupon.
In the mean time I will contact the FDA and FTC and support their case that the manufacture is controlling the extension of the patent using “Mob tactics” to bribe generic makers from producing reasonalbly priced Provigil.
Drug companies are slime!
Mike