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Carim (Modafinil)

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Carim is in a class of medications called wakefulness promoting agents. It works by changing the amounts of certain natural substances in the area of the brain that controls sleep and wakefulness.

Other names for this medication:
Alertec, Carim, Dekast, Modafinil, Modafinilo, Modalert, Modapro, Modatec, Modavigil, Modfil, Modiodal, Provake, Renea, Vigia

Similar Products:
Cymbalta, Estrace, Zyrtec, Compazine, Eldepryl, Aldactone, Altace, Hytrin, Lasix

Also known as: Modafinil


{name} (modafinil) is a medication that promotes wakefulness. It is thought to work by altering the natural chemicals (neurotransmitters) in the brain.

{name} is used to treat excessive sleepiness caused by sleep apnea, narcolepsy, or shift work sleep disorder.


The Carim dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Carim to treat
  • your age
  • other medical conditions you may have
Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Dosage for narcolepsy and sleep apnea

For daytime sleepiness caused by narcolepsy or obstructive sleep apnea, the typical dosage is 200 mg once a day in the morning. Higher doses are sometimes used, up to 400 mg daily. However, these doses may not be any more effective than 200 mg daily.

Dosage for shift work sleep disorder

For excessive sleepiness due to shift work sleep disorder, the typical dosage is 200 mg taken about one hour before the start of your work shift.

Dosage for people with liver problems

If you have severe liver problems, your doctor will likely prescribe a lower dosage. The recommended dosage for people with this condition is typically 100 mg daily.

Dosage for seniors

Seniors may be more sensitive to the effects of Carim, especially side effects. If you’re over 65 years of age, your doctor may prescribe a lower dosage.

What if I miss a dose?

If you miss a dose, take it as soon as you remember. Remember that Carim will keep you awake, so don’t take it unless you plan to be awake for several hours. If it’s close to your bedtime, skip the missed dose and take it the next day at the normal time.

Never try to catch up by taking two doses at a time. This can cause dangerous side effects.

Will I need to use this drug long-term?

Yes, Carim is usually taken long-term by people with narcolepsy or sleep apnea. These are chronic conditions that often require long-term treatment to improve symptoms of daytime sleepiness.


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of reach of children.

Side effects

The most common side effects associated with Carim are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Carim can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Carim and other medications

Below is a list of medications that can interact with Carim. This list does not contain all drugs that may interact with Carim.

Before taking Carim, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that change the effects of Carim

Several medications can lessen the activity of an enzyme called cytochrome P450 3A4 in your body. Taking these drugs with Carim can cause your body to get rid of Carim more slowly. This can cause more Carim side effects.

Examples of these medications include:

  • antiviral medications such as:
    • cobicistat (Tybost)
    • darunavir (Prezista)
    • ritonavir (Norvir)
    • Viekira Pak, Viekira XR (dasabuvir, ombitasvir, paritaprevir, ritonavir)
  • antifungal medications such as:
    • fluconazole (Diflucan)
    • itraconazole (Sporanox, Onmel)
    • ketoconazole
  • antibiotic medications such as:
    • clarithromycin (Biaxin)
    • erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin)
  • heart medications such as:
    • amiodarone (Pacerone, Nexterone)
    • diltiazem (Cardizem, Cartia XT, Diltzac, Taztia XT, Tiazac, others)
    • verapamil (Calan, Verelan)
Drugs that may be affected by Carim

Carim can increase the activity of an enzyme called cytochrome P450 3A4 in your body. This can cause your body to get rid of certain medications more quickly. As a result, these medications may become less effective.

Examples of these medications include:

  • oral contraceptives (consider using a backup method of birth control while taking Carim, and for one month after stopping it)
  • cyclosporine (Neoral, Sandimmune)
  • midazolam
  • triazolam (Halcion)
Carim can reduce the activity of enzymes called cytochrome P450 2C19 in your body. This can cause your body to get rid of certain medications more slowly. This may cause more medication side effects.

Examples of these medications include:

  • clomipramine (Anafranil)
  • diazepam (Valium)
  • omeprazole (Prilosec)
  • phenytoin (Dilantin, Phenytek)
  • propranolol (Inderal LA, InnoPran XL)
Many other medications may be affected when taken with Carim. If you take other medications, talk to your doctor and pharmacist about how to avoid potential interactions.

Monoamine oxidase inhibitors (MOAIs)

Taking Carim with monoamine oxidase inhibitors (MAOIs) might lead to dangerous side effects such as very high blood pressure, chest pain, severe headache, and increased body temperature. Carim should not be taken within 14 days of using an MAOI.

Examples of MAOIs include:

  • isocarboxazid (Marplan)
  • linezolid (Zyvox)
  • phenelzine (Nardil)
  • selegiline (Eldepryl)
  • tranylcypromine (Parnate)

Taking Carim with warfarin (Coumadin, Jantoven) may make your body get rid of warfarin more slowly. This may increase the effects of warfarin and increase your risk of side effects such as bleeding.

Carim and herbs and supplements

Carim may interact with certain supplements or herbal products you may be taking. Examples of these include:

  • acacia rigidula
  • bitter orange
  • green tea
  • guarana
  • hordenine
  • Indian snakeroot
  • octodrine
  • St. John’s wort
  • yohimbe

Taking Carim with marijuana might change how marijuana affects you. Carim alters enzymes in your body that control how quickly the body gets rid of marijuana chemicals that cause you to get high. This might increase or decrease the effects and side effects of marijuana.

Carim and foods

Carim may interact with certain foods you may eat.

Fruit juices

Drinking certain fruit juices, such as grapefruit juice and orange juice, while taking Carim might change how your body handles the drug. This could increase the amount of Carim in your body and increase your risk of side effects.

Foods and beverages that contain caffeine

Caffeine in foods and beverages might add to the stimulant effects of Carim. This can increase the risk of stimulant-related side effects such as anxiety, nervousness, trouble sleeping, and others.

Examples of foods and drinks that contain caffeine include:

  • coffee
  • chocolate
  • soda
  • tea (such as black, green, and oolong)

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