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Carim (Modafinil)
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Carim

Carim is used in the treatment of excessive daytime sleepiness (narcolepsy). It improves wakefulness and helps you to stay awake and reduces the tendency to fall asleep during the day, thus restoring the normal sleep cycle.

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

Similar Products:
Astelin, Anafranil, Antivert, Duricef, Ceftin, Mellaril, Abilify, Thorazine, Abhigra

Also known as: Modafinil

Description

How you take Carim may depend on what you’re taking it for.

Timing

If you’re taking Carim to reduce daytime sleepiness due to narcolepsy or sleep apnea, you’ll take it in the morning.

If you’re taking Carim for shift work sleep disorder, you’ll likely take it one hour before your work shift.

Carim will keep you awake for several hours, so you shouldn’t take it too close to your bedtime.

Taking Carim with food

You can take Carim with or without food. If the drug upsets your stomach, taking it with food might reduce this side effect. However, if you take it with food, Carim might take slightly longer to start working.

Can Carim be crushed?

Carim tablets should not be crushed or split. If you’re having trouble taking Carim, talk to your doctor or pharmacist about options that can make swallowing the tablet easier.

Dosage

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.

Overdose

If you overdose Carim and you don't feel good you should visit your doctor or health care provider immediately.

Storage

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.

Contraindications

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)
Warfarin

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
Marijuana

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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Physical Activity and Sedentary Time among Children with Disabilities at School. Recent advances with respect to applications in sensing, organic electronics, and the development of molecular switches are also discussed. In this short review, we first describe the emergence of placental-like structures in nonmammalian vertebrates and then transition to mammals themselves. Comparison of ultraviolet absorption strengths between 160 C, G, B, and F asteroids and carbonaceous chondrites suggests that surface minerals of most of those asteroids are thermally metamorphosed at temperatures around 600 degrees to 1000 degrees C. Amorphous silicon in contact with silver films and amorphous germanium in contact with aluminum films form crystalline precipitates when heated to hsv keratitis valtrex dosage temperatures well below those at which any liquid phase is present. Methods We investigated the functional roles of TRPM8 and TRPV1 in a meningeal inflammation-based migraine model by measuring the effects of facial TRPM8 activation on thermal allodynia and assessing receptor coexpression changes in TG neurons. This study supports our observation that biliary tract disease is more life-threatening in men.

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The technique was initially developed to meet our requirement to provide large numbers of cosmid DNAs for restriction enzyme fingerprint analyses in genome mapping projects. Further, the importance of social engagement likelihood in interacting with intention to be screened was substantiated. Somatostatin is an essential paracrine link in acid inhibition of gastrin secretion. On day 19 of gestation, four to five fetuses per dam underwent surgical ligation of the trachea. This protein structure is consistent with the CAN1 product being the plasma membrane arginine permease. Serum activities of glutamic pyruvic transaminase (GPT), sorbitol dehydrogenase (SDH), glutamic oxaloacetic transaminase (GOT) and glutamate dehydrogenase (GLDH) increased 1.8-, 2.9-, 3.8- and 41.2-fold respectively 8 h after injection, and the increased serum enzyme activities were maintained for up to 24 h.

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