nuvigil or provigil

[daisy.girl]

Can anyone tell me the difference and why I would take one over the other?
Are either available in generic?

thanks

[Redwings]

Nuvigil and Provigil are isomers -- chemical mirror images of each other. They function in pretty much the same way (which isn't completely understood), but Nuvigil is longer lasting than Provigil. The manufacturer developed Nuvigil so they could continue to have a form of the drug under patent after Provigil goes generic in the US in 2012. (Generic modafinil (Provigil) is already available internationally.) Insurers often drop their prescription restrictions for off-label use when a drug goes generic. It remains to be seen if that will happen when generic modafinil becomes available in the US next year.

[daisy.girl]

It doesn't seem that my insurance covers this drug. why?

[Redwings]

Both drugs are expensive. One way insurers control their drug costs is to restrict the use of some medications to only those conditions for which they're approved by the FDA. (Another way is to require that a person try and fail on a less-risky, less-expensive medication first.) Neither Nuvigil nor Provigil is FDA approved for MS fatigue, so some insurers won't cover it for that use. There are other stimulants available as generics, which those insurers will cover for MS fatigue because they're less expensive. When Provigil (modafenil) goes generic next year, it's reasonable to expect that it will be handled the same way.

[daisy.girl]

thanks for the explaination.....makes sense. The insurance company did allow me to have my doctor fax to them prior authorization form, so maybe they will cover it?

[Redwings]

Maybe. Can't hurt to try. Good luck!

[alanpgh]

My Provigil Experience

Sharing my experience with Provigil here:

My insurance, Highmark Blue Cross Blue Shield of Western PA, covers Provigil because my Neuro and some other doctors worked with insurance over several years to show this drug works for MS patients. I did have to try another drug first. When it didn't work, this insurance company approved my Provigil. For a few years, they had to approve it every 6 months. Now, they will approve the prescription without an appeal, but only for 6 months at a time. It was a multi-year process to get to this point, and I want to thank my doctor for doing this for many hundreds of patients in his care!

My insurance company categorizes Provigil in a special category, and the prescription has a $40. co-pay per month. This is definitely worth it for how much it reduces my fatigue.

Hope this helps!

Good Luck!

Alan

[daisy.girl]

thanks redwings and alan.

I was not sure if it would be worth the hassle of trying to get it and the cost (very limited budget here). Even 40.00 a month would not be possible.

However, I am always sooo tired and/or depressed that I don't want to do anything or go anywhere.

Merry Christmas!

[daisy.girl]

Oil of Oregano?

[daisy.girl]

thanks so much