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Re: Attenace and Nuvigil - any point?

Posted by zeugma on October 16, 2005, at 13:43:22

In reply to Re: Attenace and Nuvigil - any point? » tecknohed, posted by ed_uk on October 16, 2005, at 10:20:50

If Nuvigil has fewer interactions with other meds then it's worth it for those who are dealing with polypharmacy (probably everyone who's reading this post). Provigil affects most of the P450 system to varying extents and generally makes life complicated, becuae it induces some enzymes and inhibits others. It induces its own metabolism by 3A4, and this potentially makes the drug less effective by lowering plasma levels in unpredictable fashion.

I know that Provigil made clotrimazole completely ineffective. I haven't been able to find out what enzyme clotrimazole is metabolized by, but that's part of the problem. A drug that differentially affects so many enzymes is bound to cause unexpected problems.

-z


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