Modafinil (brand name: Provigil) is a medication used in the management of excessive sleepiness associated with a rare condition called narcolepsy. There is a great interest in modafinil for its unlicensed use as a ‘smart drug’ due to its main actions on the body: promoting wakefulness and possibly increasing cognitive performance. Movies like Limitless contributed to greater interest in smart drugs, particularly modafinil which received a label of NZT-48 drug, the limitless pill, a drug which does not exist in real life. Intrest in modafinil created a demand for this drug, and now many online pharmacies sell modafinil on the basis of a private service. In this post, I will explain how to get modafinil in the UK or where to purchase it online.
I will also discuss the following:
- the legal classification of modafinil
- mechanism of action of modafinil
- Is modafinil a ‘smart drug’?
- possible side-effects associated with modafinil use
- how to get modafinil / how to get modafinil prescription
- list of online pharmacies / online doctors which offer supply of modafinil privately
Modafinil: legal classification and availability
In the UK, modafinil is a prescription-only medication (POM). Modafinil is licensed in the UK for treatment of narcolepsy – excessive daytime sleepiness. Supply of POM medicines by a pharmacy happens typically when an appropriate prescriber, for example, a GP issues a prescription (NHS or private prescription).
Modafinil mechanism of action behind wakefulness
The exact mechanism of action of modafinil is not known. The suggested mechanism of action based on laboratory experiments includes the effect on dopamine reuptake system, where modafinil binds to the dopamine transporter (DAT). Modafinil also showed to bind to norepinephrine (NET) transporter (Minzenberg & Carter, 2007). Actions on both DAT and NET in wake-promoting centres are thought to be the main drivers of modafinil mechanism of action (Ballas & Dinges, 2009). Modafinil’s mode of action is similar to other stimulant drugs such as cocaine, methylphenidate, and the amphetamines (Mereu et al, 2013).
What does it all mean?
Dopamine and norepinephrine are neurotransmitters. Several neurotransmitters promote wakefulness in different areas of the brain. When the drug (like modafinil) binds to a transporter it prevents this transporter from the reuptake of neurotransmitter back into “synaptic cleft”, prolonging its actions, in case of modafinil it promotes wakefulness.
Modafinil effects on cognition. Is modafinil a ‘smart drug’?
The best evidence on modafinil’s ability to affects cognitive behaviour comes from a systemic review by Dr. Ruairidh Battleday and Dr. Anna-Katharine Brem from the University of Oxford and Harvard Medical School. This systemic review investigated results from 24 studies of modafinil’s effects on cognition in healthy individuals. Half of the studies investigated found that modafinil improves attention and leaning memory. Improved concentration and learning were observed when more complicated tasks were performed (Battleday & Brem, 2015). Cognitive benefits of modafinil in investigated studies were more consistent as tasks performed became longer and more complex (ox.ac.uk, 2015). Professor Guy Goodwin, President of the European College of Neuropsychopharmacology named modafinil as a cognitive enhancer, in plain language it can be called a ‘smart drug’, which can help for example with exam preparations (ibid).
Modafinil: commons side effects
Like with all medications taking modafinil comes with a risk of side effects. Common side effects experienced with modafinil include:
- headaches (a very common side effect)
- decreased appetite
- insomnia, nervousness, depression, anxiety, abnormal thinking, confusion
- dizziness and blurred vision
- nausea, dry mouth, abdominal pain, diarrhoea, dyspepsia, constipation
- fast heartbeats (tachycardia) and palpitations
- chest pain
Rare cases of serious or life-threatening rash, including Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) have been reported with the use of modafinil.
For a full list of modafinil’s side effects, please read the products information leaflet.
Although many drugs were labelled as ‘smart drugs’ modafinil is a unique wakefulness agent. Modafinil is the only ‘smart drug’, which is not a stimulant; it has a lower risk of side effects as compared with other drugs such as amphetamines.
Modafinil has low liability for abuse and dependence, making it a good candidate for use as a cognitive enhancer. Comparing with other drugs which promote wakefulness, such as amfetamines, modafinil has lower risks of side effects and is less likely to be abused (Minzenberg & Carter, 2007). Finally, as Dr Anna-Katharine Brem suggested, a better way of cognitive performance testing is needed to evaluate the benefits of drugs like modafinil.
How to get modafinil?
Smart drugs have been attracting a larger audience in recent years among students, bankers and shift workers. It is a known fact that armies around the world use stimulants to improve performance during a long duration missions (Bower, 2003).
I won’t go into details on how to get modafinil prescribed on NHS as it is very unlikely to have modafinil prescribed for any other reason than for the treatment of narcolepsy. A patient who is suspected of having narcolepsy needs to be usually referred to a ‘Sleep Centre’ for an assessment by a specialist.
Two other options for the supply of modafinil are:
- Getting a private prescription for modafinil (may be difficult)
- Use of online pharmacies / online doctors to get modafinil (private service includes the cost of a private prescription for modafinil)
Getting a private prescription for modafinil
A doctor or another prescriber can issue a private prescription after a consultation has taken place. This would happen outside the NHS, for example, in a private clinic. There are plenty of online GP services/doctors which allow online consultations; however, it would be difficult to get a prescription for modafinil from a doctor trough this route, without being referred to a specialist in the first place.
The supply of modafinil with a private prescription is the cheapest option of getting modafinil. Patients need to pay for the cost of medication(regardless of their age or exemption status) when a private prescription is brought to a pharmacy.
How much does modafinil cost on private prescription?
The basic price for modafinil are as follows:
|Generic||100mg tablets||30 tablets||£4.78|
|Generic||200mg tablets||30 tablets||£6.93|
|Provigil||100mg tablets||30 tablets||£5.00|
Prices taken from AHH Pharmaceutical. Prices taken on 06/08/2020
Prices taken from AHH Pharmaceutical. Prices taken on 06/08/2020
Additionally, you would expect to pay a markup fee, which is usually 20% (minimum). Some pharmacies charge a minimum private prescription charge which may be higher than the cost of the drug and 20% mark up fee. Some pharmacies charge a minimum price for a private prescription, which equals to NHS prescription charge.
How to get modafinil? – Private online services
There are plenty of registered online pharmacies which offer the supply of modafinil privately. Most of online pharmacies/doctors require patients to fill in a questionnaire which is then reviewed by a doctor. There is no need to speak to a doctor. Screening questionnaires are easy to follow in in most cases, patients can proceed if an acceptable answer is given. Questions may vary slightly between each pharmacy used, but generally, patients need to confirm that they have been diagnosed with narcolepsy and provide details of their health (medical history).
Once a doctor reviews answers, the order is accepted, and modafinil tablets are delivered by post.
Patients pay for the service, which includes the cost of modafinil tablets and cost of service (private prescription).
Generally, the prices of getting modafinil from online UK pharmacies or online doctor services are much higher when compared to the supply of modafinil with a private prescription from high street pharmacies.
For example, a pack of modafinil tablet (Provigil 100mg x 30 tablets) costs around £50 when private service is used from online pharmacies. The cost of the same product would be around £6 if a private prescription was brought to a high street pharmacy.
However, the main advantages of getting modafinil via this route are:
- ordering and screening questionnaire easily to follow
- included in the price is the cost of drug and cost of the private prescription (private service)
- fast delivery
- service provided by UK pharmacies with patients being able to check the registration of each pharmacy
- genuine medicines supplied
List of online pharmacies offering a supply of modafinil
In 2019 GPhC (a regulatory body for pharmacist and pharmacy owners) issued supply restrictions of certain drugs to several online pharmacies, including listed below UKMeds pharmacy. Modafinil was one of the restricted drugs. The supply of restricted medicines will be allowed once pharmacies meet certain improvements in the services they provide.
Although not all pharmacies listed below were affected, it seems that at the moment, the supply of modafinil is not provided by pharmacies. Modafinil appears to be ‘out of stock’, although, at the time of this post, modafinil is available from pharmaceutical wholesalers.
Modafinil supplied by UK registered pharmacies:
BetterHealthOnline.co.uk seems to be the only UK genuine pharmacy which still provides modafinil privately.
iQ doctor: UK online pharmacy offering a variety of private services. Generic and branded Provigil can be ordered from iQ doctor. Modafinil listed as out of stock. Visit the website to get service and stock information.
UKMeds: another genuine pharmacy, which offers many private services, including the sale of modafinil for the treatment of narcolepsy. Supply of modafinil restricted. Modafinil listed as out of stock. Visit the website to get service and stock information.
There are plenty of non-UK pharmacies/websites, which offer the supply of modafinil. Patients need, however, be cautious when using websites which are not regulated by the UK body and source of medication is unknown.
Modafinil: alternative options
Pitolisant – a new drug for the treatment of narcolepsy
Pitolisant (brand name: Wakix): Pitolisant is the only other licensed medicines in the UK for the management of narcolepsy. Wakix, however, carries a hefty price tag of around £300 per box of 30 tablets. It is not possible not to get Wakix online.
Chemically there are two forms of modafinil: L-modafinil and R-modafinil, which are mirror images of each other. The scientific term to describe two mirroring chemicals is enantiomers. L-modafinil and R-modafinil have the same chemical structure, for example, to put it in a different perspective, our hands look the same. However, the arrangement of both chemicals ‘in space’ is different, for example, our left and right hand.
Armodafinil (R-modafinil) also exists as a separate drug on its own, available on the market as a prescription-only drug, which is not available in the UK.
Other ‘smart drugs’
A stimulant drug such as methylphenidate and dexamphetamine are available in the UK for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). Most stimulant drugs used in the management of ADHD in the UK are classified as Schedule-2 controlled drugs. It is not possible to get Schedule-2 controlled drugs online (private services). GP usually prescribes drugs such as methylphenidate after diagnosis by a specialist team. It is possible to use a private clinic to get a diagnosis of ADHD.
You need a prescription to get modafinil. In the UK, modafinil is licensed as prescription-only medication - POM, the supply of modafinil is possible on prescription or privately with the use of online services. Several registered UK pharmacies offer supply of modafinil privately and therefore it is possible to buy modafinil legally. In the UK modafinil is a legal, prescription-only medication used in the management of narcolepsy.
Do you need a prescription for modafinil?
Can you legally buy modafinil online?
Does modafinil cause weight loss?
Is modafinil illegal?
You need a prescription to get modafinil. In the UK, modafinil is licensed as prescription-only medication - POM, the supply of modafinil is possible on prescription or privately with the use of online services.
Several registered UK pharmacies offer supply of modafinil privately and therefore it is possible to buy modafinil legally.
In the UK modafinil is a legal, prescription-only medication used in the management of narcolepsy.
Ballas & Dinges (2009). Stimulant and Wake-Promoting Substances. Available at:
https://www.sciencedirect.com/topics/neuroscience/modafinil Accessed on 16/04/2019
Battledaya R.M., A.-K.Bremab (2015). Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: A systematic review. Available at: https://www.sciencedirect.com/science/article/pii/S0924977X15002497 Accessed on 16/04/2019
Bower Eric (2003). Use of amphetamines in the military environment. Available at: https://www.thelancet.com/pdfs/journals/lancet/PIIS014067360315060X.pdf 16/04/2019
Maddalena Mereu, Antonello Bonci, Amy Hauck Newman, and Gianluigi Tanda (2013). The neurobiology of modafinil as an enhancer of cognitive performance and a potential treatment for substance use disorders. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800148/Accessed on 13/04/2019
Minzenberg & Carter(2007). Modafinil: A Review of Neurochemical Actions and Effects on Cognition. Available at: https://www.nature.com/articles/1301534 Accessed on 13/04/2019
Ox.ac.uk, University of Oxford (2015). Review of ‘smart drug’ shows modafinil does enhance cognition. Available at: http://www.ox.ac.uk/news/2015-08-20-review-%E2%80%98smart-drug%E2%80%99-shows-modafinil-does-enhance-cognition#Accessed on 16/04/2019