What is better: Ephedrine vs Modafinil?
Ephedrine is a medicinal substance, a stimulant, and vasoconstrictor. It sympathomimetic (acting like sympathetic nerve stimuli), stimulates alpha and beta-adrenergic receptors. Acting on varicose thickenings of efferent adrenergic fibers, the medication promotes the release of norepinephrine into the synaptic cleft. It causes vasoconstrictor, bronchodilator and psycho stimulating action, increases total peripheral vascular resistance and systemic arterial pressure, increases the minute volume of blood circulation and heart rate, improves AV conductivity, improves skeletal muscle tone, and blood glucose concentration. Ephedrine stimulates the central nervous system; its psychostimulant effect is close to amphetamine. The medication is mostly used in small dosages for bronchial asthma and other allergy-related symptoms and rarely is used for narcolepsy.
Modafinil is a wakefulness-promoting brain stimulant for narcolepsy and other conditions in which excessive sleepiness interferes with normal functioning. The medication has low dependence potential and therefore is a medication of choice for narcolepsy and for off-label uses such as coping with sleepiness in sleep deprivation, focus enhancement in ADHD, and so on. The medication affects the release of monoamines and other substances responsible for wakefulness and alertness from the synaptic clefts. It doesn’t elevate arterial pressure and can be used even in people with hypertension.
Comparison of Ephedrine vs Modafinil
Precautions for Ephedrine use
- Ephedrine should be taken only in the first half of the day or can cause insomnia.
- The termination of the therapy must be done with the gradual lowering of the dosage as a sharp discontinuation can cause severe hypotension (arterial tension drop).
- MAO inhibitors increase the pressor effect of Ephedrine and can cause headaches, arrhythmias, vomiting, hypertensive crisis, therefore, when patients take monoamine oxidase inhibitors in the previous 2-3 weeks, the doses of sympathomimetics should be reduced (to 1/10 of the usual dose).
Precautions for Modafinil use
- Modafinil should be taken only in the morning or can cause insomnia;
- Lowers the effectiveness of oral birth control
Interactions of Ephedrine
- Ephedrine weakens the action of narcotic analgesics and sleeping pills.
- When used simultaneously with cardiac glycosides, Quinidine, tricyclic antidepressants, dopamine, inhalation anesthesia agents (chloroform, enflurane, halothane, isoflurane, methoxyflurane, trichloroethylene) the risk of developing severe ventricular arrhythmias increases.
- When Ephedrine is combined with other sympathomimetic drugs increased severity of adverse reactions from the cardiovascular system is observed.
- In combined use with antihypertensive drugs, the hypotensive action is diminished.
- Simultaneous use with adrenergic bronchodilators can lead to additional excessive stimulation of the central nervous system, which can cause increased irritability, irritability, insomnia, convulsions, and arrhythmias.
- Cocaine enhances the stimulating effect on the central nervous system and the cardiovascular system.
- Co-administration with reserpine and monoamine oxidase inhibitors (including furazolidone, procarbazine, selegiline) can cause headache, cardiac arrhythmias, vomiting, a sudden and pronounced increase in blood pressure, hyperpirethic crisis;
- Combined use with non-selective beta-adrenergic blockers and nitrates causes the weakening of the therapeutic action (blockade of beta-adrenergic receptors can lead to the prevalence of alpha-adrenergic activity with the risk of developing hypertension and pronounced bradycardia with possible development of heart block);
- Combined use with phenoxybenzamine increases hypotensive action and tachycardia;
- Combined use with Phenytoin can cause a sudden decrease in blood pressure and bradycardia (depending on the dose and speed of administration); - Use with thyroid hormone drugs causes mutual enhancement of action.
- Increases the metabolic clearance of glucocorticosteroids, adrenocorticotropic hormones with prolonged use (you may need to adjust their doses);
- The medication increases the neurological effects of diatrizoates, and oxalic acid.
- Ergometrine, ergotamine, methylergometrine, and oxytocin increase the vasoconstrictor impact and the risk of ischemia and gangrene, as well as severe arterial hypertension, up to intracranial hemorrhage.
- Doxapram, sympatholytics (guanadrel, guanethidine), mazindol, mecamylamine, methyldopa, trimetaphan, methylphenidate enhance the pressor effect (constriction of blood vessels).
- Levodopa increases the risk of arrhythmias (requires a reduction in the dose of sympathomimetics).
- The formulation strengthens the stimulating impact (mutually) on the central nervous system of mazindol and methylphenidate.
- Combined use of Ephedrine with Ritodrin enhances mutual effects (including adverse reactions).
- The medication enhances the stimulating effect on the central nervous system and the risk of toxic impact of xanthines (including aminophylline, caffeine, difillin, oxtrifylline, Theophylline).
Interactions of Modafinil
Modafinil is an inducer of the CYP3A4 enzymes which results in combined use in the lowered concentrations of the medications that are metabolized with this enzyme such as opioids (hydrocodone, oxycodone, and fentanyl), and other medications.
As you can see, it is much safer to use Modafinil rather than Ephedrine as it causes minimum adverse reactions, doesn’t cause dependence and has a positive effect both on wakefulness and cognitive functions.
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