Modafinil and Blood Pressure | Should You Be Concerned?

Many nootropic users are curious if, “Modafinil blood pressure” is a real issue or not.

In other words, they’re curious to know if there is a connection between Modafinil and blood pressure going up to unhealthy levels.

Even if a smart drug enthusiast is relatively young and healthy, they do not want to deal with unwanted side effects such as hypertension. If they take Modafinil and high blood pressure ends up being the outcome, this side effect may be enough for them to avoid using Modafinil altogether.

This is why we’re writing this article:

To show you everything you need to know about Modafinil and blood pressure, including various studies and their results.

We’ll also look into the interactions, if any, between blood pressure pills and Modafinil, letting you know if any Modafinil interactions exist with the current medications you are taking.

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What is Modafinil?

Before we can talk about what the science says about Modafinil and blood pressure, let’s talk about why this pharmaceutical medication is so popular amongst young adults.

Modafinil is known as a “central nervous system” stimulant, yet its mechanism of action is so unique that it does not affect the body in the same way that drugs such as amphetamines do.

Its ability to treat excessive daytime sleepiness led the FDA to approve Modafinil in 1998 under the brand name “Provigil” as a treatment for narcolepsy, shift work sleep disorder in 2003, and obstructive sleep apnea in 2004 [1].

One of the reasons why Provigil was regarded as a revolutionary drug in sleep medicine was the increased alertness and reduced fatigue noticed in narcolepsy patients. Most remarkably, the usual stimulant side effects of abuse and dependency were absent.

Many nootropic users discovered Provigil’s wakefulness-promoting properties and its ability to boost cognition in healthy individuals who were not sleep-deprived.

CEOs, Wall Street professionals, grad students, and more began using the smart drug to improve their mental performance. For these individuals, Modafinil offered huge cognitive benefits like [2]:

• Supercharged focus
• Long-lasting duration (10-12 hours)
• Improved memory and retention
• A heightened sense of motivation

To put it informally, Modafinil’s ability to provide “superhuman energy” quickly became known to anybody wanting to improve their mental performance.

Many people from all walks of life are currently taking smart drugs like Modafinil to help them make more money, get better grades, or simply function at a higher mental capacity.

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Modafinil and Blood Pressure | The Basics

So what exactly is blood pressure, and what are the things that can increase it or decrease it?

Blood pressure can be defined as the force that allows blood to flow through your circulatory system, delivering oxygen, nutrients, antibodies, as well as expelling toxic waste products from your body [3].

Every time your heart beats (i.e. contracts), it forces out the blood that enters it. It is because of the DIFFERENCE in pressure that blood can can flow through your arteries and reach every part of your body.

Blood pressure is highest at the heart, while the arteries maintain the pressure. The arteries themselves can constrict or dilate, thereby raising or lowering blood pressure (respectively).

Blood Pressure UK, a charity in the United Kingdom dedicated to treating blood pressure problems, briefly explains how blood pressure is measured and expressed [4]:

“Blood pressure is measured in ‘millimetres of mercury’ (mmHg) and is written as two numbers…if your reading is 120/80mmHg, your blood pressure is ‘120 over 80’ [normal values]

The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats [heart muscles are tense]

The second (or bottom) number is your diastolic blood pressure. It is the lowest level your blood pressure reaches as your heart relaxes between beats [heart muscles are relaxed]”

When blood pressure is too high or too low These conditions are known as “hypertension” (>130/80 mmHg) and “hypotension” (<90/60 mmHg) [5]:

Hypertension: “too much blood is being pumped into your arteries which can cause life-threatening conditions like heart disease, stroke, type 2 diabetes, high cholesterol…Symptoms include chest pain, difficulty breathing, irregular heartbeat.”

Hypotension: “…blood is not fully flowing to your brain, arteries, and organs. Chronic low blood pressure without symptoms is almost never cause for concern, unless blood pressure drops suddenly and the brain is deprived of adequate blood supply…Symptoms include dizziness, lightheadedness, fainting”

Here’s where Modafinil comes into the picture: If you look at any official list of Modafinil side effects, you will see the following indications appear [6]:

• Chest pain
• Shortness of breath
• Fast, pounding heartbeat
• Agitation or excitement

While Modafinil is not technically seen as a “stimulant”, it is viewed as “stimulant-like” and this is enough to raise concerns amongst cardiologists treating patients with heart problems [7]:

“Although the cardiovascular impact of stimulant use is minimal in healthy populations, with minor elevations in HR and BP, concern remains regarding use in patients with preexisting cardiovascular conditions.

The adrenergic activation caused by stimulants and stimulant-like drugs may have a larger impact on autonomic regulation in patients with compromised cardiovascular function”

In short, Modafinil and blood pressure isn’t brought up in the context of hypotension. The main worry is when a user’s “Modafinil blood pressure” (i.e. blood pressure after taking Modafinil) spikes too high.

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Modafinil and High Blood Pressure

So what does the science have to say about Modafinil and high blood pressure? Does Modafinil’s theoretical effects match with what is seen in clinical studies?

According to a 2004 review of 7 placebo-controlled studies examining Modafinil’s on-label use, Modafinil was deemed safe to use in patients that had controlled hypertension [8]:

“Modafinil therapy was not associated with clinically relevant changes in [blood pressure] or [heart rate] in patients with excessive sleepiness associated with narcolepsy, [obstructive sleep apnea/hypopnea syndrome], or [shift work sleep disorder], including in patients with controlled hypertension or elevated [blood pressure].”

Another 2012 paper agreed with these observations, noting that the Modafinil -induced increases in blood pressure were normal, and quite modest compared to traditional stimulants [9]:

“…clinical studies have shown small, but consistent, increases in average values for mean systolic and diastolic blood pressure and average pulse rate in patients receiving armodafinil…Therefore, increased monitoring of blood pressure may be appropriate in patients on these compounds.”

“Heart rate and blood pressure changes have been modest; in contrast, adrenergic reuptake blockers are well known to slightly increase blood pressure and heart rate. These clinical observations suggest that at usual clinical doses, modafinil may not increase adrenergic signaling in humans.”

But this doesn’t necessarily mean a connection between Modafinil and high blood pressure is non-existent.

In sleep apnea patients, Modafinil does not appear to significantly change blood pressure unless the subjects are under mental and physical stress. In other words, if the subjects aren’t engaging in physical exercise or any activity requiring intense mental focus, then significant changes in blood pressure are not observed [10].

One 2005 clinical study involving 12 healthy patients taking 400 mg of Modafinil per day and found that Modafinil significantly increased blood pressure [11]:

“Modafinil increased resting heart rate (9.2+/-2.0 bpm; mean [+/-SE]; 95% confidence interval [CI], 4.7 to 13.6; P=0.001), resting systolic blood pressure (7.3+/-3.2 mm Hg; 95% CI, 0.2 to 14.4; P=0.044), and resting diastolic blood pressure (5.3+/-1.7 mm Hg; 95% CI, 1.4 to 9.1 mm Hg; P<0.012)”

“…This encourages caution in use of modafinil in patients with cardiovascular disease or those engaging in strenuous physical activity. In light of these studies, careful monitoring of individuals receiving modafinil for possible cardiovascular complications seems prudent.”

However, it is important to note that the typical Modafinil user takes 200 mg of Modafinil or less per day, 1-3 times per week.

Going beyond this dosage recommendation (+400 mg) — along with using other drugs that increase blood pressure — has been consistently shown to have unwanted cardiovascular events such as tachycardia, hypertension, and tremors [12, 13, 14].

We were only able to locate one study which suggested that Modafinil could act as a vasodilator (i.e. relaxes blood vessels) and lower blood pressure [15].

To summarize the science:

Modafinil and high blood pressure do have a connection, but only in people who are overdosing Modafinil, using Modafinil with other drugs that increase blood pressure, or have existing heart problems [16].

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Blood Pressure Pills and Modafinil

Let’s examine what happens when blood pressure pills and Modafinil are taken together.

According to MedicineNet.com [17]:

“Some products that may interact with this drug include: medications for high blood pressure (e.g., beta blockers such as atenolol/metoprolol, clonidine, guanabenz, methyldopa, prazosin), “blood thinners” (e.g., warfarin)”

“Modafinil can speed up or slow down the removal of other drugs from your body by affecting certain liver enzymes [such as propanolol, an anti-hypertensive drug meant to treat high blood pressure and irregular heart rate].”

This is important to note, as Modafinil may induce a state of “resistant hypertension” when taken alongside anti-hypertensive drugs [18]:

“Resistant hypertension is high blood pressure that does not respond well to aggressive medical treatment…Someone is taking three different blood pressure medications at their maximally tolerated doses, and blood pressure remains above your goal”

Whether it’s through lowering the levels of these drugs in your body, or simply affecting how effective they can be, an interaction between Modafinil and blood pressure pills definitely exists.

The same can be said for blood thinners such as Clopidrogel, which reduces blood clot formation by stopping platelets from getting stuck together [19]:

“…modafinil might decrease the effectiveness of clopidogrel. This might increase the chances a person will experience a stroke or heart attack as a result of a blood clot.”

It goes without saying that taking Modafinil alongside other classes of stimulants and select psychoactive substances can lead to synergistic increases in blood pressure and heart rate [20].

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Common Side Effects of Modafinil

The most common Modafinil side effects reported in clinical practice and scientific studies include headaches, nausea, dizziness, insomnia, dry mouth, and diarrhea [21].

The Modafinil side effects associated with high blood pressure are severe, yet occur very infrequently. Nevertheless, the official product monograph warns physicians to regularly monitor the heart rate and blood pressure in patients who are taking Modafinil. [22].

There are some limits that physicians will seek out when their patients are taking Modafinil [23]:

“Modafinil should be discontinued in patients who develop arrhythmia or moderate to severe hypertension and not restarted until the condition has been adequately evaluated and treated.”

“Modafinil should not be prescribed if the diastolic blood pressure is 100 mmHg or greater before treatment.”

To make a long story short, high blood pressure is not a common side effect of Modafinil. Incidences of using Modafinil and blood pressure increases that come about are quite rare.

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Blood Pressure and Modafinil | The Verdict

Any health enthusiasts worrying about “Modafinil blood pressure” should put their fears to rest.

Assuming they aren’t combining Modafinil with other powerful stimulants or other blood pressure pills, they will not have to worry about Modafinil and high blood pressure.

After all, every stimulant can cause changes in blood pressure, especially if the individual is prone to cardiovascular issues.

So if you’re a healthy adult under the age of 45, then Modafinil and blood pressure shouldn’t be a huge concern.

However, people with a history of hypertension and/or heart problems should check with a medical professional before they start taking Modafinil.

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