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-   -   provigal? (https://www.neurotalk.org/multiple-sclerosis/103163-provigal.html)

Riverwild 09-16-2009 08:48 PM

I've been on Provigil since 2005.
I started out at 100 mg. q day. It was increased to 200 mg. q day and then 200-400 mg. PRN

I gauge my dose on what I have to get through. I do 12 hour shifts, work as much OT as I possibly can when it's available, and want to function outside of my job as well as I can, and enjoy myself while doing it. I don't have any problem sleeping. I find it "clears" me so I can do what I need to do when I need to do it without wilting in the middle of doing stuff.

I don't take it every day since I don't want to wear out the effect. Generally it's 100-200 mg q day, but there are those days when I need more.

Start out small but ask for the 200 mg. pill on the scrip right from the start. You can split the pill. It's hugely expensive, but if insurance covers it, you are better off with the larger pill in case you have to increase up.

I stockpile. This is one drug I cannot live without if my insurance ever dies, and the U&C on my last refill of 200 mg pills was $2435.67 for 180 pills.

It's coming off patent soon and Cephalon has introduced a new one called Nuvigil. The only difference is one inactive isomer. (check Everyday Health for the explanation for that, it's where I got it from) so Provigil should be coming down in price soon, since the generic market will be opening up on it.

Dejibo 09-17-2009 08:28 AM

will pick up my script today. I hate taking any new things. I hate taking anything more than an occasional advil, and here I am on baclofen, and xanax, and copaxone and mscontin, and prilosec, and claritin, and cod liver oil, and vitamins, and calcium, and ....the list goes on and on...

its worth a try. maybe I can get moving again. thanks for the great responses. :hug:

mrsD 09-17-2009 08:54 AM

Quote:

Originally Posted by Dejibo (Post 567432)
will pick up my script today. I hate taking any new things. I hate taking anything more than an occasional advil, and here I am on baclofen, and xanax, and copaxone and mscontin, and prilosec, and claritin, and cod liver oil, and vitamins, and calcium, and ....the list goes on and on...

its worth a try. maybe I can get moving again. thanks for the great responses. :hug:

What are you taking cod liver oil for? May I ask? If it is for the Vit D? New studies show the Vitamin A blocks absorption of Vit D from cod liver oil. Cod liver oil is not a good source of EFAs either. Regular fish oil is designed for that.
This Vit A negative effect is mentioned on that new video from UCSD medical school that I put up before. That video suggested not using A when you need good D absorption.

Dejibo 09-17-2009 01:11 PM

I take the Cod liver oil for a vit D suppliment. I am not on a Vit A suppliment. I have also seen a nice rise in my blood serum levels of vit D since being on it. I am allergic to shrimp so I have to be careful of some of the fish oils that are out there. There is a nice Krill oil available and I hear great things, but since I am iodine allergic, I need to stay away from sources that mix shelled fish into the mixes. Cod liver was a safer alternative for me.

My Provigal is held up in insurance land. My ins company is asking my MD to provide answer as to why he wants me on this...sheesh! we already have folks standing between me and my MD. Why cant my MD just tell me what to go get, and have the pharmacy give it? It will be next week before I see the stuff.

mrsD 09-17-2009 01:31 PM

Well.... Cod liver oil contains retinol, real Vit A, (not betacarotene).

http://en.wikipedia.org/wiki/Cod_liver_oil

It is also less pure or less free from toxins, than fish body oils. Fish body supplements do not have either vitamin in them. They are processed by distillation, and free of heavy metals.

There are very high quality D3 only supplements, out there now that are really inexpensive.

NOW brand is very good.

freeinhou 09-17-2009 04:43 PM

I tried Provigil in 2003. Caffeine pills work better.

I expected it to do something it couldn't do. It's not for keeping you going on 4 hours sleep a night and working 80 hours a week. I forget dosage. 200 mg sounds familiar.

Tom

ewizabeth 09-17-2009 09:10 PM

Quote:

Originally Posted by freeinhou (Post 567605)
I tried Provigil in 2003. Caffeine pills work better.

I expected it to do something it couldn't do. It's not for keeping you going on 4 hours sleep a night and working 80 hours a week. I forget dosage. 200 mg sounds familiar.

Tom

You are pushing too hard Tom, you should get more sleep.

I use both after you mentioning the caffeine pills. My stomach can't handle actual coffee anymore most of the time, so I take a caffeine pill and 100 mg of Provigil in the morning after breakfast and with my other pills and vitamins.

I take another 100 mg of Provigil after lunch, and a half of a caffeine pill if I need it.

Dejibo, you can break the 200 mg Provigil tabs in half, and cut them again if you use a pill splitter. I had to start with 50 mg and very slowly work my way up.

msarkie 09-18-2009 09:35 AM

My neuro has me take 100 mg every morning whether I think I need it or not. He says there is a cumulative effect and I will have better results taking it regularly than as needed. I had started out taking it intermittently and couldn't tell it benefited me much. Now that I take it daily I can tell that I have less of an urge to sleep during the afternoon.

Dejibo 09-18-2009 10:21 AM

well, its a dead issue. My insurance company has turned down my MDs request for this rx. They said they are not paying $1300 per month because I am fatigued. The neuro argued that its a bona fide neurological acceptable treatment for MS patients, and they said ...NoPE! If I was narcoleptic or other such disorders they would consider it, but since I am not, its considered off lable usage of the med, and are not going to allow it.

Why is it that my MD cant just say "I want my patient to use this med" give me a script, send me to the pharmacy and have them fill it, bill my insurance company, and thats the end of that? Why is it some paper pusher gets to tell the head of neurology that his patient cant have the meds he prefers them to take? Sheesh! They also said between all the meds I take every month, including copaxone, if I add this it will bump me to the limit of acceptable spending on my drug plan. WTH?

I guess I will start drinking caffiene drinks, and such. He did offer me things like prozac and amantadine, which didnt work in the past, and other alternatives. I was looking forward to giving this stuff a try.

Back to the drawing board:(

ewizabeth 09-18-2009 10:46 AM

I would fight the insurance company on this, and have your doctor do so too. That really isn't fair. :mad: It will be out as generic soon, then they wouldn't have to pay as much.


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