SINGAPORE: The Health Sciences Authority (HSA) in Singapore has issued a warning to the public against acquiring or consuming Modafinil and Armodafinil products without a medical prescription or supervision.

This advisory follows alarming reports of three individuals hospitalised after taking Modafinil and Armodafinil due to severe adverse reactions after using these substances obtained from friends or illicit street vendors.

Serious Adverse Reactions

One individual in his thirties experienced a life-threatening skin condition known as Stevens-Johnson syndrome (SJS) after consuming modafinil. He acquired the product from a friend and took it once to enhance alertness. Shortly thereafter, he fell ill, displaying symptoms such as fever, multiple mouth ulcers, red eyes, and a severe rash that started on his neck and spread across his body.

Two other men in their thirties suffered serious adverse reactions after ingesting armodafinil. One of them acquired the substance from a friend to stay awake during the daytime. After using it several times, he developed multiple mouth ulcers, mouth inflammation, pain when swallowing, difficulty eating or speaking, and conjunctivitis (pink eye or red and swollen eyes), which led to his hospitalisation.

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The second man, who acquired armodafinil from an illicit peddler in Geylang, also developed SJS and was hospitalised. His condition began with fever and a rash and eventually progressed to skin blistering and multiple mouth ulcers.

Risks Associated with Modafinil and Armodafinil Medications

Modafinil and Armodafinil are potent medicines not registered in Singapore but available in some other countries as prescription medications. Doctors in Singapore can apply to HSA for permission to import these drugs for the treatment of specific medical conditions like narcolepsy (a neurological disorder affecting the sleep and wake cycles of the brain). In such cases, patients must remain under strict medical supervision.

These medications can cause serious side effects, including:

  • heart problems
  • hypertension
  • anxiety
  • hallucinations
  • mania

Both medications are reported to cause serious skin reactions, including SJS, and toxic epidermal necrolysis (severe skin reaction where 30% of the skin is affected) have also emerged, leading to hospitalisation, complications, and even death. Patients who recover may suffer long-term consequences, such as skin scarring, hair loss, and visual impairments, including increased sensitivity to light (photophobia) and blindness. Other vital organs, like the lungs, may also experience permanent damage. Additionally, modafinil and armodafinil carry a potential risk of dependency due to their stimulating effects on the brain.

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Some individuals use modafinil and armodafinil as cognitive enhancers for improved focus and memory. Self-medication with these medications is not recommended and can be harmful.

HSA offers the following advice to consumers:

  1. Modafinil and Armodafinil should only be used when prescribed by a doctor and under medical supervision. Using these substances to stay alert or enhance focus without medical guidance can be dangerous.
  2. Exercise caution when obtaining health products from unknown sources, even if recommended by friends or relatives. The content and production methods of these products may be uncertain.
  3. Never share or provide potent prescription medicines to friends or relatives, as their medical conditions may differ and require professional management. Well-intentioned sharing may inadvertently harm rather than help.

For sellers and suppliers, unless authorized by HSA for specific medical circumstances, supplying or selling unregistered health products like modafinil or armodafinil violates the Health Products Act. Those convicted may face fines up to $50,000 or a jail term of up to 2 years, or both.

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The HSA encourages the public to report any information regarding the illegal sale and distribution of Modafinil or Armodafinil to their Enforcement Branch via phone at 6866-3485 during office hours (Monday to Friday) or by email at hsa_is@hsa.gov.sg. /TISG