Modafinil's Impact on Blood Pressure

Monitoring and Contraindications

The American Geriatrics Society recommends baseline blood pressure and heart rate measurement before initiating modafinil, with more frequent monitoring when starting medication or adjusting doses, specifically assessing for hypertension, palpitations, or arrhythmias 1
Patients should be questioned about excessive stimulatory effects at each visit, and consider more intensive monitoring in high-risk populations 1

A pooled analysis of 1,529 patients demonstrated good cardiovascular tolerability, with clinically significant increases in diastolic blood pressure occurring in fewer than 1% of patients, and only 1 patient having a clinically significant increase in heart rate [@2@ is not available, but this fact is mentioned without a reference that says "ignore ref", however no reference is provided for this specific fact, it seems to be part of a larger text that was not fully included]
In a randomized crossover trial of 54 POTS patients, modafinil 100 mg significantly increased seated systolic blood pressure but did not worsen standing heart rate [@3@ is not available, however this fact is mentioned without a reference that says "ignore ref", the original reference is not provided for this specific fact]
The American College of Cardiology is not mentioned in the article, however, modafinil can affect blood pressure, though the effects are generally modest and most clinically significant during physical or mental stress, requiring increased monitoring in patients with cardiovascular disease or hypertension, according to the article, no specific reference is provided for this fact, however, it seems to be a general conclusion based on the text.