modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.olutasidenibSerious - Use Alternative (1)modafinil will decrease the level or effect of olutasidenib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Strong or moderate CYP3A inducers decrease olutasidenib (a CYP3A4 substrate) plasma concentrations and efficacy.omaveloxoloneSerious - Use Alternative (1)modafinil will decrease the level or effect of omaveloxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.omeprazoleMonitor Closely (1)modafinil will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.ondansetronMinor (1)modafinil will decrease the level or effect of ondansetron by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.opium tinctureMonitor Closely (1)opium tincture increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ospemifeneMonitor Closely (1)modafinil increases levels of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of modafinil by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.pacritinibContraindicated (1)modafinil will decrease the level or effect of pacritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.paliperidoneMonitor Closely (1)paliperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pantoprazoleMinor (1)modafinil will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown. Net effect on pantoprazole actions unknown due to opposing effects of CYP450 enzymes; monitorpapaveretumMonitor Closely (1)papaveretum increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentazocineMonitor Closely (1)pentazocine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazineMonitor Closely (1)perphenazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phendimetrazineMonitor Closely (1)modafinil and phendimetrazine both decrease sedation. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phenobarbitalMonitor Closely (1)phenobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)phenobarbital will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.phentermineMonitor Closely (1)modafinil and phentermine both decrease sedation. Use Caution/Monitor.phenylephrineMonitor Closely (1)modafinil and phenylephrine both decrease sedation. Use Caution/Monitor.phenylephrine POMonitor Closely (1)modafinil and phenylephrine PO both decrease sedation. Use Caution/Monitor.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)pholcodine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (1)pimozide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pirbuterolMonitor Closely (1)pirbuterol and modafinil both decrease sedation. Use Caution/Monitor.pirtobrutinibSerious - Use Alternative (1)modafinil will decrease the level or effect of pirtobrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration unavoidable, increase pirtobrutinib dose to 300 mg qDay (if dose is 200 mg qDay) or increase pirtobrutinib dose by 50 mg (if current pirtobrutinib dose is 50 mg or 100 mg qDay).posaconazoleMonitor Closely (1)posaconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.primidoneMonitor Closely (1)primidone will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.procarbazineMonitor Closely (1)procarbazine increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.prochlorperazineMonitor Closely (1)prochlorperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrineMonitor Closely (1)modafinil and propylhexedrine both decrease sedation. Use Caution/Monitor.protriptylineMonitor Closely (1)protriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rabeprazoleMinor (1)modafinil will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown. Net effect on pantoprazole actions unknown due to opposing effects of CYP450 enzymes; monitor ramelteonMonitor Closely (1)modafinil will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.rasagilineMonitor Closely (1)rasagiline increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode. Use caution when administering MAOIs and modafinil.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinMonitor Closely (1)rifabutin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifampinMinor (1)rifampin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rifapentineMonitor Closely (1)rifapentine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.riluzoleMinor (1)modafinil will decrease the level or effect of riluzole by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.risperidoneMonitor Closely (1)risperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ritonavirSerious - Use Alternative (1)ritonavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.roflumilastMonitor Closely (1)modafinil will decrease the level or effect of roflumilast by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Concomitant therapy may reduce therapeutic effectiveness.sageMinor (1)sage increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salmeterolMonitor Closely (1)salmeterol and modafinil both decrease sedation. Use Caution/Monitor.saquinavirMonitor Closely (2)saquinavir will increase the level or effect of modafinil by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use alternatives if available. saquinavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.scullcapMonitor Closely (1)scullcap increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)secobarbital will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.selegilineMonitor Closely (1)selegiline increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode. Use caution when administering MAOIs and modafinil.selegiline transdermalContraindicated (1)selegiline transdermal increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)serdexmethylphenidate/dexmethylphenidate and modafinil both decrease sedation. Use Caution/Monitor.shepherd's purseMonitor Closely (1)shepherd's purse increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sofosbuvir/velpatasvirMonitor Closely (1)sofosbuvir/velpatasvir increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Velpatasvir inhibits CYP3A4. Caution if coadministered with drugs with narrow therapeutics indexes.solriamfetolMonitor Closely (1)modafinil and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sorafenibMonitor Closely (1)modafinil decreases levels of sorafenib by increasing metabolism. Use Caution/Monitor.sparsentanMonitor Closely (1)sparsentan will decrease the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates. stiripentolMonitor Closely (2)stiripentol, modafinil. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment. stiripentol will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.sufentanilMonitor Closely (1)sufentanil increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tazemetostatMonitor Closely (1)tazemetostat will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (2)tecovirimat will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes. tecovirimat will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.temazepamMonitor Closely (1)temazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineMonitor Closely (1)terbutaline and modafinil both decrease sedation. Use Caution/Monitor.theophyllineMonitor Closely (1)modafinil will decrease the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.thioridazineMonitor Closely (1)thioridazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tizanidineSerious - Use Alternative (1)modafinil will decrease the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.tofacitinibMonitor Closely (1)modafinil increases levels of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. No specific dose adjustment recommended when tofacitinib coadministered with potent CYP2C19 inhibitors; decrease tofacitinib dose if coadministered with both moderate CYP3A4 and potent CYP2C19 inhibitors .topiramateMonitor Closely (1)topiramate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)tramadol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (1)trazodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triazolamMonitor Closely (1)triazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclabendazoleMonitor Closely (1)triclabendazole will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. triclofosMonitor Closely (1)triclofos increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (1)trifluoperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tucatinibSerious - Use Alternative (1)tucatinib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.vonoprazanSerious - Use Alternative (1)modafinil will decrease the level or effect of vonoprazan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.voriconazoleMonitor Closely (1)voriconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)modafinil will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.voxelotorSerious - Use Alternative (1)voxelotor will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.warfarinMonitor Closely (1)modafinil will increase the level or effect of warfarin by Other (see comment). Use Caution/Monitor. Warfarin's less potent R-enantiomer is metabolized in part by CYP3A4 (and also CYP1A2 and CYP2C19). Monitor INR more frequently if coadministered with inhibitors of these isoenzymes and adjust warfarin dose if needed. xylometazolineMonitor Closely (1)modafinil and xylometazoline both decrease sedation. Use Caution/Monitor.yerba mateMinor (1)yerba mate increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.yohimbineMonitor Closely (1)modafinil and yohimbine both decrease sedation. Use Caution/Monitor.zanubrutinibSerious - Use Alternative (1)modafinil will decrease the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of zanubrutinib (a CYP3A4 substrate) with moderate