tolerabilityrisperidoneMonitor Closely (1)risperidone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ritonavirMonitor Closely (1)armodafinil will decrease the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (2)ritonavir will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. ritonavir will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.roflumilastMonitor Closely (1)armodafinil will decrease the level or effect of roflumilast by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Concomitant therapy may reduce therapeutic effectiveness.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.rufinamideMinor (1)rufinamide will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinibMinor (1)armodafinil will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)armodafinil will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sageMinor (1)sage increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salmeterolMonitor Closely (1)salmeterol and armodafinil both decrease sedation. Use Caution/Monitor.saquinavirMonitor Closely (1)armodafinil will decrease the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.saxagliptinMinor (1)armodafinil will decrease the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.scullcapMonitor Closely (1)scullcap increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)secobarbital will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.selegilineMonitor Closely (1)selegiline increases effects of armodafinil by pharmacodynamic synergism. Use Caution/Monitor. Use caution when administering MAOIs and armodafinil.selegiline transdermalContraindicated (1)selegiline transdermal increases effects of armodafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.selumetinibSerious - Use Alternative (1)armodafinil will decrease the level or effect of selumetinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.shepherd's purseMonitor Closely (1)shepherd's purse increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sildenafilMonitor Closely (1)armodafinil will decrease the level or effect of sildenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.silodosinSerious - Use Alternative (1)armodafinil will decrease the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.simvastatinSerious - Use Alternative (1)armodafinil will decrease the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)simvastatin will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.siponimodSerious - Use Alternative (1)armodafinil will decrease the level or effect of siponimod by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of siponimod with a drug that causes moderate CYP2C9 plus a moderate or strong CYP3A4 inducer is not recommended. Coadministration with moderate or strong CYP3A4 inducers alone is not recommended for patients with CYP2C9*1/*3 and*2/*3 genotype.sirolimusSerious - Use Alternative (1)armodafinil will decrease the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)sirolimus will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.sofosbuvir/velpatasvirMonitor Closely (1)sofosbuvir/velpatasvir increases levels of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Velpatasvir inhibits CYP3A4. Caution if coadministered with drugs with narrow therapeutics indexes.Serious - Use Alternative (1)armodafinil will decrease the level or effect of sofosbuvir/velpatasvir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Velpatasvir is a substrate of CYP2B6, CYP2C8, and CYP3A4. Drugs that are moderate-to-potent inducers of CYP2B6, CYP2C8, or CYP3A4 may significantly decrease velpatasvir plasma concentrations, leading to potentially reduced therapeutic effect.solifenacinMonitor Closely (1)armodafinil will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.sonidegibSerious - Use Alternative (1)armodafinil will decrease the level or effect of sonidegib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sonidegib with strong or moderate CYP3A4 inducers.St John's WortMonitor Closely (1)St John's Wort will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)St John's Wort will decrease the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.stiripentolMonitor Closely (2)armodafinil will decrease the level or effect of stiripentol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor closely if stiripentol is coadministered with a moderate CYP3A4 inducer. stiripentol, armodafinil. 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.sufentanilMonitor Closely (1)sufentanil increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)armodafinil will decrease the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.sufentanil SLMonitor Closely (1)armodafinil decreases effects of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration of CYP3A4 inducers may decrease sufentanil levels and efficacy, possibly precipitating withdrawal syndrome in patients who have developed physical dependence to sufentanil. Discontinuation of concomitantly used CYP3A4 inducers may increase sufentanil plasma concentration.sunitinibMonitor Closely (1)armodafinil will decrease the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tacrolimusMonitor Closely (1)armodafinil will decrease the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)tacrolimus will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.tadalafilMonitor Closely (1)armodafinil will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tazemetostatMonitor Closely (2)armodafinil will decrease the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. tazemetostat will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of armodafinil 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 armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.temsirolimusMonitor Closely (1)armodafinil will decrease the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.terbutalineMonitor Closely (1)terbutaline and armodafinil both decrease sedation. Use Caution/Monitor.theophyllineMonitor Closely (2)armodafinil will decrease the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. armodafinil will decrease the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.thioridazineMonitor Closely (1)thioridazine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tinidazoleMonitor Closely (1)armodafinil will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tipranavirMonitor Closely (1)armodafinil will decrease the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tivozanibMonitor Closely (1)armodafinil will decrease the level or effect of tivozanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tizanidineSerious - Use Alternative (1)armodafinil will decrease the level or effect of tizanidine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.tolterodineMonitor Closely (1)armodafinil will decrease the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tolvaptanSerious - Use Alternative (1)armodafinil will decrease the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)tolvaptan will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.topiramateMonitor Closely (1)topiramate increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.Minor (1)topiramate will decrease the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.trabectedinMonitor Closely (1)armodafinil will decrease the level or effect of trabectedin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tramadolMonitor Closely (1)tramadol increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine increases effects of armodafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (2)armodafinil will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trazodone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)trazodone will decrease the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.triamcinolone acetonide injectable suspensionMonitor Closely (1)armodafinil will decrease the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.triazolamMonitor Closely (2)armodafinil will decrease the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. triazolam increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (1)trifluoperazine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ubrogepantMonitor Closely (1)armodafinil will decrease the level or effect of ubrogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Dose adjustment is recommended with concomitant use of ubrogepant and moderate and weak CYP3A4 inducers. (see Dosage Modifications)vardenafilMonitor Closely (1)armodafinil will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.venetoclaxSerious - Use Alternative (1)armodafinil will decrease the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of venetoclax with strong or moderate CYP3A inducers. Consider alternative treatment with agents that have less CYP3A induction.verapamilMonitor Closely (1)armodafinil will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (2)verapamil will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. verapamil will increase the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.vinblastineMinor (1)armodafinil will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vincristineMinor (1)armodafinil will decrease the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vincristine liposomalMinor (1)armodafinil will decrease the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.vinorelbineMinor (1)armodafinil will decrease the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.voclosporinSerious - Use Alternative (1)armodafinil will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.vonoprazanSerious - Use Alternative (1)armodafinil will decrease the level or effect of vonoprazan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.voriconazoleMinor (2)armodafinil will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown. voriconazole will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.voxelotorSerious - Use Alternative (2)armodafinil will decrease the level or effect of voxelotor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor is primarily metabolized by CYP3A4. Avoid coadministration with moderate or strong CYP3A4 inducers. If unable to avoid coadministration, increase voxelotor dose (see Dosage Modifications). voxelotor will increase the level or effect of armodafinil 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)armodafinil 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)armodafinil and xylometazoline both decrease sedation. Use Caution/Monitor.yerba mateMinor (1)yerba mate increases effects of armodafinil by pharmacodynamic synergism. Minor/Significance Unknown.yohimbineMonitor Closely (1)armodafinil and yohimbine both decrease sedation. Use Caution/Monitor.zafirlukastMinor (1)zafirlukast will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zaleplonMinor (1)armodafinil will decrease the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.zanubrutinibSerious - Use Alternative (1)armodafinil will decrease the level or effect of zanubrutinib by affecting hepatic/intestinal enzyme CYP3A4