Caution/Monitor.nalbuphinenalbuphine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nefazodonenefazodone will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nelfinavirnelfinavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nevirapinenevirapine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.norepinephrinenorepinephrine and modafinil both decrease sedation. Use Caution/Monitor.norgestrelmodafinil will decrease the level or effect of norgestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Moderate CYP3A4 inducers may decrease progestin concentration; consider use of additional barrier methodsnortriptylinenortriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.olanzapinemodafinil will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.olanzapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.omeprazolemodafinil will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.opium tinctureopium tincture increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ospemifenemodafinil increases levels of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.oxazepamoxazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxycodoneoxycodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxymorphoneoxymorphone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.paliperidonepaliperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.papaveretumpapaveretum increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentazocinepentazocine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentobarbitalpentobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazineperphenazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phendimetrazinemodafinil and phendimetrazine both decrease sedation. Use Caution/Monitor.phenobarbitalphenobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenterminemodafinil and phentermine both decrease sedation. Use Caution/Monitor.phenylephrinemodafinil and phenylephrine both decrease sedation. Use Caution/Monitor.phenylephrine POmodafinil and phenylephrine PO both decrease sedation. Use Caution/Monitor.phenytoinphenytoin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodinepholcodine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozidepimozide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pirbuterolpirbuterol and modafinil both decrease sedation. Use Caution/Monitor.posaconazoleposaconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.primidoneprimidone will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.procarbazineprocarbazine increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.prochlorperazineprochlorperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promethazinepromethazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrinemodafinil and propylhexedrine both decrease sedation. Use Caution/Monitor.protriptylineprotriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamquazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapinequetiapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ramelteonmodafinil will decrease the level or effect of ramelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.rasagilinerasagiline increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode. Use caution when administering MAOIs and modafinil.ribociclibribociclib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinrifabutin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifapentinerifapentine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.risperidonerisperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.roflumilastmodafinil will decrease the level or effect of roflumilast by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Concomitant therapy may reduce therapeutic effectiveness.salmeterolsalmeterol and modafinil both decrease sedation. Use Caution/Monitor.saquinavirsaquinavir 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.scullcapscullcap increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalsecobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.selegilineselegiline increases effects of modafinil by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode. Use caution when administering MAOIs and modafinil.serdexmethylphenidate/dexmethylphenidateserdexmethylphenidate/dexmethylphenidate and modafinil both decrease sedation. Use Caution/Monitor.shepherd's purseshepherd's purse increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sofosbuvir/velpatasvirsofosbuvir/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.solriamfetolmodafinil and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sorafenibmodafinil decreases levels of sorafenib by increasing metabolism. Use Caution/Monitor.sparsentansparsentan 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. stiripentolstiripentol, 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.sufentanilsufentanil increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadoltapentadol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tazemetostattazemetostat will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimattecovirimat 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.temazepamtemazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineterbutaline and modafinil both decrease sedation. Use Caution/Monitor.theophyllinemodafinil will decrease the level or effect of theophylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.thioridazinethioridazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixenethiothixene increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tofacitinibmodafinil 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 .topiramatetopiramate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.tramadoltramadol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trazodonetrazodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triazolamtriazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclabendazoletriclabendazole 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. triclofostriclofos increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazinetrifluoperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipraminetrimipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triprolidinetriprolidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.voriconazolevoriconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.warfarinmodafinil 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. xylometazolinemodafinil and xylometazoline both decrease sedation. Use Caution/Monitor.yohimbinemodafinil and yohimbine both decrease sedation. Use Caution/Monitor.ziconotideziconotide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziprasidoneziprasidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (27)acetazolamideacetazolamide will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.amantadineamantadine, modafinil. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.ambrisentanmodafinil will increase the level or effect of ambrisentan by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.American ginsengAmerican ginseng increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.anastrozoleanastrozole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.antipyrinemodafinil will decrease the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.asenapinemodafinil will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.bupropionmodafinil, bupropion. increasing metabolism. Minor/Significance Unknown. Decr levels of bupropion, but incr levels of active metabolites. .caffeinemodafinil will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.cimetidinemodafinil will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.cocaine topicalmodafinil will decrease the level or effect of cocaine topical by affecting hepatic enzyme CYP2B6 metabolism. Minor/Significance Unknown.cyclophosphamidecyclophosphamide will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.diazepammodafinil will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.eucalyptuseucalyptus increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.frovatriptanmodafinil will decrease the level or effect of frovatriptan by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.guaranaguarana increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.lansoprazolemodafinil will increase the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown. Net effect on pantoprazole actions unknown due to opposing effects of CYP450 enzymes; monitor larotrectiniblarotrectinib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.levoketoconazolemodafinil will decrease the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ondansetronmodafinil will decrease the level or effect of ondansetron by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.pantoprazolemodafinil 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; monitorrabeprazolemodafinil 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 rifampinrifampin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.riluzolemodafinil will decrease the level or effect of riluzole by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.sagesage increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.voriconazolemodafinil will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.yerba mateyerba mate increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.abametapirSerious - Use Alternative (1)abametapir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.abrocitinibMonitor Closely (1)modafinil will increase the level or effect of abrocitinib by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Start abrocitinib 50 mg qDay when coadministered with CYP2C19 inhibitors. If adequate response not achieved after 12 weeks, may increase to 100 mg qDay. Discontinue if inadequate response after dosage increase.acetazolamideMinor (1)acetazolamide will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.albuterolMonitor Closely (1)albuterol and modafinil both decrease sedation. Use Caution/Monitor.alfentanilMonitor Closely (1)alfentanil increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alosetronSerious - Use Alternative (1)modafinil will decrease the level or effect of alosetron by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.alprazolamMonitor Closely (1)alprazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use