Use Caution/Monitor.ephedrineMonitor Closely (1)ephedrine and modafinil both decrease sedation. Use Caution/Monitor.epinephrineMonitor Closely (1)epinephrine and modafinil both decrease sedation. Use Caution/Monitor.epinephrine inhaledMonitor Closely (1)modafinil, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrine racemicMonitor Closely (1)epinephrine racemic and modafinil both decrease sedation. Use Caution/Monitor.escitalopramMonitor Closely (1)modafinil will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely.esketamine intranasalMonitor Closely (1)esketamine intranasal, modafinil. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.estazolamMonitor Closely (1)estazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethanolMonitor Closely (1)ethanol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.etravirineMonitor Closely (2)modafinil will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. etravirine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.eucalyptusMinor (1)eucalyptus increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.fedratinibMonitor Closely (2)fedratinib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary. fedratinib will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary.Serious - Use Alternative (1)modafinil will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.fenfluramineMonitor Closely (1)modafinil and fenfluramine both decrease sedation. Use Caution/Monitor.fexinidazoleMonitor Closely (1)fexinidazole will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fexinidazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.fezolinetantContraindicated (1)modafinil will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsflibanserinMonitor Closely (1)modafinil will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Coadministration of flibanserin with strong CYP2C19 inhibitors may increase flibanserin exposure and increase the risk of hypotension, syncope, and CNS depression.fluphenazineMonitor Closely (1)fluphenazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.formoterolMonitor Closely (1)formoterol and modafinil both decrease sedation. Use Caution/Monitor.fosphenytoinMonitor Closely (1)fosphenytoin will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.frovatriptanMinor (1)modafinil will decrease the level or effect of frovatriptan by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.ganaxoloneSerious - Use Alternative (1)modafinil will decrease the level or effect of ganaxolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of ganaxolone with moderate or strong CYP3A4 inducers. If coadministration unavoidable, consider increasing ganaxolone dose; however, do not exceed maximum daily dose for weight.green teaMonitor Closely (1)green tea, modafinil. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.guaranaMinor (1)guarana increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.haloperidolMonitor Closely (1)haloperidol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydromorphoneMonitor Closely (1)hydromorphone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.idelalisibSerious - Use Alternative (1)idelalisib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substratesiloperidoneMonitor Closely (2)iloperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. iloperidone increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.imipramineMonitor Closely (3)modafinil will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. modafinil will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. imipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.indinavirMonitor Closely (1)indinavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.iobenguane I 131Serious - Use Alternative (1)modafinil will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.isocarboxazidContraindicated (1)isocarboxazid increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.isoproterenolMonitor Closely (1)isoproterenol and modafinil both decrease sedation. Use Caution/Monitor.istradefyllineMonitor Closely (1)istradefylline will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.itraconazoleMonitor Closely (1)itraconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ivosidenibSerious - Use Alternative (1)ivosidenib will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.ketoconazoleMonitor Closely (1)ketoconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)ketotifen, ophthalmic increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lansoprazoleMinor (1)modafinil 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 larotrectinibMinor (1)larotrectinib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lenacapavirSerious - Use Alternative (1)modafinil will decrease the level or effect of lenacapavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of lenacapavir with moderate CYP3A4 inducers.leniolisibSerious - Use Alternative (1)modafinil will decrease the level or effect of leniolisib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.letermovirMonitor Closely (1)letermovir increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levalbuterolMonitor Closely (1)levalbuterol and modafinil both decrease sedation. Use Caution/Monitor.levoketoconazoleMonitor Closely (1)levoketoconazole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)modafinil will decrease the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.levorphanolMonitor Closely (1)levorphanol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lidocaineMonitor Closely (1)modafinil will decrease the level or effect of lidocaine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.linezolidContraindicated (1)linezolid increases effects of modafinil by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.lisdexamfetamineMonitor Closely (1)lisdexamfetamine and modafinil both decrease sedation. Use Caution/Monitor.lofepramineMonitor Closely (1)lofepramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lofexidineMonitor Closely (1)lofexidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorlatinibSerious - Use Alternative (1)lorlatinib, modafinil. Either decreases effects of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of both drugs increases risk of severe hepatotoxicity.lormetazepamMonitor Closely (1)lormetazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor, modafinil. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lumateperoneSerious - Use Alternative (1)modafinil will decrease the level or effect of lumateperone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.maprotilineMonitor Closely (1)maprotiline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.marijuanaMonitor Closely (1)marijuana increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mavacamtenContraindicated (2)modafinil will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. modafinil will decrease the level or effect of mavacamten by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.melatoninMonitor Closely (1)melatonin increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meprobamateMonitor Closely (1)meprobamate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaproterenolMonitor Closely (1)metaproterenol and modafinil both decrease sedation. Use Caution/Monitor.methadoneMonitor Closely (1)methadone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methamphetamineMonitor Closely (1)methamphetamine and modafinil both decrease sedation. Use Caution/Monitor.methylenedioxymethamphetamineMonitor Closely (1)methylenedioxymethamphetamine and modafinil both decrease sedation. Use Caution/Monitor.methylphenidateMonitor Closely (1)modafinil increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.mexiletineMonitor Closely (1)modafinil will decrease the level or effect of mexiletine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.midazolamMonitor Closely (1)midazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.midodrineMonitor Closely (1)modafinil and midodrine both decrease sedation. Use Caution/Monitor.mifepristoneMonitor Closely (1)mifepristone will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.mirtazapineMonitor Closely (1)mirtazapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mitotaneMonitor Closely (1)mitotane decreases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.morphineMonitor Closely (1)morphine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.motherwortMonitor Closely (1)motherwort increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.moxonidineMonitor Closely (1)moxonidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nabiloneMonitor Closely (1)nabilone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nefazodoneMonitor Closely (1)nefazodone will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nelfinavirMonitor Closely (1)nelfinavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.norepinephrineMonitor Closely (1)norepinephrine and modafinil both decrease sedation. Use Caution/Monitor.norgestrelMonitor Closely (1)modafinil 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 methodsnortriptylineMonitor Closely (1)nortriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.olanzapineMonitor Closely (2)modafinil will decrease the level or effect of olanzapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. olanzapine increases and