Caution/Monitor.amantadineMinor (1)amantadine, modafinil. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.ambrisentanMinor (1)modafinil will increase the level or effect of ambrisentan by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.American ginsengMinor (1)American ginseng increases effects of modafinil by pharmacodynamic synergism. Minor/Significance Unknown.amitriptylineMonitor Closely (2)modafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. amitriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amobarbitalMonitor Closely (1)amobarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)amobarbital will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.amoxapineMonitor Closely (1)amoxapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.anastrozoleMinor (1)anastrozole will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.antipyrineMinor (1)modafinil will decrease the level or effect of antipyrine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.apalutamideSerious - Use Alternative (2)apalutamide will decrease the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. apalutamide will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.arformoterolMonitor Closely (1)arformoterol and modafinil both decrease sedation. Use Caution/Monitor.aripiprazoleMonitor Closely (1)aripiprazole increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.armodafinilMonitor Closely (1)armodafinil and modafinil both decrease sedation. Use Caution/Monitor.asenapineMinor (1)modafinil will decrease the level or effect of asenapine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.atazanavirSerious - Use Alternative (1)atazanavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.azelastineMonitor Closely (1)azelastine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.belladonna and opiumMonitor Closely (1)belladonna and opium increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.belzutifanMonitor Closely (1)modafinil will increase the level or effect of belzutifan by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Belzutifan is a CYP2C19 substrate. Coadministration with CYP2C19 inhibitors may increase incidence or severity of adverse effects. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended. benperidolMonitor Closely (1)benperidol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benzphetamineMonitor Closely (1)modafinil and benzphetamine both decrease sedation. Use Caution/Monitor.bortezomibMonitor Closely (1)modafinil will increase the level or effect of bortezomib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.buprenorphine buccalMonitor Closely (1)buprenorphine buccal increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.bupropionMinor (1)modafinil, bupropion. increasing metabolism. Minor/Significance Unknown. Decr levels of bupropion, but incr levels of active metabolites. .butabarbitalMonitor Closely (1)butabarbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.butalbitalMonitor Closely (1)butalbital increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.butorphanolMonitor Closely (1)butorphanol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.caffeineMonitor Closely (1)caffeine and modafinil both decrease sedation. Use Caution/Monitor.Minor (1)modafinil will decrease the level or effect of caffeine by affecting hepatic enzyme CYP1A2 metabolism. Minor/Significance Unknown.cannabidiolMonitor Closely (2)modafinil will increase the level or effect of cannabidiol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a strong CYP2C19 inhibitor. cannabidiol will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol. carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cenobamateMonitor Closely (2)cenobamate will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. cenobamate will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate. ceritinibMonitor Closely (1)ceritinib will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.chloral hydrateMonitor Closely (1)chloral hydrate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpheniramineMonitor Closely (1)chlorpheniramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cilostazolSerious - Use Alternative (1)modafinil increases toxicity of cilostazol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Decrease cilostazol dose by 50%; serum levels of 3,4-dehydrocilostazol (active metabolite) increased by strong CYP2C19 inhibitors.cimetidineMinor (1)modafinil will increase the level or effect of cimetidine by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.cinnarizineMonitor Closely (1)cinnarizine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.citalopramMonitor Closely (1)modafinil will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Citalopram 20 mg/day is the maximum recommended dose for patients taking CYP2C19 inhibitors because of the risk of QT prolongation.clarithromycinSerious - Use Alternative (1)clarithromycin will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clobazamMonitor Closely (1)modafinil will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Dosage adjustment may be required; CYP2C19 inhibitors may result in increased exposure to N-desmethylclobazam (active metabolite).clomipramineMonitor Closely (2)modafinil will decrease the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. clomipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clonazepamMonitor Closely (1)clonazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clopidogrelSerious - Use Alternative (1)modafinil decreases effects of clopidogrel by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Clopidogrel efficacy may be reduced by drugs that inhibit CYP2C19. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. Clopidogrel is metabolized to this active metabolite in part by CYP2C19. .clorazepateMonitor Closely (1)clorazepate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.clozapineMonitor Closely (2)modafinil will decrease the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. clozapine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cobicistatSerious - Use Alternative (1)cobicistat will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.cocaine topicalMinor (1)modafinil will decrease the level or effect of cocaine topical by affecting hepatic enzyme CYP2B6 metabolism. Minor/Significance Unknown.codeineMonitor Closely (1)codeine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.conivaptanSerious - Use Alternative (1)conivaptan will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.crizotinibMonitor Closely (1)crizotinib increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.crofelemerMonitor Closely (1)crofelemer increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.cyclizineMonitor Closely (1)cyclizine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyclophosphamideMinor (1)cyclophosphamide will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cyproheptadineMonitor Closely (1)cyproheptadine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.darunavirSerious - Use Alternative (1)darunavir will increase the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.desipramineMonitor Closely (1)desipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)modafinil and dexfenfluramine both decrease sedation. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)dexmethylphenidate and modafinil both decrease sedation. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)dextroamphetamine and modafinil both decrease sedation. Use Caution/Monitor.dextromoramideMonitor Closely (1)dextromoramide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diazepamMinor (1)modafinil will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.diazepam intranasalMonitor Closely (1)modafinil will increase the level or effect of diazepam intranasal by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.diethylpropionMonitor Closely (1)modafinil and diethylpropion both decrease sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dimenhydrinateMonitor Closely (1)dimenhydrinate increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dobutamineMonitor Closely (1)dobutamine and modafinil both decrease sedation. Use Caution/Monitor.dopamineMonitor Closely (1)modafinil and dopamine both decrease sedation. Use Caution/Monitor.dopexamineMonitor Closely (1)dopexamine and modafinil both decrease sedation. Use Caution/Monitor.doxepinMonitor Closely (1)doxepin increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.droperidolMonitor Closely (1)droperidol increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.duloxetineSerious - Use Alternative (1)modafinil will decrease the level or effect of duloxetine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug.efavirenzMonitor Closely (1)efavirenz will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.elacestrantSerious - Use Alternative (1)modafinil will decrease the level or effect of elacestrant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.elagolixMonitor Closely (2)elagolix will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak CYP2C19 inhibitor. Caution with sensitive CYP2C19 substrates. elagolix decreases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.eluxadolineMonitor Closely (1)modafinil increases levels of eluxadoline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C19 inhibitors.elvitegravir/cobicistat/emtricitabine/tenofovir DFMonitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.encorafenibMonitor Closely (1)encorafenib, modafinil. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.enzalutamideMonitor Closely (1)enzalutamide will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.