Modafinil, which is marketed as Provigil, is prescribed to increase daytime wakefulness in patients with sleep disorders, including narcolepsy and obstructive sleep apnea. Provigil can inhibit enzymes, called cytochromes, that break down drugs, and increase circulating levels of drugs. Provigil also can interfere with some drugs by increasing their metabolism or reducing their efficacy.
Psychiatric Drugs
Provigil interacts with many drugs prescribed for psychiatric disorders. Methylphenidate, a stimulant marketed as Ritalin, and dextroamphetamine, a stimulant marketed as Adderall are both prescribed for Attention Deficit Hyperactivity Disorder, or ADHD. Either drug taken with Provigil at the same time blocks absorption of Provigil for an hour. Clomipramine, brand name Anafranil, is used to treat obsessive-compulsive disorder, or OCD. Clomipramine does not interact with Provigil in healthy patients, but in patients with narcolepsy, Provigil may cause increased levels of clomipramine and its metabolite in the body. Triazolam, brand name Halcion, is used to treat insomnia. Taking Provigil causes triazolam to be less effective and cleared faster out of the body. Monoamine oxidase inhibitors, or MAOIs, are antidepressants, but have not been clinically studied for interaction with Provigil and thus should be avoided.
Birth Control Pills
Ethinyl estradiol is the main active ingredient of birth control pills, used to prevent conception. Ethinyl estradiol's effectiveness is reduced when Provigil is also taken, leading to risk of pregnancy.
Other Classes of Drugs
Warfarin, brand name Coumadin, is used to prevent or slow the growth of blood clots. Patients taking both Provigil and warfarin should be monitored for blood clotting ability as warfarin efficacy may be impacted. Cyclosporine, brand names Neoral, Sandimmune, and Gengraf, is an immunosuppressant used to prevent transplant rejection, and treat arthritis and psoriasis. Taking Provigil with cyclosporine may increase clearance of cyclosporine in transplant patients, leading to greater risk of transplant rejection.
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