Meta Information
ID:modafinil
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
12
Hours after target:
null
Description:
Modafinil is a long-acting wakefulness-promoting agent with a half-life of 12-15 hours, which directly interferes with the ability to fall asleep if taken too close to bedtime.
Actionable advice:
Take your dose early in the morning to avoid disrupting nighttime sleep.
Target id:
/class/estrogens
Target name:
Hormonal Contraceptives (Oral, Patch, Implant)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil strongly induces the CYP3A4 enzyme, which significantly accelerates the breakdown of hormonal contraceptives, potentially leading to contraceptive failure and unintended pregnancy.
Actionable advice:
Use a reliable non-hormonal backup method of contraception during and for one month after stopping modafinil.
Target id:
/class/maois
Target name:
Monoamine Oxidase Inhibitors (MAOIs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The combination of modafinil with MAOIs can lead to a dangerous increase in blood pressure (hypertensive crisis) due to excessive sympathomimetic effects.
Actionable advice:
Avoid using modafinil with MAOIs or within 14 days of stopping an MAOI.
Target id:
/class/cyp3a4-substrates
Target name:
Medications Metabolized by CYP3A4
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil is a moderate inducer of the CYP3A4 enzyme, which accelerates the breakdown of many medications (e.g., certain statins, benzodiazepines, immunosuppressants), reducing their effectiveness.
Actionable advice:
Consult a healthcare provider as dose adjustments or alternative medications may be necessary.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil use during pregnancy may be associated with an increased risk of congenital malformations, including cardiac anomalies and orofacial clefts.
Actionable advice:
Avoid using modafinil if you are pregnant or planning to become pregnant.
Target id:
/condition/cardiovascular-disease
Target name:
History of Heart Problems (e.g., Arrhythmia, Uncontrolled Hypertension)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil can increase heart rate and blood pressure, which may pose a significant risk for individuals with pre-existing cardiovascular conditions.
Actionable advice:
Avoid use in patients with a history of arrhythmia, uncontrolled high blood pressure, or other significant heart conditions.
Target id:
/condition/hepatic-impairment
Target name:
Severe Liver Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The liver is the primary site of modafinil metabolism; severe impairment can lead to significantly increased drug levels and a higher risk of side effects.
Actionable advice:
The dose should be reduced, typically by half, in individuals with severe hepatic impairment.
Target id:
/class/cyp2c19-substrates
Target name:
Medications Metabolized by CYP2C19
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil inhibits the CYP2C19 enzyme, which can slow the breakdown of certain drugs (e.g., omeprazole, phenytoin, diazepam), increasing their levels and risk of side effects.
Actionable advice:
Monitor for increased side effects of co-administered drugs; dose adjustments may be needed.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Warfarin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil may weakly inhibit CYP2C9, potentially slowing the metabolism of warfarin and increasing its anticoagulant effect, which raises the risk of bleeding.
Actionable advice:
Monitor INR (blood clotting time) closely when starting, stopping, or changing the dose of modafinil.
Target id:
/class/stimulants
Target name:
Other Stimulant Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining modafinil with other stimulants (e.g., amphetamines, methylphenidate) can lead to additive effects, increasing the risk of anxiety, insomnia, heart palpitations, and high blood pressure.
Actionable advice:
Avoid co-administration unless specifically prescribed and monitored by a healthcare provider.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The interaction between modafinil and alcohol is not well studied, but it may lead to unpredictable effects, impaired judgment, or an increased risk of adverse reactions.
Actionable advice:
It is generally recommended to avoid consuming alcohol while taking modafinil.
Target id:
/condition/bipolar-disorder
Target name:
Bipolar Disorder or History of Psychosis
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil can induce or exacerbate mania, delusions, hallucinations, and suicidal ideation in susceptible individuals.
Actionable advice:
Use with extreme caution and close monitoring in patients with a history of psychosis, depression, or mania.
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil may lower the seizure threshold, potentially increasing the risk of seizures in susceptible individuals or interfering with anticonvulsant medications.
Actionable advice:
Use with caution in individuals with a history of seizures.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if modafinil passes into breast milk, but due to its stimulant properties, there is a potential for adverse effects like irritability and poor sleep in the nursing infant.
Actionable advice:
Use should be avoided while breastfeeding due to potential risks to the infant.
Target id:
/circadian/wake
Target name:
Waking Up
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
null
Hours after target:
1
Description:
Taking modafinil upon waking aligns its peak effects with the desired period of wakefulness and minimizes impact on subsequent nighttime sleep.
Actionable advice:
Take your dose within one hour of waking up for optimal effect.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
1
Description:
Taking modafinil with food, especially a high-fat meal, can delay its absorption and the onset of its effects by approximately one hour, but does not reduce its overall effectiveness.
Actionable advice:
For the fastest onset of action, take on an empty stomach.
Target id:
/intervention/caffeine
Target name:
Caffeine
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Caffeine has additive stimulant effects with modafinil, which can increase the likelihood of side effects like jitteriness, anxiety, and increased heart rate.
Actionable advice:
Be mindful of caffeine intake and reduce it if you experience increased side effects.
Target id:
/class/cyp1a2-substrates
Target name:
Medications Metabolized by CYP1A2
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil is a weak inducer of the CYP1A2 enzyme, which could slightly increase the metabolism and decrease the effectiveness of drugs like theophylline or caffeine.
Actionable advice:
Be aware of a potential mild reduction in effect for drugs metabolized by CYP1A2.
Target id:
/class/tricyclic-antidepressants
Target name:
Tricyclic Antidepressants (e.g., Clomipramine, Desipramine)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Modafinil may increase levels of certain TCAs by inhibiting their metabolism, leading to a higher risk of side effects like dry mouth, constipation, and cardiac issues.
Actionable advice:
Monitor for TCA side effects and consider dose reduction if used concurrently.