Modafinil Disease Interactions
There are 7 disease interactions with modafinil.
- Cardiac disease
- Hypertension
- Psychiatric disorders
- Liver disease
- Renal dysfunction
- Seizure disorders
- Cardiovascular
CNS stimulants (applies to modafinil) cardiac disease
Major Potential Hazard, Moderate plausibility. Applicable conditions: Heart Disease, Pheochromocytoma, Hyperthyroidism
Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.
CNS stimulants (applies to modafinil) hypertension
Major Potential Hazard, Moderate plausibility.
CNS stimulants increase blood pressure and heart rate; the use of some agents may be contraindicated in patients with severe/uncontrolled hypertension. Caution should be used when administering to patients with preexisting high blood pressure (even mild hypertension) and other cardiovascular conditions. All patients under treatment should be regularly monitored for potential tachycardia and hypertension.
CNS stimulants (applies to modafinil) psychiatric disorders
Major Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis, Depression
The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.
CNS stimulants (applies to modafinil) liver disease
Moderate Potential Hazard, Moderate plausibility.
In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly in certain agents. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury; laboratory testing should be done at the first sign/symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.
CNS stimulants (applies to modafinil) renal dysfunction
Moderate Potential Hazard, Moderate plausibility.
Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly in certain agents.
CNS stimulants (applies to modafinil) seizure disorders
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures
Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with history of seizures, with prior electroencephalogram (EEG) abnormalities without seizures, and very rarely, without history of seizures and no prior EEG evidence of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures occur, therapy should be discontinued.
Modafinil (applies to modafinil) cardiovascular
Moderate Potential Hazard, Low plausibility. Applicable conditions: Cardiovascular Disease, Cerebral Vascular Disorder
In clinical trials, a few patients treated with modafinil developed chest pain, palpitations, dyspnea and transient ischemic T-wave changes in association with mitral valve prolapse or left ventricular hypertrophy. The manufacturer recommends that modafinil not be used in patients with a history of left ventricular hypertrophy or ischemic ECG changes, chest pain, arrhythmia or other clinically significant manifestations of mitral valve prolapse in association with central nervous system (CNS) stimulant use. In addition, caution is advised in patients with cardiovascular disease due to other causes, particularly hypertension and/or a recent history of myocardial infarction or unstable angina, since the use of modafinil has not been evaluated in such patients.
Modafinil drug interactions
There are 508 drug interactions with modafinil.
Modafinil alcohol/food interactions
There are 3 alcohol/food interactions with modafinil.
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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