Provigil Interactions: Alcohol, Medications, and Others

Does Provigil interact with other drugs?

Before you start taking Provigil, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Provigil interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Provigil?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Provigil. Keep in mind that this table doesn’t include all drugs that may interact with Provigil. For more information about some of these interactions, see the “Drug interactions explained” section below.

* See the “Drug Interactions Explained” section below to learn more.

When should I avoid Provigil?

Certain health conditions or other factors could raise your risk of harm if you take Provigil. In such cases, your doctor may not prescribe Provigil for you. These are known as contraindications. The list below includes contraindications of Provigil.

If you’ve had an allergic reaction. If you’ve had an allergic reaction to Provigil or any of its ingredients, your doctor likely won’t prescribe Provigil. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

If you’ve had an allergic reaction to Nuvigil. If you’ve had an allergic reaction to a drug called Nuvigil (armodafinil), your doctor likely won’t prescribe Provigil. This is because Provigil and Nuvigil are similar, and if you’re allergic to one of these drugs, you may also be allergic to the other drug. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Provigil, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Provigil is safe for you to take.

Does Provigil interact with alcohol?

You should not drink alcohol while taking Provigil. The effects of drinking alcohol while taking Provigil were not looked at in studies. Provigil is used to increase wakefulness, but alcohol can make you feel sleepy. Alcohol may reduce the effect of Provigil.

Alcohol and Provigil also cause similar side effects. These include nausea, headache, and dizziness. You may be more likely to have these side effects if you drink alcohol with Provigil.

If you have questions about consuming alcohol while taking Provigil, talk with your doctor or pharmacist.

Drug interactions explained

Learn more about certain drug interactions that can occur with Provigil.

Interaction with certain forms of hormonal birth control

Provigil can interact with certain forms of hormonal birth control. Examples of birth control medications that can interact with Provigil include:

• combination pills, such as drospirenone/ethinyl estradiol (Yasmin, Yaz)
• minipills, such as norethindrone (Camila, Heather)
• patches, such as norelgestromin/ethinyl estradiol (Xulane)
• vaginal rings, such etonogestrel/ethinyl estradiol (NuvaRing) and segesterone acetate/ethinyl estradiol (Annovera)
• implants, such as etonogestrel (Nexplanon)
• emergency contraceptives, such as levonorgestrel (Plan B) and ulipristal acetate (Ella)

What could happen

Provigil increases the activity of enzymes (proteins) that help remove certain drugs from your body, including the drugs in the birth control examples listed above. This causes the birth control drugs to be removed from your body faster than usual. With less drug in your body, these forms of birth control are less effective at preventing pregnancy.

What you can do

If you take Provigil with a hormonal form of birth control, talk with your doctor. Your doctor may recommend using an additional form of birth control, such as condoms, to prevent pregnancy. Or they may recommend switching to a form of hormonal birth control that’s not affected by Provigil, such as Depo-Provera or Mirena.

Provigil’s effect on the drugs in hormonal birth control lasts for a month after you stop taking Provigil. So you should continue using a backup method of birth control for at least 1 month after you stop taking Provigil.

If you need emergency contraception while taking Provigil, see your doctor as soon as possible. Your doctor will likely recommend the Paragard (copper) intrauterine device rather than a hormonal emergency contraceptive.

If you have questions about preventing pregnancy during treatment with Provigil, talk with your doctor or pharmacist.

Interaction with drugs broken down by certain liver enzymes

Provigil can interact with drugs broken down by a certain liver enzyme called cytochrome P450 2C19 (CYP2C19). Examples of medications that are broken down by CYP2C19 include:

• clomipramine (Anafranil)
• diazepam (Valium)
• omeprazole (Prilosec)
• phenytoin (Dilantin, Phenytek)
• propranolol (Inderal LA, Innopran XL)

What could happen

Provigil slows down the activity of the CYP2C19 liver enzyme. Taking Provigil with drugs that are broken down by this liver enzyme can cause these drugs to build up in your body. This can raise your risk of side effects with these drugs.

What you can do

If you take Provigil with a drug that’s broken down by the CYP2C19 liver enzyme, your doctor may prescribe a lower dosage of that drug. They may also ask you to watch for side effects from that drug. Side effects could be a sign that the drug is building up in your body.

If you have questions about taking Provigil with one of these drugs, talk with your doctor or pharmacist.

Interaction with cyclosporine

Provigil can interact with cyclosporine (Neoral, Sandimmune, others). Cyclosporine is an immunosuppressant and is prescribed to weaken the immune system. It can be used to treat certain immune system conditions, such as rheumatoid arthritis and psoriasis. It may also be used to help prevent organ rejection following an organ transplant.

What could happen

Provigil can increase the activity of certain enzymes that help clear cyclosporine from your body.

If you take Provigil with cyclosporine, it could make cyclosporine less effective than usual.

What you can do

If you take Provigil with cyclosporine, your doctor may carefully monitor your cyclosporine blood level. If your level is low, they may prescribe a higher dosage of cyclosporine.

If you have questions about taking Provigil with cyclosporine, talk with your doctor or pharmacist.

Are there other interactions with Provigil?

Provigil may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Provigil.

Does Provigil interact with supplements?

Before you start taking Provigil, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Provigil interactions with herbs

Provigil can interact with St. John’s wort, an herbal supplement used to ease symptoms of depression and other conditions.

Taking Provigil with St. John’s wort could make Provigil less effective than usual. Talk with your doctor before taking Provigil with this herbal supplement.

Provigil and vitamins

There are currently no reports of Provigil interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Provigil.

Does Provigil interact with food?

Yes, Provigil can interact with certain foods and drinks. For example, Provigil can interact with:

• grapefruit and grapefruit juice
• foods and drinks with caffeine, such as coffee, certain sodas, black and green tea, chocolate, and energy drinks

Consuming these foods or drinks with Provigil could raise your risk of side effects from Provigil. Talk with your doctor about whether you should avoid them while taking Provigil.

Does Provigil interact with vaccines?

There are currently no reports of Provigil interacting with vaccines. If you have questions about getting certain vaccines during your Provigil treatment, talk with your doctor.

Does Provigil interact with lab tests?

There are currently no reports of Provigil interacting with lab tests. If you have questions about having certain lab tests during your treatment with Provigil, talk with the healthcare professional ordering the test.

Does Provigil interact with cannabis or CBD?

There are currently no reports of Provigil interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Provigil.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take Provigil?

Certain medical conditions or other health factors may raise the risk of interactions with Provigil. Before taking Provigil, talk with your doctor about your health history. They’ll determine whether Provigil is right for you.

Health conditions or other factors that might interact with Provigil include:

Mental health conditions. Provigil can sometimes cause mental health side effects, such as anxiety, depression, paranoia, mania, and suicidal thoughts. If you’ve had a mental health condition in the past, you may have an increased risk of experiencing these side effects. Talk with your doctor about whether Provigil is right for you.

Certain heart conditions. Provigil may cause chest pain, shortness of breath, and palpitations (skipped or extra beats) in people with an enlarged left ventricle or mitral valve prolapse. If you’ve received a diagnosis with one of these heart conditions, or if you’ve ever had a heart attack, talk with your doctor about whether Provigil is right for you.

High blood pressure. Provigil may increase your blood pressure. If you already have high blood pressure, talk with your doctor about whether Provigil is right for you.

Liver problems. Your liver is responsible for clearing Provigil from your body. If you have liver problems, the medication could build up in your body. This could raise your risk of side effects from Provigil. If you have severe liver problems, your doctor will likely prescribe a lower dosage of Provigil for you.

Past drug or alcohol misuse or dependence. Provigil is a controlled substance that has a risk of misuse and dependence. (Misuse refers to taking a drug in a way other than how a doctor prescribes it. And with dependence, your body needs the drug to function as usual.) If you’ve misused or been dependent on drugs or alcohol in the past, talk with your doctor about whether Provigil is right for you.

Pregnancy. It’s not known whether Provigil is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Provigil.

If you do take Provigil while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects information about the effect of Provigil on pregnancy outcomes. To learn more, call 1-866-404-4106 or talk with your doctor.

Breastfeeding. It’s not known whether it’s safe to take Provigil while breastfeeding. It’s not known if the drug passes into breast milk. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction. If you’ve had an allergic reaction to Provigil, to any of its ingredients, or to a similar drug called armodafinil (Nuvigil), your doctor will likely not prescribe Provigil. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Common questions about Provigil and interactions

Find answers to some frequently asked questions about Provigil and possible interactions.

Does Provigil have interactions with SSRIs?

Provigil doesn’t usually interact with selective serotonin reuptake inhibitors (SSRIs).

Provigil is prescribed to treat excessive daytime sleepiness caused by certain sleep problems in adults. SSRIs are prescribed to treat depression and anxiety disorders in adults and some children. Examples of SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).

It’s not uncommon for doctors to prescribe these drugs together. However, an interaction is possible in people who have low levels of a certain liver enzyme called cytochrome P450 2D6 (CYP2D6). This is a rare condition. In someone with this condition, taking Provigil with an SSRI could increase the risk of side effects from the SSRI.

If you have questions about taking Provigil with an SSRI, talk with your doctor or pharmacist.

Is there an interaction between Provigil and venlafaxine?

No, Provigil isn’t known to interact with venlafaxine (Effexor XR).

Provigil is prescribed to treat excessive daytime sleepiness caused by certain sleep problems in adults. Venlafaxine is prescribed to treat depression and certain anxiety disorders in adults and some children.

It’s not uncommon for doctors to prescribe these drugs together. However, venlafaxine can make some people feel sleepy. Provigil is used to increase wakefulness. If venlafaxine makes you sleepy, Provigil may not work as well for you.

If you have questions about taking Provigil with venlafaxine, talk with your doctor or pharmacist.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Provigil. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Provigil treatment.

It’s also important to understand Provigil’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Provigil, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Provigil exactly as prescribed can also help prevent interactions.

What should I ask my doctor?

If you still have questions about Provigil and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Could I still take Provigil even if it interacts with a health condition I have?
• If I take Provigil and have certain health conditions, will I be monitored more closely during treatment?
• Do I need to tell you if I start taking another medication or supplement during my Provigil treatment?
• Does Provigil have interactions with recreational drugs?

To learn more about Provigil, see these articles:

• Provigil (modafinil)
• Side Effects of Provigil: What You Need to Know
• Dosage Details for Provigil

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.