Provigil interactions: Alcohol, medications, and other factors

Provigil interactions with other medications

Before you start treatment with Provigil, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Provigil interacts with supplements, herbs, or vitamins, see the “Provigil and other interactions” section below.)

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

Here’s a table of drugs that can interact with Provigil. Keep in mind that this table doesn’t include all drugs that may interact with Provigil. Some of these interactions are described in detail just below in “Drug interactions in depth.”

When to avoid Provigil

In some cases, factors or conditions could prevent your doctor from prescribing Provigil due to the risk of harm. These are known as contraindications. The contraindications of Provigil include:

Having had an allergic reaction to Provigil or any of its ingredients

If you have had an allergic reaction to Provigil or any of its ingredients, your doctor will likely not prescribe Provigil. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Provigil, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Provigil.

Provigil interaction with alcohol

Your doctor will likely recommend that you not drink alcohol while taking Provigil. They’ll also usually advise you not to take any prescription or over-the-counter drugs that contain alcohol during Provigil treatment.

Alcohol can worsen excessive sleepiness, which you’re receiving Provigil to treat. This can make Provigil less effective. In addition, the safety of consuming alcohol while taking Provigil hasn’t been studied.

If you have concerns about avoiding alcohol while you’re taking Provigil, talk with your doctor before starting treatment.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Provigil.

Estrogens and progestins

Provigil can interact with estrogen and progestin medications, which are used to prevent pregnancy, treat symptoms of menopause, and many other uses.

Interaction result: Provigil can make estrogens and progestins less effective.

Interaction explained: Provigil can increase the activity of enzymes (a special type of protein) that break down estrogens and progestins. This can lower the level of estrogens or progestins in your system, which can make the medication less effective.

Examples of medications that contain estrogens, progestins, or both: Here are some medications that contain estrogens, progestins, or both and that may interact with Provigil:

• ethinyl estradiol/desogestrel (Bekyree, others)
• ethinyl estradiol/levonorgestrel (Ashlyna, Jaimiess, others)
• ethinyl estradiol/norethindrone (Activella, Cyonanz, others)
• levonorgestrel (Mirena, others)
• estradiol/drospirenone (Angeliq)

Steps you or your doctor may take: If you are taking an estrogen or progestin as birth control, your doctor will likely suggest using an alternative method of birth control while you’re taking Provigil, and for at least one month after your last Provigil dose if you stop treatment.

If you’re using an estrogen or progestin for uses other than preventing pregnancy, your doctor may increase the dose of the estrogen/progestin medication. Or, they may suggest exploring other treatments for your condition which don’t interact with Provigil. Finally, they may suggest exploring a treatment for excessive sleepiness other than Provigil that doesn’t interact with estrogens/progestins.

Certain benzodiazepines

Provigil may interact with certain benzodiazepines, which are prescribed for treating anxiety, seizures, insomnia, and other conditions.

Interaction result: Depending on the benzodiazepine, Provigil can make certain benzodiazepines more or less effective.

Interaction explained: Provigil can increase or decrease the activity of enzymes (a special type of protein) which break down certain benzodiazepines. This interaction differs based on the specific benzodiazepine.

Provigil may increase the activity of enzymes which break down midazolam and triazolam, for example. This can make midazolam or triazolam less effective.

On the other hand, Provigil may decrease the activity of enzymes which break down diazepam. This can increase the level of diazepam in your system, and raise your risk for side effects diazepam may cause.

Examples of benzodiazepine drugs: Here are some benzodiazepines that may interact with Provigil:

• alprazolam (Xanax)
• diazepam (Valium, others)
• midazolam (Nayzilam, Seizalam)
• triazolam (Halcion)

Steps you or your doctor may take: If you take a benzodiazepine listed above and are prescribed Provigil, your doctor may suggest trying a different benzodiazepine that doesn’t interact with Provigil. Or, they may adjust the dose of the benzodiazepine that interacts with Provigil.

Certain statins

Provigil can interact with certain statins, which are prescribed to treat high cholesterol, among other uses.

Interaction result: Provigil can make certain statins less effective.

Interaction explained: Provigil can increase the activity of enzymes (a special type of protein) which break down certain statins after you take a dose. This can lower the level of the statin in your system, which can make it less effective.

Examples of statin drugs: Here are specific statins that may interact with Provigil:

• atorvastatin (Lipitor, Atorvaliq)
• lovastatin (Altoprev)
• simvastatin (Zocor, Flolipid)

Steps you or your doctor may take: If you take atorvastatin, lovastatin, or simvastatin and are prescribed Provigil, your doctor may increase your atorvastatin, lovastatin, or simvastatin dosage. There are other statins available besides these which do not interact with Provigil. So, your doctor could also suggest switching to a different statin which doesn’t interact with Provigil.

Provigil and other interactions

Provigil may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Provigil.

Provigil interactions with supplements

Before you start treatment with Provigil, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

In addition to interactions described below, Provigil may interact with supplements that contain caffeine. To learn more about the interaction between Provigil and caffeine, see the “Provigil interactions with food” section. Some supplements used for athletic performance, such as pre-workout supplements, may contain caffeine.

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

Provigil interactions with herbs

Doctors may recommend you avoid taking St. John’s wort with Provigil. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may affect how well your body absorbs drugs that have actions similar to Provigil. And this may lead to a low level of Provigil in your system. If the level of Provigil in your system is too low, the drug may not work to treat excessive sleepiness.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Provigil interactions with vitamins

There are no specific reports of vitamins interacting with Provigil. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Provigil.

Provigil interactions with food

Provigil may interact with caffeine. Consuming too much caffeine while taking Provigil can increase the risk of side effects, including irritability, nervousness, and insomnia. Examples of foods and beverages that contain caffeine include:

• coffee
• tea
• chocolate
• energy drinks

Because of this interaction, your doctor will likely recommend limiting how much caffeine you consume during Provigil treatment. Also, talk with your doctor about any medications you may take that contain caffeine, such as acetaminophen/aspirin/caffeine (Excedrin Extra Strength).

Grapefruit and grapefruit juice can also interact with Provigil. Specifically, grapefruit products can stop your body from breaking down Provigil. This raises the level of Provigil in your body, which increases your risk of side effects from Provigil.* Due to this risk, your doctor may recommend not consuming grapefruit and grapefruit juice while taking the drug. Or, they may suggest not altering your intake of grapefruit or grapefruit juice during treatment.

* For details about Provigil’s side effects, see this article.

If you’d like to learn more about eating certain foods during treatment with Provigil, talk with your doctor.

Provigil interactions with vaccines

There aren’t any known interactions between Provigil and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Provigil interactions with lab tests

Provigil isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.

PROVIGIL INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Provigil. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Provigil.

The impact of cannabis may affect how well you stick to your Provigil treatment plan. And, based on how Provigil works, cannabis could impact how well Provigil treats excessive sleepiness.

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

Certain medical conditions and other factors may increase the risk of interactions with Provigil. Before you take this drug, be sure to talk with your doctor about your health history. Provigil may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Provigil include:

• Heart problems, such as high blood pressure or past heart attack: Provigil can cause heart-related side effects, including increased blood pressure and chest pain. Be sure to tell your doctor about your heart health and any heart problems you may have before you begin taking Provigil. Your doctor may want to monitor your heart health closely if they prescribe Provigil to you.
• Severe kidney condition, such as end stage kidney disease: Having a severe kidney condition, such as end stage kidney disease, can make it harder for your body to get rid of Provigil. This can raise the level of Provigil in your system, raising your risk of side effects of Provigil. Your doctor can help determine whether it’s safe for you to take Provigil.
• Liver condition, such as cirrhosis: If you have a severe liver condition, such as cirrhosis, your doctor may prescribe a lower Provigil dose to you. Severe liver problems can affect how well your body breaks down Provigil after you take a dose. This can raise the level of Provigil in your system, raising your risk for side effects of Provigil.
• Mental health condition, such as psychosis: Provigil can rarely cause side effects related to mental health, including hallucinations, delusions, and suicidal ideation. You may be at higher risk for these side effects if you have an existing mental health condition, such as depression or psychosis. Your doctor can help determine whether you can safely take Provigil.
• Substance misuse disorder, such as alcohol use disorder: Provigil is a controlled substance, which means it has potential for drug misuse, dependence, and addiction. If you have a substance use disorder, you may be at higher risk for these effects if you take Provigil. Your doctor can help determine whether Provigil is safe for you to take.
• Allergic reaction: If you’ve had an allergic reaction to Provigil or any of its ingredients, your doctor will likely not prescribe Provigil. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Provigil while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Provigil may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Provigil. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Provigil is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss when used at very high doses. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Provigil. They can advise you on the right treatment plan for you.

Preventing interactions

You can take certain steps to help prevent interactions with Provigil. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Provigil label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork sometimes called the medication guide or patient package insert, may contain details about interactions.

If Provigil doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Provigil by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.