Taking Modafinil When You Are On Birth Control Pills
Modafinil can inhibit the action of oral contraceptives and can cause
the liver to metabolize hormones faster.
Women who use low dosage oral contraceptives (steroidal drugs) should
be aware that Provigil (Modafinil) may decrease the effectiveness of oral
contraceptives. Experts recommend using another form of birth control
while taking modafinil and for at least one month after you stop taking
modafinil. Embryotoxic effects have been observed in some, but not all
animal studies and there were never adequate clinical trials in pregnant
women to establish safety.
A scientific study showed that the pharmacokinetics of steady-state ethinyl
estradiol (ethinylestradiol) and single-dose triazolam were altered by
taking Provigil. In the study, the modafinil treatment group had a marked
decrease in maximum observed plasma concentrations and areas under the
plasma concentration-time curve for triazolam relative to placebo, with
a much smaller decrease in these parameters for ethinyl estradiol. The
half-life of triazolam was also decreased, but the half-life of ethinyl
estradiol did not appear to be affected by treatment with modafinil.
The researchers concluded that Modafinil induced CYP3A4/5 activity in
humans in vivo, suggesting that there is potential for metabolic drug-drug
interactions between modafinil and substrates of CYP3A4/5. However, the
induction appeared to be more gastrointestinal than hepatic in nature.
Oral birth control pills mentioned here are also called steroid contraceptives
(birth control medicines, including birth control pills and implants (e.g.,
Norplant) It is important that you use another method of birth control
to avoid pregnancy during and for a month after modafinil therapy.
Oral and implantable contraceptives are less effective while you are
taking modafinil. You should use an additional method of contraception
while you are taking Provigil and for one month after discontinuing this
medication.
Note also that modafinil is in pregnancy category C. The medical community
feels it should only be used in pregnant or nursing women if the benefits
outweigh the risks. A reassuring study in 2020 found nodafinil use is not associated with an increase in incidence of birth defects. Consult your doctor.
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