Drug interactions
Alprazolam + Modafinil
Severity: Minor
Alprazolam and Modafinil: minor interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Modafinil is wake-promoting and may partly offset alprazolam sedation, but it also weakly induces CYP3A4 and may lower alprazolam exposure. This could reduce anxiolytic effect, though the clinical impact is generally modest and variable.
What this interaction means in plain words
Alprazolam and Modafinil have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Alprazolam belongs to Central Nervous System; Modafinil belongs to Central Nervous System.
Why it happens
Modafinil weakly induces CYP3A4, which could increase alprazolam clearance, along with opposing pharmacodynamic effects on arousal.
What to do
Monitor for reduced anxiolytic response when modafinil is started and for rebound anxiety or sedation when it is stopped. Adjust the alprazolam dose only if clinically needed.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Modafinil?
MediHelp rates the interaction as minor. Alprazolam and Modafinil have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Modafinil is wake-promoting and may partly offset alprazolam sedation, but it also weakly induces CYP3A4 and may lower alprazolam exposure. This could reduce anxiolytic effect, though the clinical impact is generally modest and variable.
How serious is the interaction between Alprazolam and Modafinil?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced anxiolytic response when modafinil is started and for rebound anxiety or sedation when it is stopped. Adjust the alprazolam dose only if clinically needed.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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