Modafinil Affects Birth Control: True or False?

Modafinil Affects Birth Control: True or False? : Certain meds may feature sex-specific pharmacological profiles. Consequently, it’s crucial to comprehend their exceptional pharmacokinetic properties to optimize women’s health. Taking some meds like modafinil (Provigil) or cimetidine (Tagamet) without first learning about their negative effects and probable drug interactions may be dangerous.

Women may be putting themselves at risk of unintended pregnancy while combining the most popular wake-promoting drug modafinil and birth control pills, as there is a drug interaction between this medicine & hormonal contraception.

This guide covers modafinil’s effect, how it interacts with birth control methods, whether it’s OK to use the barrier method while administering modafinil, and what to expect if combining modafinil and birth control pills.

What Is Modafinil, and How Does It Work?

Modafinil, sold under the brand name Provigil, is a wake-fostering agent. It is effective in treating narcolepsy, shift work sleep disorder, and obstructive sleep apnea. The Food and Drug Administration (FDA) approved it for these disorders [1]. Physicians often prescribe it off-label as the most effective medicine to treat jet lag, attention deficit hyperactivity disorder, Alzheimer’s disease, depression, memory decline in elderly people, Parkinson’s disease, chronic fatigue syndrome, and several other health conditions. In a placebo-controlled study regarding modafinil treatment of fatigue in patients with amyotrophic lateral sclerosis (ALS), the drug proves to be very effective [2].

Although modafinil’s exact mode of action is not fully understood, it’s thought to alter the concentrations of some chemicals in the brain called neurotransmitters. Modafinil augments the levels of serotonin, histamine, orexin, and norepinephrine in the brain. Also, it binds to the dopamine transporter and inhibits dopamine reuptake, thus augmenting its concentrations.

Modafinil is often used off-prescription by healthy individuals such as students, business executives, military personnel, astronauts, and professionals to power their brain function & boost productivity. This “smart tab” effectively ameliorates memory and attention, improves mental acuity, heightens vigilance & alertness, and increases concentration & focus. Furthermore, the drug positively affects motivation and mood.

FDA’s regulation of modafinil as a Schedule IV controlled substance under the US federal law is because it’s considered to have a lower potential for abuse compared to traditional stimulants, and it’s unlikely to cause addiction. It is safe and well-tolerated, but like any other drug, it’s linked with side effects and contraindications. Never mix it with other meds without a recommendation from a physician.

What Is the Problem with Modafinil and Birth Control Methods?

Modafinil interacts with specific types of contraceptives, making them less efficacious, which increases the likelihood of getting pregnant [3]. The “smart tab” can also induce birth defects in an unborn child and certainly must never be administered if planning to become pregnant. Concerning modafinil and birth control, it’s extremely necessary to make sure you’re using the right contraceptive method when taking the “smart drug.”

Modafinil is understood as an enzyme-inducer, which implies it augments the action of enzymes in the liver that are also used to break down the contraceptive. When the action of these enzymes is augmented, the contraceptive in the body is broken down rapidly, giving it less time to function. In this case, drug interaction between modafinil and ethinylestradiol (a synthetic estrogen) exists, most likely via the CYP3A4 enzyme pathway. It’s conceivable that this interaction could also impact progestogens.

Some trials have investigated other meds that are also enzyme-inducers with contraceptives, and there is evidence to show that contraceptives become less efficacious with these enzyme-inducers. A decrease in birth control pills’ efficacy is a possibility with modafinil. It could consequently reduce the contraceptive effectiveness of combined hormonal contraceptives (the combined tab, patch, and vaginal ring), the progestogen-only tab, and the subdermal implant.

Can You Use the Barrier Method While Taking Modafinil?

The barrier methods, which include diaphragms, condoms, caps that can be used alongside a spermicide, and the female condom Femidom®, are deemed less dependable forms of contraception. Although they don’t interact with the “smart tab,” using them alone may not prevent you from being pregnant. We recommend that you don’t depend on these options while administering modafinil.

You must persist in using efficacious contraception as long as you are taking this wake-promoting medicine. If you quit the drug for any reason, you must continue using an effective contraceptive for two months after quitting. The reason is that your body requires time for the enzyme action, which modafinil interferes with, to just return to normal.

Modafinil & Birth Control Pills: Is It Worth the Risk?

Modafinil can inhibit the activity of low-dose oral contraceptives and can compel the liver to metabolize hormones quicker. This may lead to breakthrough bleeding, spotting, or pregnancy [4].

Further, modafinil can be linked with a significantly augmented peril for malformation [5][6]. It may cause birth defects in an unborn child. These include lip & cleft palate, heart defects, and other abnormalities affecting boys. You shouldn’t administer the “smart tab” if planning to become pregnant. Talk to your physician about the conceivable alternatives to the “smart tab.” Besides, if you are already taking modafinil and plan to become pregnant, be sure to discuss this with your doctor as soon as possible. This is to arrange how you can safely stop taking modafinil and manage your sleep disorder signs.

Note that the “smart tab” is in pregnancy category C. It should only be used in pregnant or nursing females if the advantages outweigh the perils. However, one reassuring study discovered that modafinil use isn’t associated with an increase in the incidence of birth defects [7]. In any case, consulting a doctor before taking any medicine is paramount.

Resume

If using oral contraceptives, be aware that modafinil lessens the efficacy of the pills. Birth control methods may not work as well when co-administered with this wake-promoting med, thus increasing the chance of getting pregnant. If you’re prescribed the “smart tab,” inform your physician which contraceptive you are using. In some cases, alternative options should be considered. Failure to tell can lead to irreversible consequences.

References

By Karl Greenblatt and Ninos Adams. Last update: February 22, 2022. Retrieved: September 13, 2022. Ncbi.nlm.nih.gov.
Modafinil Treatment of Fatigue in Patients with ALS: A Placebo-Controlled Study. By Judith G. Rabkin, Paul H. Gordon, Martin McElhiney, et al. Published: February 10, 2009. Onlinelibrary.wiley.com.
Sleep Medications and Women: A Review of Issues to Consider for Optimizing the Care of Women with Sleep Disorders. Andrew Krystal & Hrayr Attarian. Published: October 26, 2016. Link.springer.com.
Armodafinil; Modafinil/Steroidal Contraceptives Interactions. Retrieved: September 13, 2022. Webmd.com.
New (But Still Not Enough) Data on Modafinil and Pregnancy. By MGH Center for Women’s Mental Health. Published: October 20, 2020. Womensmentalhealth.org.
Sleep Disorder Drug Modafinil Linked to Increased Risk of Birth Defects and Also to Reduced Effectiveness of Contraception. Published: November 16, 2020. Gov.uk.
Narcolepsy Drug Doesn’t Raise Odds for Birth Defects: Study. By Robert Preidt. Published: September 4, 2020. Usnews.com.