Modafinil + St. Johns Wort

MODERATE — Monitor Closely

🟡 USE CAUTION — St. Johns Wort and Modafinil may interact. Talk to your doctor before combining.

Evidence level: LIMITED

What this interaction means

St. John's Wort may make Provigil less effective by speeding up its breakdown.

How it works (mechanism)

CYP3A4 induction may reduce modafinil levels.

Practical advice

St. Johns Wort can affect how your body processes Modafinil. Your doctor may need to monitor drug levels or adjust doses of Modafinil while you're also taking St. Johns Wort.

Timing

Take Modafinil in the morning — stimulants should be taken early to avoid insomnia. St. Johns Wort can be taken at a separate time. Stimulating botanicals (guarana, yerba mate) amplify cardiovascular effects — use caution. Calming adaptogens (ashwagandha, lemon balm) can balance stimulant side effects when taken in the afternoon.

Risk factors

Higher risk with: liver impairment, genetic CYP enzyme variations (poor or ultra-rapid metabolizers), older age, polypharmacy (many medications).

Symptoms to watch for

Watch for signs of altered drug metabolism: either increased side effects (drug levels too high) or decreased effectiveness (drug levels too low). Report any changes to your doctor.

What to tell your doctor

Mention this combination at your next appointment. Ask: "Should I adjust timing or doses of St. Johns Wort and Modafinil?" Your doctor may want to monitor specific lab values.

Safer alternatives

Stimulant combinations can increase cardiovascular strain. Reduce caffeine intake and avoid other stimulating supplements. Discuss with your prescriber: non-stimulant ADHD options (atomoxetine, guanfacine) or L-theanine for focus without the sympathomimetic load.

Frequently asked questions

Can I take Modafinil and St. Johns Wort together?

St. John's Wort may make Provigil less effective by speeding up its breakdown.

When should I take Modafinil vs St. Johns Wort?

Take Modafinil in the morning — stimulants should be taken early to avoid insomnia. St. Johns Wort can be taken at a separate time. Stimulating botanicals (guarana, yerba mate) amplify cardiovascular effects — use caution. Calming adaptogens (ashwagandha, lemon balm) can balance stimulant side effects when taken in the afternoon.

What symptoms should I watch for if I combine Modafinil and St. Johns Wort?

Watch for signs of altered drug metabolism: either increased side effects (drug levels too high) or decreased effectiveness (drug levels too low). Report any changes to your doctor.

Are there safer alternatives to combining Modafinil with St. Johns Wort?

Stimulant combinations can increase cardiovascular strain. Reduce caffeine intake and avoid other stimulating supplements. Discuss with your prescriber: non-stimulant ADHD options (atomoxetine, guanfacine) or L-theanine for focus without the sympathomimetic load.

What should I tell my doctor about taking Modafinil and St. Johns Wort?

Mention this combination at your next appointment. Ask: "Should I adjust timing or doses of St. Johns Wort and Modafinil?" Your doctor may want to monitor specific lab values.

Explore more interactions

Or browse the full interaction database (121,000+ pairs).