Puravive - Nuvigil (Armodafinil) Interaction

Interaction Details

Armodafinil is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Armodafinil is classified as belonging to the following category: P-Glycoprotein Substrates

Puravive contains quercetin. Theoretically, concurrent use of quercetin and P-glycoprotein substrates might alter the effects and adverse effects of the drugs. There is preliminary evidence suggesting that quercetin inhibits the P-glycoprotein efflux pump in the gastrointestinal tract. This inhibition could potentially increase the bioavailability and serum levels of drugs transported by this pump. For example, a small study in healthy volunteers found that pretreatment with quercetin increased bioavailability and plasma levels following a single dose of cyclosporine (Neoral, Sandimmune) (source: https://pubmed.ncbi.nlm.nih.gov/15581264/). However, other small studies have shown that quercetin might decrease the absorption of talinolol, another substrate of the gastrointestinal P-glycoprotein efflux pump. Interestingly, several days of quercetin treatment did not significantly affect the pharmacokinetics of saquinavir (Invirase) in another small study (source: https://pubmed.ncbi.nlm.nih.gov/16945047/). The reason for these discrepancies is not entirely clear. Until more is known, it is advisable to use quercetin cautiously in combination with P-glycoprotein substrates.

Interaction Rating

Likelihood of Occurrence

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists

Interaction Details

Armodafinil is classified as belonging to the following category: Stimulant Drugs

Puravive contains Panax ginseng. Panax ginseng has demonstrated stimulant effects in some studies, which could potentially heighten the effects of other stimulant drugs (source: https://pubmed.ncbi.nlm.nih.gov/8879982/). It is unlikely this would result in a significant risk of side effects, but it is important to be aware of.

Interaction Rating

Likelihood of Occurrence

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Armodafinil Overview

• Armodafinil is used to treat excessive sleepiness caused by narcolepsy (a condition that causes excessive daytime sleepiness) or shift work sleep disorder (sleepiness during scheduled waking hours and difficulty falling asleep or staying asleep during scheduled sleeping hours in people who work at night or on rotating shifts). Armodafinil is also used along with breathing devices or other treatments to prevent excessive sleepiness caused by obstructive sleep apnea/hypopnea syndrome (OSAHS; a sleep disorder in which the patient briefly stops breathing or breathes shallowly many times during sleep and therefore does not get enough restful sleep). Armodafinil is in a class of medications called wakefulness-promoting agents. It works by changing the amounts of certain natural substances in the area of the brain that controls sleep and wakefulness.

Puravive - More Interactions

Puravive interacts with 1188 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.