Modafinil and Cyclosporine Ophthalmic: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Modafinil
Cyclosporine Ophthalmic
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced cycloSPORINE exposure and reduced efficacy of cycloSPORINE
Interaction Deep Dive
Concomitant use of cycloSPORINE (a CYP3A4 substrate) and modafinil (a CYP3A4 inducer) may result in decreased cycloSPORINE plasma concentrations. If concurrent therapy is required, monitor circulating cycloSPORINE levels and make appropriate dosage adjustments as necessary12. One case report has described an organ transplant recipient who experienced a 50% reduction in her cycloSPORINE blood levels following one month of therapy with modafinil 200 mg daily. It was postulated that modafinil induced the metabolism of cycloSPORINE, possibly through the cytochrome P450 3A4 system 3.
Why it happens (mechanism)
Induction of CYP3A4-mediated cycloSPORINE metabolism
Literature reports
1 report — tap to read
a) One case report has described an organ transplant recipient who experienced a 50% reduction in her cycloSPORINE blood levels following one month of therapy with modafinil 200 mg daily. It was postulated that modafinil induced the metabolism of cycloSPORINE, possibly through the cytochrome P450 3A4 system 3.
Common questions
Can I take Modafinil and Cyclosporine Ophthalmic together?
Reduced cycloSPORINE exposure and reduced efficacy of cycloSPORINE Always confirm with your pharmacist or prescriber before making any change.
How serious is the Modafinil and Cyclosporine Ophthalmic interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Modafinil or Cyclosporine Ophthalmic need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: NEORAL(R) oral soft gelatin capsules oral solution, cyclosporine modified oral soft gelatin capsules oral solution. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Product Information: SANDIMMUNE(R) oral capsules, oral solution, intravenous injection, cyclosporine oral capsules, oral solution, intravenous injection. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Product Information: PROVIGIL(R) oral tablets, modafinil oral tablets. Teva Pharmaceuticals USA Inc (per DailyMed), North Wales, PA, 2019. DailyMed
Keep reading about Modafinil
Keep reading about Cyclosporine Ophthalmic
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