Drug & supplement interaction

Adrafinil + Crizotinib

Crizotinib brand name: Xalkori.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Crizotinib falls into 2 drug categories that Adrafinil can interact with; the most serious is rated moderate. Theoretically, drugs that inhibit CYP3A4 might increase the levels and clinical effects of adrafinil.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Adrafinil and Crizotinib

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Adrafinil interacts with whole categories of medication. Crizotinib falls into 2 of those categories, so it can interact with Adrafinil in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 2

Why this applies to Crizotinib

Crizotinib falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Adrafinil interacts with.

Theoretically, drugs that inhibit CYP3A4 might increase the levels and clinical effects of adrafinil.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil is metabolized by CYP3A4.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist of this pairing. Your body turns adrafinil into modafinil, and modafinil is cleared mainly by a liver enzyme called CYP3A4. Crizotinib (Xalkori) can block that same enzyme. So in theory, if you took both, modafinil could clear more slowly and build up, leading to stronger stimulant effects like trouble sleeping, jitteriness, a fast or pounding heartbeat, headache, or higher blood pressure.

I want to be honest about how solid this is: it's a theoretical concern based on how these drugs are processed, not real-world case reports, so the actual risk may be small. Still, crizotinib is a serious cancer medicine, and adrafinil is unregulated and hard on the liver. Please don't combine them without first running it by your oncologist or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Crizotinib also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, adrafanil might reduce levels and clinical effects of CYP3A4 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP3A4 activity.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Crizotinib (Xalkori): your liver clears it using an enzyme called CYP3A4. When you take adrafinil, your body turns it into modafinil, which can mildly speed up that same enzyme. The concern is that a faster enzyme could lower your crizotinib levels, which might mean your cancer treatment doesn't work as well as it should. With a drug this important, even a modest drop in levels is worth taking seriously.

That said, this is a theoretical interaction based on how these drugs work, not strong human studies, and modafinil is only a weak inducer. Still, I wouldn't gamble with a cancer medicine. Please don't change anything on your own. Talk with your oncologist or pharmacist before combining these.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Adrafinil Also Interacts With Other Medications

Adrafinil has 1 major, 1,055 moderate known drug interactions in our database — the Crizotinib one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,055 No known interaction 1,774 (incl. Crizotinib)
Taking anything else?

Check Another of Your Medications Against Adrafinil

Covers the 2,830 medications we’ve checked against Adrafinil. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Crizotinib

This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Crizotinib page lists 157 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 8 major · 112 moderate · 37 minor.

From our pharmacist’s overview on the Crizotinib page

“Grapefruit tops my worry list for crizotinib (Xalkori), a targeted pill for ALK-positive lung cancer. It blocks the enzyme (CYP3A4) that clears crizotinib, letting levels climb and side effects with them, and it is one of eight major-rated entries among the 157 supplements and herbs on file for this drug.”

Reviewed by 2 · Jul 18, 2026

Open the Crizotinib interaction page

One more smart check

Taking Adrafinil as Part of a Dietary Supplement Product? Check It for Interactions

We hold 7 real supplement products containing Adrafinil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Adrafinil. Your product may carry other ingredients that interact with Crizotinib too, on top of Adrafinil — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Adrafinil and Crizotinib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Adrafinil
Top half

#560 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Crizotinib
Steady interest

#2,058 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Adrafinil

What is Adrafinil?

Adrafinil
  • Wakefulness and alertness
  • Fatigue
  • Focus and concentration
  • Cognitive enhancement (nootropic)
  • Daytime sleepiness

Adrafinil is a synthetic compound that the body converts into modafinil, a prescription wakefulness-promoting drug. It is sometimes sold as a nootropic supplement, but it is unregulated, carries real risks (especially to the liver), and is banned in some sports and countries. Talk with a doctor or pharmacist before using it.

Read the full Adrafinil monograph & all interactions
Medication

About Crizotinib

What Is Crizotinib Used For?

Brand name: Xalkori

Xalkori (crizotinib) is used to treat adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumors test positive for the ALK or ROS1 gene abnormality, as confirmed by an FDA-approved test.

Xalkori is also used to treat pediatric patients aged 1 year and older and young adults with relapsed or refractory systemic ALK-positive anaplastic large cell lymphoma (ALCL). Additionally, it treats adult and pediatric patients aged 1 year and older with unresectable, recurrent, or refractory ALK-positive inflammatory myofibroblastic tumor (IMT). Note: Xalkori's safety and effectiveness in older adults with relapsed or refractory ALK-positive ALCL have not been established.

See full Crizotinib drug information
Keep checking

Other Drugs & Adrafinil

Browse every other medication we’ve checked against Adrafinil — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
1,055Moderate
0Minor
1,773No known interaction
1 Major 1,055 Moderate 1,773 No interaction
Major

1 interaction

Moderate

1,055 interactions

Showing 60 of 1,055 moderate interactions — see all 1,055 on the Adrafinil page.

No interaction 1,773 drugs checked — show the list

We also checked Adrafinil against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,773 medications checked with no known interaction — see the full Adrafinil list.

See the full Adrafinil interactions page
See every supplement checked against Crizotinib, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Adrafinil monograph › Uses, safety, and every drug interaction in one place Crizotinib supplement interactions › Every supplement checked against Crizotinib, ranked by severity Crizotinib drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Adrafinil and Crizotinib Together: Common Questions

Can you take Adrafinil with Crizotinib?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Adrafinil and Crizotinib?
Crizotinib belongs to more than one drug category, and Adrafinil interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Adrafinil and Crizotinib interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Crizotinib and Adrafinil?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.