Drug & supplement interaction

Adrafinil + Enzalutamide

Enzalutamide brand name: Xtandi.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Adrafinil and Enzalutamide in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Adrafinil and Enzalutamide

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Enzalutamide and Adrafinil in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Adrafinil safety at a glance

Adrafinil overall Use caution It converts to a prescription stimulant-like drug and may stress the liver, so it should not be used casually.
Pregnancy Possibly Unsafe When used orally. Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been associated with reports of intrauterine growth restr... Read the full pregnancy detail
Breastfeeding Possibly Unsafe When used orally. Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been associated with reports of intrauterine growth restr... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Enzalutamide and Adrafinil? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Enzalutamide

Interactions in our licensed database are recorded against drug classes, not just single drug names. Enzalutamide is filed under 6 classifications — including cytochrome p450 2c9 (cyp2c9) inducers, cytochrome p450 2c19 (cyp2c19) inducers, cytochrome p450 3a4 (cyp3a4) inducers. Adrafinil has documented interactions with 11 drug classes — the most serious being modafinil (provigil) (major), antihypertensive drugs (moderate) and cytochrome p450 1a2 (cyp1a2) substrates (moderate) — and none of Enzalutamide’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Adrafinil Does Interact With Other Medications

Adrafinil has 1 major, 1,056 moderate known drug interactions in our database — Enzalutamide isn’t one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,056 No known interaction 1,773 (incl. Enzalutamide)
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.

What to actually watch for

No Interaction Found — But Data Suggests Adrafinil and Enzalutamide May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • A severe skin reaction Worth acting on Additional detail

    Adrafinil

    “Adrafinil is a precursor to the stimulant prescription drug modafinil. Serious drug rashes, including erythema multiforme/Stevens Johnson syndrome (EM/SJS), have been reported following the use of modafinil.”

    Adrafinil · Natural Medicines adverse-effect record, reported in erythema.

    2 sources cited
    1. 104950. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
    2. 109229. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Raised blood pressure Worth acting on Additional detail

    Adrafinil

    “Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to increase heart rate and diastolic and systolic blood pressure. Hypertension and tachycardia have been reported.”

    Adrafinil · Natural Medicines adverse-effect record, reported in hypertension.

    3 sources cited
    1. 104950. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
    2. 109225. Lowe DW, Dobson E, Jewett AG, Whisler EE. Adrafinil: Psychostimulant and purported nootropic? Am J Psych Res J. 2021;17(1):7-9. DOI
    3. 109229. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Tiredness reported in 24.7% of FDA reports for Enzalutamide Additional detail

    Adrafinil

    “Anecdotally, feelings of withdrawal have been reported following cessation of adrafinil. Symptoms included fatigue, irritability, lack of focus, headache, and gastrointestinal symptoms. It is unknown if individuals reporting these symptoms were also taking other substances.

    Adrafinil is a precursor to the stimulant prescription drug modafinil.”

    Adrafinil · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 109225. Lowe DW, Dobson E, Jewett AG, Whisler EE. Adrafinil: Psychostimulant and purported nootropic? Am J Psych Res J. 2021;17(1):7-9. DOI
    2. 104950. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
    3. 109229. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Weight loss / Reduced appetite / Nausea reported in 5.8% of FDA reports for Enzalutamide Additional detail

    Adrafinil

    “Adrafinil is a precursor to the stimulant prescription drug modafinil. Nausea is a common adverse effect of modafinil. Decreased appetite is common in children and adolescents and may be related to weight loss.”

    Adrafinil · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    2 sources cited
    1. 104950. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
    2. 109229. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Anxiety or restlessness / Trouble sleeping Additional detail

    Adrafinil

    “Anecdotally, headache, poor concentration, irritability, sedation, disturbed sleep, unpleasant stimulation, and anxiety have been reported following intake of adrafinil. It is unknown if individuals reporting these symptoms were also taking other substances.

    Adrafinil is a precursor to the stimulant prescription drug modafinil. Insomnia, headache, and nervousness are common adverse effects of modafinil.”

    Adrafinil · Natural Medicines adverse-effect record, reported in anxiety.

    4 sources cited
    1. 109225. Lowe DW, Dobson E, Jewett AG, Whisler EE. Adrafinil: Psychostimulant and purported nootropic? Am J Psych Res J. 2021;17(1):7-9. DOI
    2. 104950. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
    3. 109229. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
    4. 109226. Thobois S, Xie J, Mollion H, Benatru I, Broussolle E. Adrafinil-induced orofacial dyskinesia. Mov Disord 2004;19(8):965-6. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Headache Additional detail

    Adrafinil

    “There is limited reliable information available about the safe use of adrafinil. However, adrafinil is a precursor to the stimulant prescription drug modafinil and may cause similar adverse effects.

    Most Common Adverse Effects:

    Orally: Disturbed sleep, headache, malodorous urine, and unpleasant stimulation.

    Serious Adverse Effects (Rare):

    Orally: Orofacial dyskinesia.”

    Adrafinil · Natural Medicines adverse-effect record, reported in cluster headache.

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

Reported for Adrafinil but not commonly for Enzalutamide: mood changes or irritability, a fast or pounding heartbeat, dehydration and drowsiness.

Effects for Enzalutamide come from the ADVERSE REACTIONS section of its FDA label; effects for Adrafinil come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 58,437 voluntary FDA FAERS reports for Enzalutamide that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Adrafinil in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally. Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been associated with reports of intrauterine growth restriction and spontaneous abortion. Also, animal studies show that developmental toxicity occurs with use of modafinil during pregnancy. Although modafinil, and possibly adrafinil, might have addictive potential, the potential for abuse is low. However, there have been anecdotal reports of withdrawal symptoms following use of adrafinil, alone or in combination with other products. Avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Everything else you take

See Every Supplement That Interacts With Enzalutamide

This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enzalutamide page lists 49 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Alkanna (moderate), Alpine Ragwort (moderate), Black Tea (moderate) and Boneset (moderate).

By severity: 1 major · 36 moderate · 12 minor.

Open the Enzalutamide 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. Even though Adrafinil itself has no known interaction with Enzalutamide, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Adrafinil and Enzalutamide 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

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

29 days ago today
Medication Enzalutamide
Top half

#973 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Adrafinil reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Adrafinil and Enzalutamide records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Synthetic compound (not from a plant) · Capsules, tablets, powder

An interaction check asks whether these two react with each other — it does not ask whether Adrafinil is a good idea for someone in your situation. Here is what our Adrafinil record says about it on its own.

Adrafinil: dosing

There is no officially established or standardized supplement dose for adrafinil, and it is not approved as a dietary supplement by health authorities. Doses used historically as a prescription medicine were determined by doctors and are not the same as casual self-dosing.If a product is used, follow the directions on the label and do not exceed them. Because of the liver risk, it is generally not recommended for daily or long-term use, and periodic liver function testing may be wise.

From our Adrafinil monograph — the full record covers uses, side effects and every documented interaction.

Read the full Adrafinil monograph & all interactions
Medication

About Enzalutamide

What Is Enzalutamide Used For?

Brand name: Xtandi

Xtandi (enzalutamide) is used to treat prostate cancer in three specific situations: castration-resistant prostate cancer (CRPC), metastatic castration-sensitive prostate cancer (mCSPC), and non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis (high-risk BCR).

Castration-resistant means the cancer has continued to grow despite low testosterone levels. Castration-sensitive means the cancer still responds to testosterone-lowering therapy. In most of these cases, Xtandi is used alongside a GnRH analog (a hormone-lowering injection) or after surgical removal of the testicles — except in the high-risk BCR setting, where it may be used with or without a GnRH analog.

Most-Reported Side Effects for Enzalutamide

From FAERS, the FDA’s public side-effect reporting system (58,437 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 10,267 reports
Malignant neoplasm progression 5,468 reports
Prostatic specific antigen increased 4,344 reports
Asthenia 4,171 reports
Hot flush 3,882 reports
See full Enzalutamide 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
1,056Moderate
0Minor
1,772No known interaction
1 Major 1,056 Moderate 1,772 No interaction
Major

1 interaction

Moderate

1,056 interactions

Showing 60 of 1,056 moderate interactions — see all 1,056 on the Adrafinil page.

No interaction 1,772 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 1,772 medications checked with no known interaction — see the full Adrafinil list.

See the full Adrafinil interactions page
See every supplement checked against Enzalutamide, ranked by severity
Evidence & sources

Adrafinil References

The 7 references that drive our Adrafinil monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Lowe DW, Dobson E, Jewett AG, Whisler EE. Adrafinil: Psychostimulant and purported nootropic? Am J Psych Res J. 2021;17(1):7-9. DOI
  3. Thobois S, Xie J, Mollion H, Benatru I, Broussolle E. Adrafinil-induced orofacial dyskinesia. Mov Disord 2004;19(8):965-6. PubMed
  4. Chariot J, Appia F, Vaille C, Rozé C. Effect of modafinil on pancreatic exocrine secretion in rats. A comparison with adrafinil and related drugs. Fundam Clin Pharmacol 1987;1(4):243-52. PubMed
  5. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
  6. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
  7. Kinslow, CJ, Shapiro SD, Grunebaum MF, Miller EC. Acute hypertensive crisis and severe headache after concurrent use of armodafinil and tranylcypromine: Case report and review of the literature. Clinical Short Communication. October 2018; 393:1-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Adrafinil and Enzalutamide Together: Common Questions

Is it safe to take Adrafinil with Enzalutamide?
We do not list a known interaction between Adrafinil and Enzalutamide. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Adrafinil and Enzalutamide have any of the same side effects?
Yes — our sources link each of them separately to 9 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Adrafinil and Enzalutamide combination checked?
Interactions in our licensed database are recorded against drug classes. Enzalutamide is filed under 6 classifications, and Adrafinil has documented interactions with 11 drug classes — none of Enzalutamide's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Adrafinil interact with any other medications?
Yes. Adrafinil has 1,057 documented drug interactions in our database — Enzalutamide is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Enzalutamide interact with any supplements?
Yes. Enzalutamide has documented interactions with 49 supplements in our database — Adrafinil is not one of them. The Enzalutamide interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Adrafinil monograph Uses, safety profile, and every drug interaction in one place Enzalutamide drug information The full plain-English guide to this medication Enzalutamide supplement interactions Every supplement checked against Enzalutamide, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 7 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Enzalutamide 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.