Drug & supplement interaction

Adrafinil + Norelgestromin, Ethinyl Estradiol

Norelgestromin, Ethinyl Estradiol brand names: Ortho Evra, Evra.

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

Norelgestromin, Ethinyl Estradiol falls into 3 drug categories that Adrafinil can interact with; the most serious is rated moderate. Theoretically, adrafinil might reduce the levels and clinical effects of CYP1A2 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Adrafinil and Norelgestromin, Ethinyl Estradiol

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Adrafinil interacts with whole categories of medication. Norelgestromin, Ethinyl Estradiol falls into 3 of those categories, so it can interact with Adrafinil in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to Norelgestromin, Ethinyl Estradiol

Norelgestromin, Ethinyl Estradiol falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Adrafinil interacts with.

Theoretically, adrafinil might reduce the levels and clinical effects of CYP1A2 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP1A2 activity in vitro.
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 with your Ortho Evra patch (norelgestromin plus ethinyl estradiol) and adrafinil. Your body turns adrafinil into modafinil, and modafinil may slightly speed up a liver enzyme called CYP1A2. In theory, revving up that enzyme could lower the level of the hormones in your birth control, which raises a concern about it working less reliably (think breakthrough bleeding, or in the worst case, reduced protection against pregnancy).

I want to be honest: this particular link is theoretical, based on lab data, not real-world cases, so it's a weak signal. Still, because dependable contraception matters so much, I'd run it by your doctor or pharmacist before combining them. They can tell you if a backup method is worth using.

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. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
  3. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

2 of 3

Norelgestromin, Ethinyl Estradiol also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.

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 connection with your Ortho Evra patch (norelgestromin and ethinyl estradiol). The estrogen part is a mild blocker of an enzyme called CYP3A4. That same enzyme is what turns adrafinil's active product, modafinil, into less active pieces. So in theory, slowing that enzyme a little could let modafinil build up slightly and feel stronger, meaning more wakefulness-type effects like jitteriness, trouble sleeping, a faster heartbeat, or headaches.

I want to be honest though: this is only a theoretical concern based on how the drugs work, not real-world reports, and the birth control's effect on this enzyme is fairly weak. The bigger worry with adrafinil itself is liver strain, since it's unregulated. Please run it by your pharmacist or doctor before combining them.

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

3 of 3

Norelgestromin, Ethinyl Estradiol 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 concern with using adrafinil alongside your Ortho Evra (Evra) patch. Once your liver turns adrafinil into modafinil, that modafinil can mildly speed up an enzyme called CYP3A4, which is one of the pathways your body uses to break down the hormones (norelgestromin and ethinyl estradiol) in your birth control. Speeding that up could lower hormone levels a bit, and in theory that may make the patch less reliable at preventing pregnancy. You might also notice changes like breakthrough spotting.

I want to be honest that this is a theoretical interaction based on how these drugs work, not something proven in patients. Still, because an unplanned pregnancy is a big deal, please talk with your doctor or pharmacist before combining them, and ask whether a backup method makes sense.

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 Norelgestromin, Ethinyl Estradiol 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. Norelgestromin, Ethinyl Estradiol)
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 Norelgestromin, Ethinyl Estradiol

This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Norelgestromin, Ethinyl Estradiol page lists 203 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate), Activated Charcoal (moderate) and African Wild Potato (moderate).

By severity: 2 major · 168 moderate · 33 minor.

From our pharmacist’s overview on the Norelgestromin, Ethinyl Estradiol page

“St. John's wort is the first entry to check if you wear the Ortho Evra patch (norelgestromin and ethinyl estradiol).”

Reviewed by 2 · Jul 18, 2026

Open the Norelgestromin, Ethinyl Estradiol 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 Norelgestromin, Ethinyl Estradiol 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 Norelgestromin, Ethinyl Estradiol 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

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

29 days ago today
Medication Norelgestromin, Ethinyl Estradiol
Top 25%

#698 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
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 Norelgestromin, Ethinyl Estradiol, 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 Norelgestromin, Ethinyl Estradiol supplement interactions › Every supplement checked against Norelgestromin, Ethinyl Estradiol, 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 Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Adrafinil and Norelgestromin, Ethinyl Estradiol Together: Common Questions

Can you take Adrafinil with Norelgestromin, Ethinyl Estradiol?
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 3 interactions listed for Adrafinil and Norelgestromin, Ethinyl Estradiol?
Norelgestromin, Ethinyl Estradiol 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 Norelgestromin, Ethinyl Estradiol 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

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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.