Adrafinil + Relugolix, Estradiol, Norethindrone Acetate
Relugolix, Estradiol, Norethindrone Acetate brand name: Myfembree.
Relugolix, Estradiol, Norethindrone Acetate 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 reportAdrafinil and Relugolix, Estradiol, Norethindrone Acetate
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. Relugolix, Estradiol, Norethindrone Acetate 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).
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
1 of 3Why this applies to Relugolix, Estradiol, Norethindrone Acetate
Relugolix, Estradiol, Norethindrone Acetate falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Adrafinil interacts with.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP1A2 activity in vitro.
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.
Here's the gist with Myfembree (relugolix, estradiol, and norethindrone). When your liver converts adrafinil into modafinil, that modafinil may speed up an enzyme called CYP1A2 just a little. Since the estrogen part of Myfembree is partly handled by that enzyme, in theory revving it up could lower estradiol levels slightly. If that happened, you might notice more breakthrough bleeding, hot flashes, or a weaker handle on the symptoms this combo is meant to treat.
I want to be honest though: this is theoretical, based only on lab data, and modafinil is a weak inducer. It may never amount to anything noticeable. Adrafinil also carries real liver risks of its own, so please check with your pharmacist or doctor before pairing them.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
- Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS
2 of 3Relugolix, Estradiol, Norethindrone Acetate also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil is metabolized by CYP3A4.
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.
Here's the thing about Myfembree (which combines relugolix, estradiol, and norethindrone). The estradiol and progestin pieces are partly handled by the same liver enzyme, CYP3A4, that turns adrafinil into its active form, modafinil. In theory, if these hormones slow that enzyme down even a little, more modafinil could build up, which might mean stronger stimulant effects from the adrafinil like jitteriness, a racing heart, trouble sleeping, headache, or anxiety.
I want to be honest though: this concern is purely theoretical, based on how the drugs are processed, not on real cases. It's still worth flagging because adrafinil is unregulated and rough on the liver. Please loop in your doctor or pharmacist before combining the two.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 3Relugolix, Estradiol, Norethindrone Acetate also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP3A4 activity.
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.
Here's the situation with Myfembree (relugolix, estradiol, and norethindrone). All three of these ingredients are at least partly broken down by a liver enzyme called CYP3A4. Adrafinil turns into modafinil in your body, and modafinil can gently speed up that enzyme. In theory, that means your body could clear these hormones a little faster than usual.
Why does that matter? If estradiol and norethindrone levels drop, the birth control and symptom-control benefits of this medication could weaken, raising the chance of breakthrough bleeding or an unintended pregnancy. I'll be honest though, this is a theoretical concern based on how the drugs work, not proven harm. Still, since reliable contraception is part of why people take Myfembree, please run this by your doctor or pharmacist before combining them.
- Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
- 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.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Adrafinil Also Interacts With Other Medications
Adrafinil has 1 major, 1,055 moderate known drug interactions in our database — the Relugolix, Estradiol, Norethindrone Acetate one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Adrafinil
We haven’t checked that one against Adrafinil yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Adrafinil. Pick one to open its full report.
See Every Supplement That Interacts With Relugolix, Estradiol, Norethindrone Acetate
This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Relugolix, Estradiol, Norethindrone Acetate page lists 219 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 · 174 moderate · 37 minor.
From our pharmacist’s overview on the Relugolix, Estradiol, Norethindrone Acetate page
“Grapefruit is where I would start on this page. Myfembree (relugolix, estradiol, and norethindrone acetate) depends on the CYP3A4 enzyme to be cleared, and grapefruit juice blocks that enzyme, raising drug levels and side effect risk.”
Reviewed by 2 · Jul 18, 2026
Open the Relugolix, Estradiol, Norethindrone Acetate interaction page
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 Relugolix, Estradiol, Norethindrone Acetate 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:
Where Adrafinil and Relugolix, Estradiol, Norethindrone Acetate 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.
#561 of 1,452 supplements looked up here in the last 7 days
#260 of 2,830 medications looked up here in the last 7 days
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.
About Adrafinil
What is 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.
About Relugolix, Estradiol, and Norethindrone
What Is Relugolix, Estradiol, and Norethindrone Used For?
Brand name: Myfembree
Myfembree is approved for two conditions in premenopausal women: managing heavy menstrual bleeding caused by uterine fibroids (non-cancerous growths in the uterus), and managing moderate to severe pain caused by endometriosis (a condition where tissue similar to the uterine lining grows outside the uterus).
Treatment with Myfembree should not exceed 24 months because of the risk of ongoing bone loss that may not fully reverse after stopping the medication.
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.
No drugs match “”.
1 interaction
1,055 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Phentermine ›
- Hydrocortisone ›
- Methylphenidate ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Phenylpropanolamine ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Nicotine ›
- Orphenadrine ›
- Oxybutynin ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Miconazole ›
- Phenylephrine ›
- Pseudoephedrine ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Diethylpropion ›
- Everolimus ›
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.
- Levothyroxine ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Escitalopram ›
- Isotretinoin ›
- Tirzepatide ›
- Docusate ›
- Sumatriptan ›
- Hydroxyurea ›
- Valacyclovir ›
- Metformin ›
- Semaglutide ›
- Levothyroxine, Liothyronine ›
- Amoxicillin ›
- Methotrexate ›
- Azithromycin ›
- Pregabalin ›
- Doxycycline ›
- Gabapentin ›
- Lamotrigine ›
- Acyclovir ›
- Duloxetine ›
- Methylene Blue ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Ezetimibe ›
- Cyclopentolate ›
- Cephalexin ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Thyroid Hormone ›
- Avatrombopag Maleate ›
- Levetiracetam ›
- Carbidopa, Levodopa ›
- Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide ›
- Levodopa ›
- Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Magnesium Hydroxide (otc Drug) ›
- Canagliflozin, Metformin ›
- Alginic Acid, Aluminum Hydroxide ›
- Acarbose ›
- Mitomycin ›
- Aspirin, Butalbital ›
- Venlafaxine ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Flutemetamol F-18 ›
- Levothyroxine Sodium ›
- Charcoal (otc Drug) ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Efgartigimod Alfa-fcab ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Articaine, Epinephrine ›
- Daunorubicin, Cytarabine ›
- Peginterferon Alfa-2a, Ribavirin ›
- Alpha-1 Proteinase Inhibitor ›
- Aminolevulinic Acid Hydrochloride ›
- Cefaclor ›
Showing the 60 most looked-up of 1,773 medications checked with no known interaction — see the full Adrafinil list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Relugolix, Estradiol, Norethindrone Acetate Is Linked to Lower Levels of 5 Nutrients
Natural Medicines records Relugolix, Estradiol, Norethindrone Acetate as a medicine that can lower these. This is not an interaction with Adrafinil — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Relugolix, Estradiol, Norethindrone Acetate nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Adrafinil and Relugolix, Estradiol, Norethindrone Acetate Together: Common Questions
Can you take Adrafinil with Relugolix, Estradiol, Norethindrone Acetate?
Why are there 3 interactions listed for Adrafinil and Relugolix, Estradiol, Norethindrone Acetate?
How serious is the Adrafinil and Relugolix, Estradiol, Norethindrone Acetate interaction?
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.