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A Complete Guide On Modafinil Breastfeeding And Pregnancy

A Complete Guide On Modafinil Breastfeeding And Pregnancy

 

Administering Modafinil and birth control lowers the effectiveness of the contraceptive, thus elevating the possibility of pregnancy. The Modafinil pregnancy category is C and has a 15% likelihood of causing congenital disabilities. Breastfeeding while Modafinil has risks of developing jitteriness, insomnia, and poor weight gain; however, the relative infant dose (RID) of Modafinil is 5.3% and is considered safe for breastfeeding. 

 

 

What would happen if you take Modafinil and birth control, or is taking Modafinil during pregnancy or breastfeeding safe? Numerous questions are associated with the administration of the Nootropic during one of the most empowering and crucial phases in a woman's life.  

Modafinil is a psychostimulant clinically proven to help with excessive daytime sleepiness. It is prevalent for being one of the most tolerant medicines with lower health risks. However, this asserted safety profile of Modafinil doesn't really apply during pregnancy or for nursing mothers. The use of Modafinil and birth control is also contradicted in numerous conditions. 

This comprehensive blog evaluates the risks of taking Modafinil and birth control, along with determining the effect of the Nootropic on the infant or fetus if administered during pregnancy or breastfeeding. 

 

Modafinil Birth Control- An Overview

A woman taking birth control is often diagnosed with mood swings or depression. Research indicates it is common in women with mood disorders [1]. A study shows that people using hormonal contraceptives have a higher propensity to use antidepressants [2].  

Modafinil, having prominent antidepressant properties, shows preliminary evidence for treating major depressive conditions. Patients unresponsive to their first line of antidepressants are also prescribed Modafinil [3]. So, most women taking birth control often co-administer Modafinil to improve the signs of depression, unaware of the possible consequences. 

 

Scientific Evidence On Modafinil And Birth Control Interaction 

Modafinil or its brand drugs, such as Modalert, are enzyme inducers that increase the liver enzyme's action. These enzymes play a crucial role in breaking down contraceptives, thus giving them less time to act than intended [4]. 

Dr. Sarah Branch, a leading clinician, states that [5]-

 

"Modafinil can lower the effectiveness of hormonal contraceptives. Women should continue with their birth control pills after two months of discontinuing Modafinil or Modalert dosage."

 

There is no scientific evidence indicating the implications of taking birth control with Modafinil; however, there is notable evaluation of the interaction between other enzyme inducers with Modafinil. 

The theoretical data supported by the Faculty of Sexual Health and Reproduction Medicine of The Royal College of Obstetrics and Gynaecology indicates that contraceptives are unsafe with Modafinil [4]. 

 

Types of Contraceptive

Form of Contraceptive 

Safety Profile

 

Combined hormonal

contraceptives

Combined oral

contraceptives 

x

Vaginal delivery system

x

Transdermal Patch

x

Non-hormonal contraceptives

Intra-uterine

contraceptive device copper (IUD-Cu) 

✔️






 

Progesterone only hormone

contraceptives


 

Progesterone-only

Intrauterine system

(IUD)

✔️

Progesterone-only

oral contraceptives

x

Depot

Medroxyprogesterone

acetate (DMPA)

✔️

Subdermal Implant

x

Depot Norethisterone

enanthate

✔️

 

Benefits of Taking Modafinil With Birth Control 

Before we discuss the negative impact of taking Modafinil and birth control, let us understand the hypothetical benefits of taking them together. However, do not get us wrong; 

We Do Not Recommend Taking Modafinil And Birth Control Together-

We just want you to have a better picture of all the possibilities (both good and bad) of co-administering them together. 

 

Enhancement in Emotional Memory-

We already know the benefits of Modafinil in a person's cognition. However, hormonal contraceptives can also improve emotional memory. These are deep memory that is rooted within our psyche [6]. 

 

Taking Modafinil and Birth Control reduces the sign of ADHD-

Popular ADHD medicines such as Adderall and Ritalin respond better in women depending on the elevated hormone in the women. A higher estrogen level gives a better response, whereas progesterone exhibits a diminished outcome [7]. So, we can theorize that women with ADHD with higher estrogen levels will showcase better results than men. 

 

Health Risks Of Taking Modafinil With Birth Control 

The benefits of taking Modafinil and Modafinil were hypothetical and were discussed on clinical grounds. There still has been no eminent evidence to support these speculations. However, the adverse effects of co-administering them together have well-backed scientific data and are worth your attention. 

Lower the efficacy of Birth Control-

The conjugative intake of Modafinil and birth control can reduce its effectiveness, thus increasing the chances of getting pregnant. 

A study indicates that using Modafinil can significantly lower Ethinyl estradiol (a compound that is formulating birth control) by 18% by enhancing the activity of the CYP3A4/5 enzyme that aids in metabolizing hormonal contraceptives [8]. 

Women who buy Modalert 200mg tablets must be aware of the consequences of taking the Nootropic with the four prominent birth control options- Patch birth controls, subdermal implants, viginal rings, and pills containing one or several hormones. 

 

So, should you stop taking contraceptives when under Modafinil treatment? 

Thankfully, NO! You can continue taking Modafinil with birth control. 
Contraceptives such as DMPA (depot medroxyprogesterone acetate), Copper IUD, and LNG-IUS (Levonorgestrel-releasing intrauterine system) are considered safe when taken with Modafinil [9]. 

 

Signs of Lower Perseverance-

Modafinil can assist you in persevering through complex tasks. However, birth control can lower the level of perseverance while performing a cognitive task [10]. 

 

Modafinil Pregnancy Category 

In 1979, the FDA established the five risk categories- A, B, C, D, and X to indicate the potency of a drug to cause birth defects during pregnancy. Modafinil is a Category C drug for pregnancy and breastfeeding [1]. The use of the Nootropic during pregnancy can risk the occurrence of congenital malformations [12]. 

 

Modafinil pregnancy category

 

Modafinil Pregnancy- An Evaluation Of Its Adverse Effects 

The Medicines and Healthcare Products Regulatory Agency (MHRA) warns to review the risks associated with Modafinil and pregnancy before administering it. The perils of taking Modafinil during pregnancy are listed below. 

 

An interim report by Cephalon on Modafinil pregnancy

In 2018, Teva Branded Pharmaceutical Products and Cephalon (the manufacturers of Modafinil) released a temporary report from Pregnancy Registries indicating that 15% of infants' significant malfunctions are associated with Modafinil exposure [14]. 

 

Modafinil pregnancy

 

 

Risks of Birth Defects-

Neonatal disorders can result from co-administering Modafinil and birth control. A US study involving 61 babies exposed to Modafinil during pregnancy showed congenital malformations, including hypospadias, congenital heart defects, and orofacial clefts [5]. 

The fetus is also diagnosed with multiple sclerosis (27%) and sleep disorder (39%), according to a study evaluating the risk of Modafinil pregnancy in 49 women [13]. Based on the same study, the other side effects resulting from Modafinil, if taken during Pregnancy, are hospitalization due to malfunction, diabetes, hypertension, mood disorder, and other mental and behavioral disorders [13]. 

Anecdotal experiences shared by most pregnant women on being on Modafinil the whole time or until they received a positive report showed no signs of adverse effects [14]. 

Modafinil pregnancyModafinil pregnancy

 

Advice From Healthcare Professionals On Modafinil Use During Pregnancy 

Before prescribing Modafinil, the women must be informed about the risk of teratogenicity (the ability to cause birth defects in the fetus). 

Health Canada has issued the following guidelines regarding Modafinil pregnancy [15]. 

  • Pregnant women or the ones planning a child should not take Modafinil or Modalert online without a prescription. 
  • Since Modafinil lowers the potency of hormonal birth control, consulting a physician for an alternative is essential. 
  • To avoid neonatal dysfunction, it is advised to get a pregnancy test done a week before starting Modafinil treatment. 

After discontinuation of the Modafinil dosage, the use of effective contraceptives must be followed for the next two months. It will give your body the time to return to the regular enzyme activity that Modafinil has affected. 

 

During Pregnancy, one must always take Modafinil, Modalert, and Provigil after consulting a doctor.  

 

Modafinil Breastfeeding- Warnings And Health Risks 

No specific human trials indicating the impact of Modafinil on breastmilk are performed to come to an assertive conclusion. However, several clinical studies suggest Modafinil's effect on the mother's milk and breastfeeding infant. 

When deciding if a medicine must be taken during breastfeeding, the benefits and risks must outweigh the following-

  • Continuing the medicine + breastfeeding
  • Breastfeeding + adjusting the medication temporarily
  • Stop breastfeeding + continue with your dosage [16]

The Modafinil's ability to cross over the mother's milk is due to its structure-  

  • The low molecular weight of 273 Da.
  • The long elimination half-life is 15 hours. 
  • 60% protein binding.

Also, due to its mechanism of action on the central nervous system and various neurotransmitter receptors, the Nootropic may pass via the blood-brain barrier to the newborn [17]. 

A study on a 27-year-old woman with idiopathic hypersomnolence taking Modafinil dosage during her pregnancy was analyzed for Armodafinil, the active form of Modafinil. The maximum concentration of Armodafinil was 2.4 μg/mL 2 hours after administration. It gradually decreased over 24 hours [17]. 

 

Modafinil breastfeeding

 

The study indicates that the infant dose was 0.18 mg/kg/day, and the relative infant dose was about 5.3%, which is below the theoretical threshold for medical concern (10%). Since Modafinil enters the infant via breast milk, it first reaches the gastrointestinal tract and undergoes first-pass metabolism through the liver. It is essential to look for signs of insomnia, poor weight gain, and jitteriness. If any of these events occur, it is recommended for the mother to either discontinue breastfeeding or administer the Nootropic [17]. 


FAQ's

Provigil is a Modafibnil brand and showcase similar properties and safety profile. Since Modafinil is considered safe for breastfeeding, therefore Provigil too can be taken.

Adhd medications and brain stimulants such as Modafinil do pass into the breast milk.

Healthcare providers do not recommend the use of Adderall during breastfeeding. Women taking Adderall during pregnancy or breastfeeding must closely monitor their infant for signs of adverse effects.

No medicine must be administered without consulting your physician if you are pregnant or breastfeeding. However, the medicines to avoid are Advil, Tylenol, antibiotics, antacids, and histamine H2 blockers.

Modafinil is a category C drug for pregnancy and breastfeeding. It should not be administered during pregnancy without a doctor's prescription. It can cause congenital malformations in the infant.

Modafinil pregnancy category is C and is not advisable to be taken without consulting a physician.

Clinical studies indicate that the use of Modafinil is not associated with any fertility problems.

One can beat pregnancy fatigue by-

  • exercising 

  • taking naps

  • relaxing 

  • staying hydrated 

  • changing the sleeping posture 

  • eating meals that will help to maintain a stable blood sugar level. 

 

The standard dose of Modafinil is 200mg. However, if you are taking any hormonal contraceptive, it is best to consult a doctor before administering any dose of Modafinil.

Yes, stimulants such as Modafinil affect birth control by lowering their efficacy.

Yes, getting pregnant while taking Modafinil is possible. Since the Nootropic lowers the effectiveness of your birth control, the rate of conceiving is high.

Modafinil can lower the efficacy of birth control and, therefore, the possibility of pregnancy.


References-

  1. What to Know About Birth Control and Depression, WebMD. 
  2. Association of Hormonal Contraception With Depression, JAMA network. 
  3. A retrospective chart review of the effects of modafinil on depression as monotherapy and as adjunctive therapy, PubMed. 
  4. Modafinil in women of childbearing potential, nhs.uk. 
  5. Sleep disorder drug modafinil linked to increased risk of birth defects and also to reduced effectiveness of contraception, gov.uk. 
  6. Women using hormonal contraceptives show increased valence ratings and memory performance for emotional information, Nature. 
  7. How Does ADHD Impact Women Differently? additudemag. 
  8. Effect of modafinil on the pharmacokinetics of Ethinyl estradiol and triazolam in healthy volunteers, PubMed. 
  9. Modafinil taken by students as a “smart drug” could reduce effectiveness of hormonal contraception: CEU Clinical Update, fsrh. 
  10. Women taking hormonal contraceptives have reduced perseverance on cognitive tasks, study finds, psypost. 
  11. FDA Pregnancy Categories, Drugs. 
  12. Modafinil (Provigil): increased risk of congenital malformations if used during pregnancy, gov.uk. 
  13. First-Trimester Pregnancy Exposure to Modafinil and Risk of Congenital Malformations, JAMA network. 
  14. Found out I’m 8 weeks pregnant, have taken modafinil nearly every day in those past 8 weeks. Is it going to be okay?, Reddit. 
  15. New (But Still Not Enough) Data on Modafinil and Pregnancy, womensmentalhealth. 
  16. ADHD Medications and Breastfeeding, infantrisk. 
  17. Evaluating Transfer of Modafinil Into Human Milk During Lactation: A Case Report, jcsm.