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apalutamide will decrease the level or effect of modafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stay clear of or Use Alternate Drug. Coadministration of apalutamide, a powerful CYP3A4 inducer, with medicines that happen to be CYP3A4 substrates can result in decrease publicity to these medications.cyclophosphamide will raise the