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In people who are deficient in CYP2D6, coadministration of modafinil with substrates of CYP2D6 which have ancillary routes of elimination by CYP2C19 (eg, tricyclic antidepressants and selective serotonin reuptake inhibitors) may possibly cause elevated circulating levels of these medicine and require dose adjustment (Robertson et al 2000; PROVIGILÂ