Correct (2): Modafinil induces CYP3A4 and reduces blood levels of estrogen-containing contraceptives; pregnancy can result. An additional or alternative non-hormonal method is recommended during and for 1 month after stopping. (1) Wrong. (3) Modafinil has no contraceptive effect. (4) Timing does not solve the metabolism issue.
In-depth explanation
Memory Tip CYP3A4 inducers that reduce hormonal contraception: rifampin, modafinil, carbamazepine, phenytoin, topiramate >200 mg, St. John's wort. CPG Counsel about backup or non-hormonal methods at initiation.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.