What drugs should not be taken with gabapentin
Pro Research Analysisby 
Searched over 200M research papers
Drug Interactions with Gabapentin: What to Avoid
Gabapentin, an anticonvulsant and analgesic medication, is widely used for treating conditions such as epilepsy and neuropathic pain. However, it is crucial to be aware of its potential interactions with other drugs to avoid adverse effects and ensure safe usage.
Opioids and Gabapentin: A Dangerous Combination
One of the most significant interactions of gabapentin is with opioids. Combining gabapentin with opioids can enhance the effects of both drugs, leading to increased risks of respiratory depression, hypoventilation, and potentially fatal respiratory failure1 2 3. This combination is particularly dangerous for individuals with a history of substance use disorders (SUD), as they are more likely to misuse these medications2 3.
Benzodiazepines and Alcohol: Increased Sedation
Gabapentin should also be used cautiously with benzodiazepines and alcohol. These substances can potentiate the sedative effects of gabapentin, leading to excessive drowsiness, dizziness, and impaired motor functions. This combination can be particularly hazardous, increasing the risk of accidents and falls2 3.
Antihypertensive Drugs: Losartan
Losartan, an antihypertensive medication, is another drug that can interact with gabapentin. The interaction between gabapentin and losartan can alter the effectiveness of both drugs, potentially leading to suboptimal control of blood pressure and increased side effects1.
Antiepileptic Drugs: Phenytoin
Phenytoin, another antiepileptic drug, can interact with gabapentin, affecting the plasma levels of both medications. This interaction can lead to either reduced efficacy or increased toxicity, necessitating careful monitoring and possible dosage adjustments1.
Other Notable Interactions
- Caffeine: Caffeine can reduce the effectiveness of gabapentin, potentially diminishing its therapeutic benefits1.
- Ethacrynic Acid: This diuretic can interact with gabapentin, leading to altered drug levels and increased risk of side effects1.
- Mefloquine: An antimalarial drug, mefloquine can interact with gabapentin, potentially leading to increased neurotoxic effects1.
- Magnesium Oxide: This supplement can interfere with the absorption of gabapentin, reducing its effectiveness1.
Conclusion
Gabapentin is a valuable medication for many patients, but it is essential to be aware of its potential interactions with other drugs. Opioids, benzodiazepines, alcohol, losartan, phenytoin, caffeine, ethacrynic acid, mefloquine, and magnesium oxide are some of the substances that should be avoided or used with caution when taking gabapentin. Always consult with a healthcare provider before combining gabapentin with other medications to ensure safe and effective treatment.
Sources and full results
Most relevant research papers on this topic
Review about gabapentin misuse, interactions, contraindications and side effects
Gabapentin is a potential drug of abuse for recreational use, opioid withdrawal, and methadone effects, with potential interactions and side effects.
Systematic Review
Rigorous Journal
Highly CitedGabapentin misuse, abuse and diversion: a systematic review.
Gabapentin misuse is prevalent globally, with substance abuse populations at a higher risk for misuse/abuse, primarily for recreational purposes and self-medication.
Systematic ReviewRigorous JournalHighly CitedHow addictive are gabapentin and pregabalin? A systematic review
Gabapentinoids show limited addictive power, with pregabalin being more addictive, and should be avoided or administered with caution in patients with substance use disorders.
Systematic ReviewHighly CitedA Clinical Overview of Off-label Use of Gabapentinoid Drugs.
Off-label use of gabapentinoids for pain is widespread, but clinicians should be aware of limited evidence and inform patients that potential benefits are uncertain for most off-label uses.
Literature ReviewRigorous JournalHighly CitedGabapentin Use During Pregnancy and Lactation With and Without Concurrent Opioid Exposure: Considerations and Future Directions
Gabapentin use during pregnancy and lactation should be considered with caution due to potential developmental risks and interactions with opioids.
Literature ReviewAbuse and diversion of gabapentin among nonmedical prescription opioid users in Appalachian Kentucky.
Nonmedical prescription opioid users in Appalachian Kentucky are abusing and diversion gabapentin, potentially substituting it for other licit and illicit drugs.
Highly CitedNotes from the Field: Trends in Gabapentin Detection and Involvement in Drug Overdose Deaths — 23 States and the District of Columbia, 2019–2020
Gabapentin-related overdose deaths in 23 states and the District of Columbia increased by 5% from 2018 to 2019, with a higher incidence in unintentional or undetermined cases compared to the previous year.
Gabapentin does not interact with a contraceptive regimen of norethindrone acetate and ethinyl estradiol
Gabapentin does not interact with a contraceptive regimen of norethindrone acetate and ethinyl estradiol, making it unlikely to cause contraceptive failure.
Non-RCTGabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study
Co-prescription of opioids and gabapentin is associated with a significantly increased risk of accidental opioid-related death, with moderate-dose and high-dose gabapentin use causing a nearly 60% increase in the odds of death.
Observational StudyRigorous JournalHighly CitedGabapentin. A review of its pharmacological properties and clinical potential in epilepsy.
Gabapentin shows promise as an adjunct treatment for partial epilepsy, reducing seizure frequency by over 50% in some refractory patients.
Literature ReviewHighly Cited