Gabapentin Interactions With Other Medications and Substances

Gabapentin can interact with other prescription and over-the-counter medications, vitamins, and herbal supplements.

People should be sure to give a doctor a full list of their current medications and supplements before taking gabapentin.

The results of another 2017 review suggest that the following are some of the main substances that interact with the drug:

- caffeine, which is present in tea, coffee, and cola
- ethacrynic acid, which is a diuretic
- losartan, which is a medication for high blood pressure
- magnesium oxide, which is a mineral supplement and antacid
- mefloquine, which is an antimalarial drug
- morphine, which is an opioid pain medication
- phenytoin, which is an anti-seizure medication

If gabapentin causes sleepiness, a person should speak with a doctor before taking other medications that can also cause drowsiness, including:

- antianxiety medications
- antidepressants
- antihistamines
- cold and flu medications
- muscle relaxers
- narcotics, which are pain medications
- sleeping pills

Presence of other health conditions

To ensure that gabapentin is safe to take, a person should tell a doctor if they also currently have or have ever had:

- diabetes
- dialysis treatment
- drug or alcohol misuse issues
- heart disease
- kidney disease
- liver disease
- seizures (if taking gabapentin for conditions unrelated to seizures)

Gabapentin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with gabapentin. This list does not contain all drugs that may interact with gabapentin.

Before taking gabapentin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Opioids

When used with gabapentin, opioids can cause dangerous effects in the body. Some examples of these drugs include morphine, hydrocodone, and oxycodone.

Taking gabapentin with an opioid increases your risk for severe sleepiness, respiratory depression, coma, and even death.

Stomach acid drugs

When used with gabapentin, certain drugs used to treat stomach acid problems can reduce the amount of gabapentin in your body. This can make it less effective. Taking gabapentin 2 hours after taking these drugs can help prevent this problem. Examples of these drugs include:

aluminum hydroxide
magnesium hydroxide

The gabapentin dosage your doctor prescribes will depend on several factors. These include:

the type and severity of the condition you’re using gabapentin to treat
your age
the form of gabapentin you take
other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Risks of Taking Gabapentin During Pregnancy and When breastfeeding

Risks during pregnancy and when breastfeeding

People who are pregnant and those who intend to become pregnant should tell a doctor before taking gabapentin.

Research from 2020 suggests that taking this drug during pregnancy may be associated with a higher risk of cardiac malformations in the fetus, a condition called small for gestational age, and preterm birth.

However, it is also essential to control seizures during pregnancy, so pregnant people should only take the drug if it is absolutely necessary.

People should never start or stop taking gabapentin for seizure control before talking with a doctor. They will assess the potential risks and benefits.

After childbirth, gabapentin passes into breast milk. At low levels, it may not affect the infant. However, it is best to discuss this issue with a doctor before breastfeeding.

At the federal level, gabapentin is not listed as a controlled drug, is considered a non-addictive medication, and is considered by the Centers for Disease Control and Prevention as a substitute for opiates for chronic pain. However, there are growing concerns about its potential for misuse.

Several US states have moved gabapentin to the Schedule V controlled substance category. Gabapentin does not have a high risk of an overdose but can increase the euphoria caused by opioids and reduce drug withdrawals. An Australian study examined fatal gabapentinoid-related poisoning and discovered that concomitant other drug use to be almost universal in such cases.

Furthermore, gabapentin can bypass the blocking effects of addiction treatment medications, and unfortunately, does not show up in urine drug tests.

Withdrawal Symptoms From Gabapentin

It is rare to experience withdrawal symptoms from Gabapentin, but it does happen. A review of medical journals published between 1993, when Gabapentin was approved, and 2015, found 18 case reports of Gabapentin addiction, dependence, or withdrawal.

Doctors publish case reports when they encounter a patient with a rare disorder or with a condition that they want to make their colleagues aware of. Case reports are significant because they help further knowledge and identify subjects worthy of future research.

It’s worth noting that just because there are so few reports of gabapentin withdrawal, doesn’t necessarily mean it’s as rare as people once thought. It’s possible that many people simply don’t seek treatment for gabapentin withdrawal.

According to the Drug Enforcement Administration (DEA), gabapentin use is on the rise. Doctors wrote more than double the amount of gabapentin prescriptions in 2017 as they did in 2011.

The illicit use of gabapentin also appears to be increasing.

In a small survey of prescription drug abusers in Appalachian Kentucky, 15 percent reported using gabapentin to get high. That number is a 165 percent increase from the year prior and a 2,950 percent increase from 2008.

It appears as though gabapentin dependence and withdrawal are most common among people who use at least one other substance, such as opioids or alcohol. In the case reports, all patients had past drug or alcohol addiction issues.

Opioid users have reported using gabapentin to intensify their high. Cocaine users have reported the same, as well as attempts to use gabapentin to help alleviate cocaine withdrawal.

Signs and Symptoms

Among the documented cases, gabapentin withdrawal began between 12 hours and 7 days after the last dose.

The majority saw withdrawal symptoms within 24 to 48 hours.

Common Symptoms

The most common symptom was agitation, occurring in about half of the recorded cases. Confusion and disorientation were the next most common symptoms, followed by:

- - Sweating
  - Gastrointestinal symptoms
  - Tremors
  - Fast heart rate
  - High blood pressure
  - Insomnia

In many of the cases reported in the medical journals, individuals entered gabapentin withdrawal without the intention to do so.

This was typically a result of running out of gabapentin or leaving it at home during a trip out of town.

This sample of cases is unlikely to be reflective of most people’s experiences with gabapentin withdrawal. The reason for this is that only people with severe or alarming symptoms seek emergency medical treatment.

Among the cases reported, gabapentin withdrawal symptoms typically peaked three days after someone’s last dose. In almost all cases, doctors eventually treated the symptoms by resuming the previous gabapentin dose. Once people resumed their dose, their symptoms disappeared within hours.

NT16 Neurontin 600mg, NT26 Neurontin 800mg – Pfizer U.S. Pharmaceuticals Group

Pill with imprint NT 16 is White, Elliptical/Oval and has been identified as Neurontin 600 mg. It is supplied by Pfizer U.S. Pharmaceuticals Group.

Neurontin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs.

Risk cannot be ruled out during pregnancy. Neurontin 600 mg is not a controlled substance under the Controlled Substances Act (CSA).

Neurontin

Generic Name

gabapentin

Imprint

NT 16

Strength

600 mg

Color

White

Size

18.00 mm

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Pfizer U.S. Pharmaceuticals Group

Inactive Ingredients

poloxamer 407, copovidone, corn starch, magnesium stearate, hydroxypropyl cellulose, magnesium silicate, candelilla wax, water

Note: Inactive ingredients may vary.

Labelers / Repackagers

NDC Code	Labeler / Repackager
00071-0513	Pfizer Inc.
54868-4491 (Discontinued)	Physicians Total Care Inc. (repackager)
63874-1073	Altura Pharmaceuticals Inc. (repackager)
55289-0850	PDRX Pharmaceuticals Inc. (repackager)

NT 26 (Neurontin 800 MG)

Pill with imprint NT 26 is White, Elliptical/Oval and has been identified as Neurontin 800 MG. It is supplied by Pfizer U.S. Pharmaceuticals Group.

Neurontin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy. Neurontin 800 MG is not a controlled substance under the Controlled Substances Act (CSA).

Neurontin

Generic Name

gabapentin

Imprint

NT 26

Strength

800 MG

Color

White

Size

19.00 mm

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Pfizer U.S. Pharmaceuticals Group

Inactive Ingredients

poloxamer 407, copovidone, corn starch, magnesium stearate, hydroxypropyl cellulose, magnesium silicate, candelilla wax, water

Note: Inactive ingredients may vary.

Labelers / Repackagers

NDC Code	Labeler / Repackager
00071-0401	Pfizer Inc.
54868-4600 (Discontinued)	Physicians Total Care Inc. (repackager)
35356-0061	Lake Erie Medical and Surgical Supply (repackager)

T1 Gabapentin 600mg, T3 Gabapentin 800mg – Ascent Pharmaceuticals, Inc.

T 1 (Gabapentin 600 mg)

Pill with imprint T 1 is White, Elliptical/Oval and has been identified as Gabapentin 600 mg. It is supplied by Camber Pharmaceuticals, Inc.

Gabapentin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy.

Gabapentin 600 mg is not a controlled substance under the Controlled Substances Act (CSA).

Gabapentin

Imprint

T 1

Strength

600 mg

Color

White

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Camber Pharmaceuticals, Inc.

Manufacturer

Ascent Pharmaceuticals, Inc.

National Drug Code (NDC)

31722-0166

Inactive Ingredients

mannitol, hydroxypropyl cellulose, crospovidone, talc, silicon dioxide, glyceryl dibehenate, magnesium stearate

T 3 (Gabapentin 800 mg)

Pill with imprint T 3 is White, Elliptical/Oval and has been identified as Gabapentin 800 mg. It is supplied by Camber Pharmaceuticals, Inc.

Gabapentin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy. Gabapentin 800 mg is not a controlled substance under the Controlled Substances Act (CSA).

Gabapentin

Imprint: T 3
Strength: 800 mg
Color: White
Shape: Elliptical/Oval
Availability: Prescription only
Drug Class: Gamma-aminobutyric acid analogs
Pregnancy Category: C – Risk cannot be ruled out
CSA Schedule: Not a controlled drug
Labeler / Supplier: Camber Pharmaceuticals, Inc.
Manufacturer: Ascent Pharmaceuticals, Inc.
National Drug Code (NDC): 31722-0167
Inactive Ingredients: mannitol, hydroxypropyl cellulose, crospovidone, talc, silicon dioxide, glyceryl dibehenate, magnesium stearate

NT16 Gabapentin 600mg, NT26 Gabapentin 800mg – Greenstone LLC

Pill with imprint NT 16 is White, Elliptical/Oval and has been identified as Gabapentin 600 mg. It is supplied by Greenstone LLC.

Gabapentin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy. Gabapentin 600 mg is not a controlled substance under the Controlled Substances Act (CSA).

Gabapentin

Imprint

NT 16

Strength

600 mg

Color

White

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Greenstone LLC

National Drug Code (NDC)

59762-4355

NT 26 (Gabapentin 800 mg)

Pill with imprint NT 26 is White, Elliptical/Oval and has been identified as Gabapentin 800 mg. It is supplied by Greenstone LLC.

Gabapentin

Imprint: NT 26
Strength: 800 mg
Color: White
Shape: Elliptical/Oval
Availability: Prescription only
Drug Class: Gamma-aminobutyric acid analogs
Pregnancy Category: C – Risk cannot be ruled out
CSA Schedule: Not a controlled drug
Labeler / Supplier: Greenstone LLC
National Drug Code (NDC): 59762-4460

G6 Gabapentin 600mg, G8 Gabapentin 800mg – Ascend Laboratories, LLC

G 6 (Gabapentin 600 mg)

Pill with imprint G 6 is White, Elliptical/Oval and has been identified as Gabapentin 600 mg. It is supplied by Ascend Laboratories, LLC.

Gabapentin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy. Gabapentin 600 mg is not a controlled substance under the Controlled Substances Act (CSA).

Gabapentin

Imprint

G 6

Strength

600 mg

Color

White

Size

17.00 mm

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Ascend Laboratories, LLC

National Drug Code (NDC)

67877-0428

Inactive Ingredients

corn starch, poloxamer 407, magnesium silicate, hydroxypropyl cellulose, copovidone, magnesium stearate

G 8 (Gabapentin 800 mg)

Pill with imprint G 8 is White, Elliptical/Oval and has been identified as Gabapentin 800 mg. It is supplied by Ascend Laboratories, LLC.

Gabapentin

Imprint: G 8
Strength: 800 mg
Color: White
Size: 19.00 mm
Shape: Elliptical/Oval
Availability: Prescription only
Drug Class: Gamma-aminobutyric acid analogs
Pregnancy Category: C – Risk cannot be ruled out
CSA Schedule: Not a controlled drug
Labeler / Supplier: Ascend Laboratories, LLC
National Drug Code (NDC): 67877-0429
Inactive Ingredients: corn starch, poloxamer 407, magnesium silicate, hydroxypropyl cellulose, copovidone, magnesium stearate

Logo 4443 600 (Gabapentin 600mg), Logo 4444 800 (Gabapentin 800 mg) – Teva Pharmaceuticals USA

Logo 4443 600 (Gabapentin 600 mg)

Pill with imprint Logo 4443 600 is White, Elliptical/Oval and has been identified as Gabapentin 600 mg. It is supplied by Teva Pharmaceuticals USA.

Gabapentin is used in the treatment of postherpetic neuralgia; epilepsy and belongs to the drug class gamma-aminobutyric acid analogs. Risk cannot be ruled out during pregnancy. Gabapentin 600 mg is not a controlled substance under the Controlled Substances Act (CSA).

Gabapentin

Imprint

Logo 4443 600

Strength

600 mg

Color

White

Shape

Elliptical/Oval

Availability

Prescription only

Drug Class

Gamma-aminobutyric acid analogs

Pregnancy Category

C – Risk cannot be ruled out

CSA Schedule

Not a controlled drug

Labeler / Supplier

Teva Pharmaceuticals USA

National Drug Code (NDC)

00172-4443 (Discontinued)

Logo 4444 800 (Gabapentin 800 mg)

Pill with imprint Logo 4444 800 is White, Elliptical/Oval and has been identified as Gabapentin 800 mg. It is supplied by Teva Pharmaceuticals USA.

Gabapentin

Imprint: Logo 4444 800
Strength: 800 mg
Color: White
Shape: Elliptical/Oval
Availability: Prescription only
Drug Class: Gamma-aminobutyric acid analogs
Pregnancy Category: C – Risk cannot be ruled out
CSA Schedule: Not a controlled drug
Labeler / Supplier: Teva Pharmaceuticals USA
National Drug Code (NDC): 00172-4444 (Discontinued)