Gabapentin is a medication commonly prescribed to manage nerve pain and certain types of seizures. It functions by affecting chemical messengers in the brain and nerves, helping to calm overactive nerve cells. Understanding potential drug interactions is important, as combining gabapentin with other substances can alter its effects or lead to unexpected side effects.
Medications That Increase Sedation and Drowsiness
Combining gabapentin with other medications that depress the central nervous system (CNS) can significantly increase sedation, dizziness, and impaired coordination. Gabapentin itself can cause drowsiness and dizziness, and these effects are amplified when taken with other CNS depressants. The Food and Drug Administration (FDA) issued a warning in 2019 about the heightened risk of serious breathing problems when gabapentin is combined with other CNS depressants.
Opioids, such as oxycodone or morphine, are a major concern because they can cause tiredness and slow breathing, effects that are worsened when combined with gabapentin. This combination also increases the risk of severe sleepiness, difficulty breathing, coma, and even death.
Benzodiazepines, like alprazolam or lorazepam, also intensify drowsiness and dizziness when taken with gabapentin. Similarly, certain antihistamines, such as diphenhydramine, and muscle relaxants like cyclobenzaprine, can increase sedative effects. Alcohol also acts as a CNS depressant, and drinking it while taking gabapentin can increase the risk of sleepiness and dizziness.
Medications Affecting Gabapentin Absorption or Clearance
Some medications can interfere with how gabapentin is absorbed into the bloodstream or eliminated from the body, potentially altering its effectiveness. Gabapentin is primarily excreted unchanged by the kidneys. This means substances affecting absorption in the digestive tract or kidney function could impact its concentration in the body.
Antacids containing aluminum and magnesium, such as Maalox or Mylanta, are known to reduce gabapentin absorption by up to 20%. This occurs because these antacids can bind to gabapentin, preventing its proper uptake. To avoid this interaction, take gabapentin at least two hours before or after an antacid containing aluminum or magnesium. Other medications impacting kidney function may also alter gabapentin clearance, as its removal depends on healthy kidney function.
Important Considerations and When to Seek Medical Advice
Always inform healthcare providers, including doctors and pharmacists, about all medications, supplements, and herbal remedies being taken. This allows them to check for potential drug interactions and adjust dosages or recommend alternatives to avoid adverse effects. Never adjust gabapentin doses or stop taking the medication without consulting a healthcare provider, as suddenly stopping can increase the risk of seizures if gabapentin is used for seizure control.
Be aware of signs that may indicate a potential adverse drug interaction. These can include unusual dizziness, extreme drowsiness, confusion, impaired coordination, breathing difficulties (such as slow or shallow breathing), or unusual weakness. If these symptoms occur, contact a doctor for guidance. Seek immediate emergency medical attention if severe breathing problems, blue-colored lips, unresponsiveness, or signs of a serious allergic reaction like a rash, hives, or swelling of the face, lips, or throat develop.