Gabapentin (Neurontin) is an anticonvulsant (antiseizure) medication that’s FDA approved to treat seizures and post-herpetic neuralgia (nerve pain from shingles). It’s also considered a first-choice treatment option for general nerve pain. But this is an off-label use.
Gabapentin is also available as Gralise, an extended-release (ER) formulation. It’s approved for post-herpetic neuralgia. Another ER formulation (Horizant) is FDA approved for post-herpetic neuralgia and restless leg syndrome.
Though gabapentin has many uses, it can interact with other medications. Some gabapentin interactions may worsen the side effects of gabapentin, like dizziness and sleepiness. Others may make gabapentin less effective.
Serious breathing problems can happen if you take gabapentin with drugs that cause severe sleepiness or decreased awareness. Some examples include narcotic opioids, anti-anxiety medicines, antidepressants, and antihistamines. If you are 65 years of age or older and/or have a condition that affects your lungs, such as chronic obstructive pulmonary disease (COPD), there is an increased risk for breathing problems. Watch for increased sleepiness or decreased breathing when you start taking gabapentin or when the dose is increased. Get help right away if you develop breathing problems.
Seek immediate medical attention if these symptoms develop:
- Confusion.
- Unusual dizziness or lightheadedness.
- Slowed, shallow or trouble breathing.
- Unresponsiveness (can’t wake up).
- Bluish-colored or tinted skin, especially on lips, fingers or toes.
What other medications and products can interact with gabapentin?
Products that interact with gabapentin include:
- Alcohol.
- Antihistamine-containing cold, cough and allergy products.
- Certain medicines for anxiety or sleep.
- Certain medicines for depression, such as amitriptyline, fluoxetine and sertraline.
- Certain medicines for seizures, such as phenobarbital and primidone.
- Certain medicines for stomach problems. (Wait two hours after taking aluminum and magnesium-containing antacids before taking gabapentin.)
- General anesthetics, local anesthetics, or muscle relaxants given before surgery.
- Narcotic pain medicines.
Cautions with other medicines
Some medicines may affect how gabapentin works or increase the chance of you having side effects.
Antacids can reduce the amount of gabapentin that the body takes in so it does not work as well. To stop this happening, if you need to take an antacid, take it at least 2 hours before or after your dose of gabapentin.
Tell your doctor if you’re taking any of these medicines before you start gabapentin treatment:
- strong painkillers, such as morphine – these can make you very tired and dizzy when you start taking gabapentin
- antidepressants, such as amitriptyline or fluoxetine
- antipsychotic medicines for mental health problems like schizophrenia or bipolar disorder
- a medicine to prevent malaria called mefloquine
Mixing gabapentin with herbal remedies or supplements
Taking herbal remedies and supplements that can make you feel dizzy or drowsy while you’re taking gabapentin could make these side effects worse.