Gabapentin interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Gabapentin needs care, as documented in this source.

• Kidney Diseases

  Major

  Gabapentin is primarily eliminated unchanged by the kidney. Therapy with gabapentin should be administered cautiously in patients with impaired renal function. Dosage adjustments and titration should be made in accordance with product package labeling and individual patient response.

  4 sources

  1. Vollmer KO, von Hodenberg A, Kolle EU "Pharmacokinetics and metabolism of gabapentin in rat, dog and man." Arzneimittelforschung 36 (1986): 830-9
  2. "Product Information. Neurontin (gabapentin)." Parke-Davis (2001):
  3. Mclean MJ "Clinical pharmacokinetics of gabapentin." Neurology 44 (1994): 17-22
  4. Blum RA, Comstock TJ, Sica DA, Schultz RW, Keller E, Reetze P, Bockbrader H, Tuerck D, Busch JA, Reece PA, et al. "Pharmacokinetics of gabapentin in subjects with various degrees of renal function." Clin Pharmacol Ther 56 (1994): 154-9

• Substance-Related Disorders

  Major

  Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

  7 sources

  1. Cavallaro R, Regazzetti MG, Covelli G, Smeraldi E "Tolerance and withdrawal with zolpidem." Lancet 342 (1993): 374-5
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. Gericke CA, Ludolph AC "Chronic abuse of zolpidem." JAMA 272 (1994): 1721-2
  4. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  5. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  6. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  7. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):

• Depressive Disorder

  Moderate

  Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

  16 sources

  1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
  2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
  3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
  4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
  5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
  6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
  7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
  8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):

  Show all 16 sourcesShow fewer sources

  9. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
  10. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  11. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
  12. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
  13. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
  14. "Product Information. Xcopri (cenobamate)." SK Life Science, Inc. (2020):
  15. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
  16. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):

• Diseases requiring hemodialysis

  Moderate

  Gabapentin is removed by hemodialysis and should be administered after dialysis.

  2 sources

  1. "Product Information. Neurontin (gabapentin)." Parke-Davis (2001):
  2. Wong MO, Eldon MA, Keane WF, Turck D, Bockbrader HN, Underwood BA, Sedman AJ, Halstenson CE "Disposition of gabapentin in anuric subjects on hemodialysis." J Clin Pharmacol 35 (1995): 622-6