When taking gabapentin, it’s important to be aware of certain interactions, substances, and activities that can amplify side effects or reduce the medication’s effectiveness.
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
Here’s a guide on what to avoid:
1. Alcohol
- Combining gabapentin with alcohol can increase:
- Drowsiness
- Dizziness
- Impaired motor coordination
- Risk of central nervous system (CNS) depression
- This combination also raises the risk of accidents or falls.
2. Other CNS Depressants
- Examples: Opioids, benzodiazepines, sedatives, or antihistamines (e.g., diphenhydramine).
- These can enhance gabapentin’s sedative effects, leading to:
- Excessive sedation
- Respiratory depression (potentially dangerous)
- Cognitive impairment
3. Operating Heavy Machinery or Driving
- Gabapentin may cause dizziness, drowsiness, or blurred vision, especially when starting the medication or increasing the dose.
- Avoid activities requiring alertness until you understand how gabapentin affects you.
4. High-Magnesium or High-Aluminum Antacids
- Why: These antacids (e.g., Maalox, Mylanta) can reduce the absorption of gabapentin.
- Recommendation: Take gabapentin at least 2 hours after antacids.
5. Sudden Discontinuation
- Abruptly stopping gabapentin can lead to:
- Withdrawal symptoms (e.g., anxiety, insomnia, sweating, or seizures)
- A return or worsening of the condition it was treating.
- Recommendation: Always taper off gabapentin under medical supervision.
6. Grapefruit
- While grapefruit does not directly interact with gabapentin, it can interact with medications metabolized by the liver. Check with your doctor if you take other medications with gabapentin.
7. Overlapping Sedative Medications
- Examples: Sleep aids (e.g., zolpidem), muscle relaxants, or other antiepileptic drugs.
- These can increase the risk of sedation, confusion, and falls.
8. Large Changes in Diet
- Gabapentin may interact with certain foods or supplements if the timing or content disrupts its absorption. It’s generally recommended to maintain a consistent routine for taking the medication.
9. Cannabis
- Cannabis use can amplify gabapentin’s sedative effects, increasing drowsiness, dizziness, and confusion.
10. Other Medications or Substances
- Opiates (e.g., oxycodone, morphine): Increases risk of respiratory depression.
- Herbal supplements: Particularly sedatives like valerian or kava, which can enhance drowsiness.
- Caffeine: May interfere with gabapentin’s ability to reduce nerve pain in some people.