Dosing & Uses
Dosage Forms & Strengths
capsule
- 100mg
- 300mg
- 400mg
tablet
- 300mg (Gralise)
- 600mg (Gralise, Neurontin)
- 800mg (Neurontin)
oral solution
- 250mg/5mL
Partial Seizures
Neurontin
- Adjunctive therapy for partial seizures with or without secondary generalization
- Initial: 300 mg PO q8hr
- May increase up to 600 mg PO q8hr; up to 2400 mg/day administered and tolerated in clinical studies; up to 3600 mg administered for short duration and tolerated
Postherpetic Neuralgia
Neurontin
- Day 1: 300 mg PO qDay
- Day 2: 300 mg PO q12hr
- Day 3: 300 mg PO q8hr
- Maintenance: Subsequently titrate as needed up to 600 mg PO q8hr; doses >1800 mg/day have demonstrated no additional benefit
Gralise
- Titrate gradually to 1800 mg/day PO; take qDay with evening meal
- Day 1: 300 mg PO qDay
- Day 2: 600 mg PO qDay
- Days 3-6: 900 mg PO qDay
- Days 7-10: 1200 mg PO qDay
- Days 11-14: 1500 mg PO qDay
- Day 15 and after (maintenance): 1800 mg PO qDay
Dosing considerations
- Gralise tablets swell in gastric fluid and gradually release gabapentin
Restless legs syndrome (Off-label)
100-300 mg PO 2 hr before bedtime on first day; may titrate every 2 weeks until symptom relieve achieved (range 300-1800 mg/day)
Cocaine withdrawal (Off-label)
800-1500 mg/day PO in divided doses for up to 9 months
Insomnia (Off-label)
Up to 1800 mg PO evenings for up to 9 weeks
Diabetic Neuropathy (Off-label)
900 mg/day PO initially; may increase gradually q3Days to 1800-3600 mg/day
Tremors in multiple sclerosis (Off-label)
1200-1800 mg/day PO as monotherapy
Hot flashes-cancer related (Off-label)
200-1600 mg PO qDay to q6hr for 4-8 weeks
Amyotrophic Lateral Sclerosis (Orphan)
Neurontin
Orphan indication sponsor
- Warner-Lambert Company, Parke-Davis Pharmaceutical Research Division; 2800 Plymouth Road; Ann Arbor, MI 48105
Dosing Modifications
Renal impairment (Neurontin)
- CrCl >60 mL/min: 300-1200 mg PO TID
- CrCl 30-60 mL/min: 200-700 mg q12hr
- CrCl 15-29 mL/min: 200-700 mg qDay
- CrCl <15 mL/min: 100-300 mg qDay
- Hemodialysis (CrCl <15 mL/min): Administer supplemental dose (range 125-350 mg) posthemodialysis, after each 4 hr dialysis interval; further dose reduction should be in proportion to CrCl (eg, CrCl of 7.5 mL/min should receive one-half daily posthemodialysis dose)
Renal impairment (Gralise)
- CrCl ≥60 mL/min: 1800 mg qDay with evening meal
- CrCl 30-59 mL/min: 600-1800 mg qDay with evening meal
- CrCl <30 mL/min or hemodialysis: Do not administer
Administration
Reducing the dose, discontinuing the drug, or substituting an alternative medication should be done gradually over a minimum of 1 week or longer
Swallow Gralise tablets whole; do not cut, crush, or chew them
Dosage Forms & Strengths
capsule
- 100mg
- 300mg
- 400mg
tablet
- 300mg (Gralise)
- 600mg (Gralise, Neurontin)
- 800mg (Neurontin)
oral solution
- 250mg/5mL
Partial Seizures
Neurontin
- Adjunctive therapy for partial seizures with or without secondary generalization in patients older than 12 years of age with epilepsy; also indicated as adjunctive therapy for partial seizures in pediatric patients aged 3-12 years
- <3 years: Safety and efficacy not established
- 3-12 years (initial dose): 10-15 mg/kg/day PO divided q8hr initially; titrate up in approximately 3 days to effective maintenance dose
- 3-4 years (maintenance dose): 40 mg/kg/day PO divided q8hr
- 5-12 years (maintenance dose): 25-35 mg/kg/day PO divided q8hr
- >12 years (initial dose): 300 mg PO q8hr; may increase up to 600 mg PO q8hr
Dosing Considerations
Gralise tablets swell in gastric fluid and gradually release gabapentin
Dosing Modifications
Renal impairment: Gabapentin dose reduction may be required, depending on renal function
Interactions
Interaction Checker
No Results
Contraindicated
Serious
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious (18)
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine subdermal implant
buprenorphine subdermal implant and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine transdermal
buprenorphine transdermal and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl
fentanyl and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl intranasal
fentanyl intranasal and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl iontophoretic transdermal system
fentanyl iontophoretic transdermal system and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transdermal
fentanyl transdermal and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transmucosal
fentanyl transmucosal and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- methohexital
methohexital and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- metoclopramide intranasal
gabapentin, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- oliceridine
oliceridine and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- olopatadine intranasal
gabapentin and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- opicapone
opicapone and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- remifentanil
remifentanil and gabapentin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and gabapentin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- valerian
valerian and gabapentin both increase sedation. Avoid or Use Alternate Drug.
- zuranolone
gabapentin, zuranolone. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of zuranolone with other CNS depressants may increase impairment of psychomotor performance or CNS depressant effects. If unavoidable, consider dose reduction. .
Monitor Closely (148)
- acrivastine
acrivastine and gabapentin both increase sedation. Use Caution/Monitor.
- alprazolam
gabapentin, alprazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- aluminum hydroxide
aluminum hydroxide decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amisulpride
amisulpride and gabapentin both increase sedation. Use Caution/Monitor.
- amitriptyline
gabapentin, amitriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- amobarbital
gabapentin, amobarbital. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- amoxapine
gabapentin, amoxapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- asenapine
asenapine and gabapentin both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and gabapentin both increase sedation. Use Caution/Monitor.
- avapritinib
avapritinib and gabapentin both increase sedation. Use Caution/Monitor.
- belladonna and opium
gabapentin, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- benzhydrocodone/acetaminophen
gabapentin, benzhydrocodone/acetaminophen. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- brexanolone
brexanolone, gabapentin. Either increases toxicity of the other by sedation. Use Caution/Monitor.
gabapentin, brexanolone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. - brexpiprazole
gabapentin, brexpiprazole. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
brexpiprazole and gabapentin both increase sedation. Use Caution/Monitor. - brimonidine
brimonidine and gabapentin both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and gabapentin both increase sedation. Use Caution/Monitor.
- brompheniramine
gabapentin, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buprenorphine
gabapentin, buprenorphine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buprenorphine buccal
gabapentin, buprenorphine buccal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buprenorphine subdermal implant
gabapentin, buprenorphine subdermal implant. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buprenorphine transdermal
gabapentin, buprenorphine transdermal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buprenorphine, long-acting injection
gabapentin, buprenorphine, long-acting injection. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- bupropion
gabapentin, bupropion. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- buspirone
gabapentin, buspirone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- butabarbital
gabapentin, butabarbital. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- butalbital
gabapentin, butalbital. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- butorphanol
gabapentin, butorphanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- calcium carbonate
calcium carbonate decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- carbinoxamine
gabapentin, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- cariprazine
cariprazine and gabapentin both increase sedation. Use Caution/Monitor.
- cetirizine
gabapentin, cetirizine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- chloral hydrate
gabapentin, chloral hydrate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- chlordiazepoxide
gabapentin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- chlorpheniramine
gabapentin, chlorpheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- citalopram
gabapentin, citalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- clemastine
gabapentin, clemastine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- clobazam
gabapentin, clobazam. Either increases effects of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
gabapentin, clobazam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
clobazam and gabapentin both increase sedation. Use Caution/Monitor. - clomipramine
gabapentin, clomipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- clonazepam
gabapentin, clonazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- clonidine
clonidine and gabapentin both increase sedation. Use Caution/Monitor.
- clorazepate
gabapentin, clorazepate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- codeine
gabapentin, codeine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- cyproheptadine
gabapentin, cyproheptadine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- daridorexant
gabapentin and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desipramine
gabapentin, desipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- desloratadine
gabapentin, desloratadine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
desloratadine and gabapentin both increase sedation. Use Caution/Monitor. - desvenlafaxine
gabapentin, desvenlafaxine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- deutetrabenazine
gabapentin and deutetrabenazine both increase sedation. Use Caution/Monitor.
- dexbrompheniramine
dexbrompheniramine and gabapentin both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
gabapentin, dexchlorpheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- diazepam
gabapentin, diazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- diazepam buccal
diazepam buccal and gabapentin both increase sedation. Use Caution/Monitor.
gabapentin, diazepam buccal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. - diazepam intranasal
gabapentin, diazepam intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
diazepam intranasal and gabapentin both increase sedation. Use Caution/Monitor. - difelikefalin
difelikefalin and gabapentin both increase sedation. Use Caution/Monitor.
- dimenhydrinate
gabapentin, dimenhydrinate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- diphenhydramine
gabapentin, diphenhydramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- doxepin
gabapentin, doxepin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- doxylamine
gabapentin, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- duloxetine
gabapentin, duloxetine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- escitalopram
gabapentin, escitalopram. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- esketamine intranasal
esketamine intranasal, gabapentin. Either increases toxicity of the other by sedation. Use Caution/Monitor.
gabapentin, esketamine intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. - estazolam
gabapentin, estazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- eszopiclone
gabapentin, eszopiclone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
eszopiclone and gabapentin both increase sedation. Use Caution/Monitor. - ethanol
gabapentin, ethanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fentanyl
gabapentin, fentanyl. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fentanyl intranasal
gabapentin, fentanyl intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fentanyl transdermal
gabapentin, fentanyl transdermal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fentanyl transmucosal
gabapentin, fentanyl transmucosal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fexofenadine
gabapentin, fexofenadine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fluoxetine
gabapentin, fluoxetine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- flurazepam
gabapentin, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- fluvoxamine
fluvoxamine, gabapentin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coaadministration with CNS depressant may result in fatal respiratory depression. Use lowest dose possible and monnitor for respiratory depression and sedation.
- ganaxolone
gabapentin and ganaxolone both increase sedation. Use Caution/Monitor.
- gepirone
gabapentin, gepirone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- hydrocodone
gabapentin, hydrocodone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- hydromorphone
gabapentin, hydromorphone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- hydroxyzine
gabapentin, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- imipramine
gabapentin, imipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- isocarboxazid
gabapentin, isocarboxazid. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- lasmiditan
lasmiditan, gabapentin. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- lemborexant
lemborexant, gabapentin. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levetiracetam
levetiracetam and gabapentin both increase sedation. Use Caution/Monitor.
- levocetirizine
gabapentin, levocetirizine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
levocetirizine and gabapentin both increase sedation. Use Caution/Monitor. - levomilnacipran
gabapentin, levomilnacipran. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- levorphanol
gabapentin, levorphanol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- loratadine
gabapentin, loratadine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
loratadine and gabapentin both increase sedation. Use Caution/Monitor. - lorazepam
gabapentin, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- loxicodegol
gabapentin, loxicodegol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- lumateperone
gabapentin, lumateperone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
lumateperone and gabapentin both increase sedation. Use Caution/Monitor. - lurasidone
lurasidone, gabapentin. Either increases effects of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
lurasidone and gabapentin both increase sedation. Use Caution/Monitor. - magnesium supplement
magnesium supplement will decrease the level or effect of gabapentin by Other (see comment). Modify Therapy/Monitor Closely. Drug may form a chelate with polyvalent cations; may decrease absorption by the intestinal tract; applies to oral forms; may administer 2 hr from polyvalent cation administration
- maprotiline
gabapentin, maprotiline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- meclizine
meclizine and gabapentin both increase sedation. Use Caution/Monitor.
- meperidine
gabapentin, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- meprobamate
gabapentin, meprobamate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- methadone
gabapentin, methadone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- methsuximide
methsuximide and gabapentin both increase sedation. Use Caution/Monitor.
- midazolam
gabapentin, midazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- midazolam intranasal
midazolam intranasal, gabapentin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
gabapentin, midazolam intranasal. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. - milnacipran
gabapentin, milnacipran. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- mirtazapine
gabapentin, mirtazapine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- molindone
molindone and gabapentin both increase sedation. Use Caution/Monitor.
- morphine
gabapentin, morphine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
gabapentin, morphine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. - nalbuphine
gabapentin, nalbuphine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- nefazodone
gabapentin, nefazodone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- nitrous oxide
nitrous oxide and gabapentin both increase sedation. Use Caution/Monitor.
- nortriptyline
gabapentin, nortriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- oliceridine
gabapentin, oliceridine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- orlistat
orlistat decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.
- oxazepam
gabapentin, oxazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- oxycodone
gabapentin, oxycodone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- oxymorphone
gabapentin, oxymorphone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- paroxetine
gabapentin, paroxetine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- pentazocine
gabapentin, pentazocine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- pentobarbital
gabapentin, pentobarbital. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- phenelzine
gabapentin, phenelzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- promethazine
gabapentin, promethazine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- protriptyline
gabapentin, protriptyline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- quazepam
gabapentin, quazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- ramelteon
gabapentin, ramelteon. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- remifentanil
gabapentin, remifentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- remimazolam
gabapentin, remimazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- samidorphan
gabapentin, samidorphan. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- sertraline
gabapentin, sertraline. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- sevelamer
sevelamer decreases levels of gabapentin by increasing elimination. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium citrate/citric acid
sodium citrate/citric acid decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer gabapentin at least 2 hr after each dose to avoid chelation with magnesium. .
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer gabapentin at least 2 hr after each dose to avoid chelation with magnesium. .
- stiripentol
stiripentol, gabapentin. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation. .
- sufentanil
gabapentin, sufentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- sufentanil SL
gabapentin, sufentanil SL. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- suvorexant
gabapentin, suvorexant. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- tapentadol
gabapentin, tapentadol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- tasimelteon
gabapentin, tasimelteon. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
tasimelteon and gabapentin both increase sedation. Use Caution/Monitor. - temazepam
gabapentin, temazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- tramadol
gabapentin, tramadol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- tranylcypromine
gabapentin, tranylcypromine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- trazodone
gabapentin, trazodone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- triazolam
gabapentin, triazolam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- trimipramine
gabapentin, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- triprolidine
gabapentin, triprolidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- venlafaxine
gabapentin, venlafaxine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- vilazodone
gabapentin, vilazodone. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- vortioxetine
gabapentin, vortioxetine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- xanomeline/trospium
gabapentin, xanomeline/trospium. Either increases levels of the other by decreasing elimination. Use Caution/Monitor. Coadministration of trospium with other drugs eliminated by active tubular secretion may increase plasma concentrations of trospium and/or the concomitantly used drug owing to competition for this elimination pathway. Monitor for increased frequency and/or severity of adverse reactions.
- zaleplon
gabapentin, zaleplon. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- zolpidem
gabapentin, zolpidem. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
Minor (15)
- acetaminophen IV
gabapentin decreases levels of acetaminophen IV by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.
- acetaminophen rectal
gabapentin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.
- atracurium
gabapentin decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- biotin
gabapentin decreases levels of biotin by unspecified interaction mechanism. Minor/Significance Unknown. Biotin supplementation may be necessary.
- cisatracurium
gabapentin decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyanocobalamin
gabapentin decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- dexmethylphenidate
dexmethylphenidate increases effects of gabapentin by decreasing metabolism. Minor/Significance Unknown.
- levocarnitine
gabapentin decreases levels of levocarnitine by unspecified interaction mechanism. Minor/Significance Unknown.
- pancuronium
gabapentin decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rapacuronium
gabapentin decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- rocuronium
gabapentin decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
- sage
sage decreases effects of gabapentin by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction; some species of sage may cause convulsions.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of gabapentin by decreasing metabolism. Minor/Significance Unknown.
- succinylcholine
gabapentin decreases effects of succinylcholine by pharmacodynamic antagonism. Minor/Significance Unknown.
- vecuronium
gabapentin decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
>10%
Ataxia (1-13%)
Dizziness (16-20%)
Drowsiness (5-21%)
Fatigue (11-15%)
Somnolence (16-20%)
1-10%
Diplopia (6-10%)
Nystagmus (6-10%)
Tremor (6-10%)
Amblyopia (1-5%)
Back pain (1-5%)
Constipation (1-5%)
Depression (1-5%)
Dry mouth (1-5%)
Dysarthria (1-5%)
Dyspepsia (1-5%)
Hostility (5-8% children)
Hyperkinesia (3-5%)
Increased appetite (1-5%)
Leukopenia (1-5%)
Myalgia (1-5%)
Nervousness (1-5%)
Peripheral edema (1-5%)
Pharyngitis (1-5%)
Pruritus (1-5%)
Rhinitis (1-5%)
Vasodilation (1-5%)
Weight gain (1-5%)
Abnormal vision (>1%)
Anorexia (>1%)
Arthralgia (>1%)
Asthenia (>1%)
HTN (>1%)
Malaise (>1%)
Paresthesia (>1%)
Purpura (>1%)
Vertigo (>1%)
Postmarketing Reports
Angioedema
Blood glucose fluctuation
Breast enlargement
Erythema multiforme
Elevated liver function tests
Fever
Hyponatremia
Jaundice
Stevens-Johnson syndrome
Adverse events following abrupt discontinuation have also been reported; the most frequently reported events have been anxiety, insomnia, nausea, pain, and sweating
Postmarketing reports
Changes in libido, ejaculation disorders, and anorgasmia
Agitation (pediatric)
Respiratory depression
Bullous pemphigoid
Warnings
Contraindications
Hypersensitivity
Cautions
Increased blood CPK levels and rhabdomyolysis reported
Antiepileptic drugs increase risk of suicidal thoughts or behavior in patients taking these drugs for any indication; monitor for emergence or worsening depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
Anaphylaxis and angioedema reported after first dose or at any time during treatment; instruct patients to discontinue therapy and seek medical care should they experience signs or symptoms of anaphylaxis or angioedema
May cause CNS depression, which may impair ability to operate heavy machinery; advise patients not to drive until they have gained enough experience to assess whether therapy will impair ability to drive
Extended release formulation (Gralise) not studied in the treatment of seizures
Extended release formulation (Gralise), not interchangeable with immediate release
May potentiate effects of other sedatives or ethanol when administered concomitantly
Do not discontinue abruptly (may increase seizure frequency); gradually taper over a minimum of 1 week
Ages 3-12 years: Risk of neuropsychiatric adverse events, including emotional lability, hostility, thought disorders, and hyperkinesia
Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as multiorgan hypersensitivity, reported; some of these events have been fatal or life-threatening; typically presents with fever, rash, and/or lymphadenopathy in association with other organ system involvement (eg, hepatitis, nephritis, hematologic abnormalities, myocarditis, myositis) and may resemble an acute viral infection
Serious, life-threatening, or fatal respiratory depression reported when coadministered with central nervous system depressants, including opioids, or in the setting of underlying respiratory impairment; consider initiating therapy at low dose and monitor for symptoms of respiratory depression and sedation if co-prescribing of another CNS depressant, like opioid, or prescribing to patients with underlying respiratory impairment
Pregnancy & Lactation
Pregnancy
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs) during pregnancy; encourage women during pregnancy to enroll in North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling the toll free number 1-888-233-2334 or visiting https://www.aedpregnancyregistry.org/
Totality of available data from published prospective and retrospective cohort studies pertaining to use during pregnancy has not indicated an increased risk of major birth defects or miscarriage; there are important methodological limitations hindering interpretation of these studies; in nonclinical studies in mice, rats, and rabbits, the drug was developmentally toxic (increased fetal skeletal and visceral abnormalities, and increased embryofetal mortality) when administered to pregnant animals at doses similar to or lower than those used clinically
Lactation
Gabapentin is secreted in human milk following oral administration; effects on breastfed infant and on milk production are unknown; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from treatment or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
GABA analogue; structurally related to neurotransmitter GABA, but has no effect on GABA binding, uptake, or degradation; presence of gabapentin binding sites throughout the brain reported; mechanism for analgesic and anticonvulsant activity unknown
Absorption
Variable from proximal small bowel by L-amino transport system
Neurontin
- Bioavailability: Inversely proportion to dose; 60% (900 mg/day); 47% (1200 mg/day); 34% (2400 mg/day); 33% (3600 mg/day); 27% (4800 mg/day)
- Peak plasma time: 2-4 hr
- Peak plasma concentration: 8536 ng/mL
- AUC: 141,301 ng•hr/mL
Gralise
- Bioavailability: Increased with high fat meal
- Peak plasma time: 8 hr
- Peak plasma concentration: 9585 ng/mL (1800 mg qDay)
- AUC: 132,808 ng•hr/mL
Distribution
Protein bound: <3%
Vd: 58 L
Metabolism
Gabapentin is not appreciably metabolized in humans
Not a substrate, inducer, or inhibitor of CYP450 isoenzymes
Elimination
Half-life: 5-7 hr
Dialyzable: Yes
Renal clearance: 225 mL/min; 125 mL/min (if older than 70 y)
Total body clearance: Proportional to CrCl
Excretion: Urine
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Gralise oral - | 450 mg tablet |  | |
| Gralise oral - | 900 mg tablet |  | |
| Gralise oral - | 750 mg tablet |  | |
| Gralise oral - | 300 mg tablet |  | |
| Gralise oral - | 600 mg tablet |  | |
| Gralise oral - | 300 mg (9)- 600 mg (24) tablet |  | |
| Neurontin oral - | 300 mg capsule |  | |
| Neurontin oral - | 400 mg capsule |  | |
| Neurontin oral - | 800 mg tablet |  | |
| Neurontin oral - | 600 mg tablet |  | |
| Neurontin oral - | 100 mg capsule |  | |
| Neurontin oral - | 600 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
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