Can I Take Gabapentin When I Take Other Medicines and Herbal Supplements ?

Some medicines may affect how gabapentin works or increase the chance of you having side effects.

Antacids are medicines that counteract (neutralise) the acid in your stomach to relieve indigestion and heartburn.

They come as a liquid or chewable tablets and can be bought from pharmacies and shops without a prescription.

When antacids are used

Antacids may help if you have:

    • indigestion
    • heartburn or acid reflux – also known as gastro-oesophageal reflux disease (GORD)
    • a stomach ulcer
    • gastritis (inflammation of the stomach lining)

They can quickly relieve your symptoms for a few hours. But they do not treat the underlying cause and long-term use is not recommended.

Common types of antacids

Many different types of antacid are available. Some are sold under a brand name and others are named after their main ingredient. Brands include Gaviscon (alginic acid) and Pepto-Bismol (bismuth subsalicylate).

Ingredients to look for include:

      • aluminium hydroxide
      • magnesium carbonate
      • magnesium trisilicate
      • magnesium hydroxide
      • calcium carbonate
      • sodium bicarbonate

Some antacids also contain other medicines, such as an alginate (which coats your gullet with a protective layer) and simeticone (which reduces flatulence).

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.

Potential issues with herbal medicines

If you’re taking, or plan to take, any herbal medicines, be aware of the following:

    • They may cause problems if you’re taking other medicines. They could result in reduced or enhanced effects of the medicine, including potential side effects.
    • You may experience a bad reaction or side effects after taking a herbal medicine.
    • Not all herbal medicines are regulated. Remedies specially prepared for individuals don’t need a licence, and those manufactured outside the UK may not be subject to regulation.
    • Evidence for the effectiveness of herbal medicines is generally very limited. Although some people find them helpful, in many cases their use tends to be based on traditional use rather than scientific research.

Certain groups of people should be particularly wary of taking herbal medicines.

Who should avoid herbal medicines?

Taking a herbal medicine may not be suitable for:

    • people taking other medicines
    • people with serious health conditions, such as liver or kidney disease
    • people who are going to have surgery
    • pregnant or breastfeeding women
    • the elderly
    • children – as with all medicines, herbal medicines should be kept out of the sight and reach of children

Speak to your doctor or pharmacist for advice before trying a herbal medicine if you fall into one of these groups.

Are there any serious interactions with gabapentin and other medications?

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.

Can I drink alcohol while taking gabapentin?

Avoid drinking alcohol while taking gabapentin. Drinking alcohol with gabapentin could increase sleepiness or dizziness.

Can I drive or ride a bike after I take Gabapentin ?

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults.

Gabapentin is known as an anticonvulsant or antiepileptic drug.

You may feel sleepy, tired or dizzy when you first start taking gabapentin. This may also happen if your dose has increased.

If this happens to you, do not drive or ride a bike until you feel better.

It’s an offence to drive a car if your ability to drive safely is affected. It’s your responsibility to decide if it’s safe to drive. If you’re in any doubt, do not drive.

If you have epilepsy, you are generally not allowed to drive until:

    • you have not had any seizures (while awake) for 1 year
    • you have only had seizures while you’re asleep

If you change your epilepsy medicine, your doctor will tell you whether you need to stop driving and for how long.

Do I need to stay on the same brand of Gabapentin?

Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy.

Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).

Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Most people do not have to stay on the same brand of gabapentin as there’s very little difference between brands.

Talk to your doctor if you have been asked to switch to a different brand and are worried about that.

If your epilepsy has been hard to control in the past and the brand you’re now taking is working well for you, your doctor may recommend you stay on the same one.

How and when to take Gabapentin ?

Gabapentin is a prescription medicine. It’s important to take it as advised by your doctor.

Dosage and strength

Each capsule of gabapentin contains 100mg, 300mg or 400mg of gabapentin. Each tablet contains 600mg or 800mg of gabapentin.

If you’re taking gabapentin as a liquid, 2ml is usually the same as taking a 100mg tablet or capsule. Always check the label.

Dosage for epilepsy

The usual dose for:

    • adults and older children (aged 12 and over) is 900mg to 3,600mg a day, split into 3 doses
    • younger children (aged 6 to 12) – varies depending on their weight

Dosage for nerve pain

The usual dose to treat nerve pain in adults is 900mg to 3,600mg a day, split into 3 doses.

Changes to your dose

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days. Once you find a dose that suits you, it will usually stay the same.

How to take Gabapentin ?

Swallow gabapentin capsules and tablets whole with a drink of water or juice. Do not chew them.

You can take gabapentin with or without food, but it’s best to do the same each day.

Try to space your doses evenly through the day. For example, you could take it first thing in the morning, early afternoon and at bedtime.

If you or your child are taking a liquid, it will come with a plastic syringe or spoon to measure your dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen spoon, as it will not measure the right amount.

How long to take it for

If you have epilepsy, it’s likely that once your condition is under control you’ll still need to take gabapentin for many years.

If you have nerve pain, once your pain has gone you’ll continue to take gabapentin for several months or longer to stop it coming back.

If you forget to take it

If you forget a dose, take it as soon as you remember. If it’s within 2 hours of the next dose, it’s better to leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you have epilepsy, it’s important to take this medicine regularly. Missing doses may trigger a seizure.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much gabapentin can cause unpleasant side effects.

Urgent advice: Contact 111 for advice or go to A&E now if:

you take more than your prescribed dose of gabapentin and:

    • you feel dizzy or sleepy
    • you have double vision
    • you start slurring your words
    • you have diarrhoea
    • you pass out (faint)

If you need to go to A&E, take the gabapentin packet or leaflet inside it, plus any remaining medicine, with you.

Stopping gabapentin

It’s important not to stop taking gabapentin suddenly, even if you feel fine. Stopping gabapentin suddenly can cause serious problems.

If you have epilepsy, stopping gabapentin suddenly can cause seizures that will not stop.

If you’re taking it for any reason and stop suddenly, you may have a severe withdrawal syndrome. This can have unpleasant symptoms, including:

    • anxiety
    • difficulty sleeping
    • feeling sick
    • pain
    • sweating

It’s possible to prevent withdrawal seizures and other symptoms by gradually reducing the dose of gabapentin.

Do not stop taking gabapentin without talking to your doctor – you’ll need to reduce your dose gradually.

Risks of taking Gabapentin during pregnancy and when breastfeeding

Risks during pregnancy and when breastfeeding

People who are pregnant and those who intend to become pregnant should tell a doctor before taking gabapentin.

Research from 2020 suggests that taking this drug during pregnancy may be associated with a higher risk of cardiac malformations in the fetus, a condition called small for gestational age, and preterm birth.

However, it is also essential to control seizures during pregnancy, so pregnant people should only take the drug if it is absolutely necessary.

People should never start or stop taking gabapentin for seizure control before talking with a doctor. They will assess the potential risks and benefits.

After childbirth, gabapentin passes into breast milk. At low levels, it may not affect the infant. However, it is best to discuss this issue with a doctor before breastfeeding.