What cannot be mixed with gabapentin?
Gabapentin should not be combined with alcohol, opioids, or other CNS depressants. These combinations of gabapentin multiply sedative effects, increasing your risk of severe drowsiness, respiratory depression, and even fatal overdose. Certain medications, including some antacids, can reduce gabapentin absorption by up to 20%.
Patients with a history of alcohol withdrawal or drug use disorder need careful prescription drug monitoring when taking this medication. The Food and Drug Administration warns that combining gabapentin with substances that slow brain activity significantly raises safety concerns. If you’re taking gabapentin, consult your doctor before using any new medication or supplement to prevent dangerous interactions.
Why can’t you drink coffee with gabapentin?
Caffeine can interfere with the anxiolytic effects and therapeutic potential of gabapentin. Caffeine stimulates the central nervous system while gabapentin suppresses it. These opposing mechanisms of action may reduce gabapentin’s effectiveness for treating anxiety, pain, and seizures. Caffeine can worsen certain symptoms of alcohol withdrawal that gabapentin is meant to treat, including insomnia and irritability.
Both substances can affect sleep, but in opposite ways, disrupting the improved sleep benefits that gabapentin provides. For optimal clinical efficacy of your medication, consider limiting coffee intake or spacing consumption several hours apart from your gabapentin dose.
Can gabapentin be hard on the liver?
Unlike many other prescription drugs, gabapentin doesn’t undergo significant hepatic metabolism, making it generally liver-friendly. It has minimal impact on liver function, even with long-term use. This makes gabapentin a preferred option for individuals with alcohol use disorders who may have compromised liver health. The action of gabapentin bypasses liver processing as it’s eliminated primarily through kidney filtration unchanged.
If you’re experiencing jaundice or unusual fatigue, seek medical attention, as rare cases of liver reaction have been reported. For those with severe liver disease, dosage adjustments may be necessary based on kidney function rather than liver status.
Why can’t you take vitamin D with gabapentin?
There’s no established contraindication between vitamin D and gabapentin, but some studies suggest gabapentin may affect calcium absorption, which is crucial for vitamin D metabolism. Calcium supplements (often taken with vitamin D) can reduce gabapentin absorption by approximately 20% if taken simultaneously. The potential benefits of both treatments can be maintained by spacing doses at least 2 hours apart.
How long can you stay on gabapentin?
Many people take gabapentin for years without problems. The effects of gabapentin remain consistent for treating nerve pain, seizures, and even helping with alcohol use disorder symptoms. Some potential long-term effects include weight gain, mild memory issues, and drowsiness that might affect your daily tasks. Unlike many prescription drugs, gabapentin doesn’t typically create strong physical dependence.
Your doctor might adjust your dose over time based on your body’s response to alcohol (if you’re in recovery) or changes in your pain levels. Regular check-ins help catch side effects early while confirming that beneficial usage continues to outweigh drawbacks.
Do you build up a resistance to gabapentin?
You can develop some tolerance to gabapentin, but it happens much slower than with other drugs. If you’re using it for severe alcohol withdrawal or to improve effects on sleep during recovery, you might notice decreasing effectiveness over time. Several forms of gabapentin, including generic gabapentin and gabapentin enacarbil extended-release, show similar patterns. The effects of gabapentin vary between patients, and some never build tolerance. If your medication seems less effective at managing depressive symptoms or reducing alcohol consumption, talk to your doctor about adjusting your treatment plan.
Resources
Myrick H, Anton R, Voronin K, Wang W, Henderson S. A double-blind evaluation of gabapentin on alcohol effects and drinking in a clinical laboratory paradigm. Alcohol Clin Exp Res. 2007 Feb;31(2):221-7. doi: 10.1111/j.1530-0277.2006.00299.x. PMID: 17250613.
Vania Modesto-Lowe, Gregory C. Barron, Benjamin Aronow, Margaret Chaplin, Gabapentin for alcohol use disorder: A good option, or cause for concern?, Cleveland Clinic Journal of Medicine Dec 2019, 86 (12) 815-823; DOI: 10.3949/ccjm.86a.18128
Mason BJ, Quello S, Shadan F. Gabapentin for the treatment of alcohol use disorder. Expert Opin Investig Drugs. 2018 Jan;27(1):113-124. doi: 10.1080/13543784.2018.1417383. Epub 2017 Dec 23. PMID: 29241365; PMCID: PMC5957503.
Reyes Fernandez PC, Wright CS, Warden SJ, Hum J, Farach-Carson MC, Thompson WR. Effects of Gabapentin and Pregabalin on Calcium Homeostasis: Implications for Physical Rehabilitation of Musculoskeletal Tissues. Curr Osteoporos Rep. 2022 Dec;20(6):365-378. doi: 10.1007/s11914-022-00750-x. Epub 2022 Sep 23. PMID: 36149592; PMCID: PMC10108402.
Further reading
Is gabapentin considered a benzo?
How does alcohol affect the brain?
Effects of alcohol use on mental health
Is alcoholism a genetic condition?
