Drug interactions
Buprenorphine + Gabapentin
Severity: Major
Buprenorphine and Gabapentin: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Gabapentinoids combined with opioids increase the risk of profound sedation, respiratory depression, coma and death. Regulators have warned about this risk, particularly in older patients and those with lung disease or opioid-use disorder.
What this interaction means in plain words
Buprenorphine and Gabapentin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Buprenorphine belongs to Musculoskeletal; Gabapentin belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression.
What to do
Use the lowest effective doses and titrate gradually, monitoring for sedation and slowed breathing. Avoid other CNS depressants and counsel patients and caregivers about warning signs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Buprenorphine
- Alvimopan + Buprenorphine Contraindicated
- Buprenorphine + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Buprenorphine + Olanzapine / samidorphan Contraindicated
- Buprenorphine + Phenelzine Contraindicated
- Buprenorphine + Pimozide Contraindicated
- Buprenorphine + Thioridazine Contraindicated
Other interactions of Gabapentin
Frequently asked questions
Can I take Buprenorphine with Gabapentin?
MediHelp rates the interaction as major. Buprenorphine and Gabapentin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Gabapentinoids combined with opioids increase the risk of profound sedation, respiratory depression, coma and death. Regulators have warned about this risk, particularly in older patients and those with lung disease or opioid-use disorder.
How serious is the interaction between Buprenorphine and Gabapentin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and titrate gradually, monitoring for sedation and slowed breathing. Avoid other CNS depressants and counsel patients and caregivers about warning signs.
What other medicines interact with Buprenorphine?
MediHelp also lists interactions of Buprenorphine with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Olanzapine / samidorphan. The full list is on the Buprenorphine page.
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