Drug interactions
Clonazepam + Gabapentin
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.
Overview
Additive CNS and respiratory depression leading to excessive sedation, dizziness, impaired coordination, and risk of hypoventilation, especially in older adults, those with respiratory disease, or when other CNS depressants are present.
Mechanism of action
Pharmacodynamic interaction: clonazepam enhances GABA-A activity; gabapentin binds the alpha-2-delta subunit of voltage-gated calcium channels reducing excitatory neurotransmission. Combined effects increase CNS depression and suppress respiratory drive. No significant pharmacokinetic interaction.
Clinical management
Avoid combination when possible. If coadministration is necessary, use lowest effective doses, titrate slowly, adjust gabapentin for renal function, avoid other CNS depressants (e.g., alcohol, opioids), and monitor closely for excessive sedation and respiratory depression; advise against driving or hazardous tasks until individual response is known.
Drug reference
References
- FDA warns about serious breathing problems with seizure and nerve pain medicines gabapentin and pregabalin — FDA Drug Safety Communication
- Neurontin (gabapentin) Prescribing Information — Warnings and Precautions: Respiratory depression/CNS depressants — FDA Label
- Clonazepam (Klonopin) Prescribing Information — Warnings and Precautions: Concomitant use with CNS depressants — FDA Label
- Gabapentin and pregabalin: Uses, dosing, adverse effects, and drug interactions — UpToDate
- Gabapentin: Drug Interactions (benzodiazepines) — Lexicomp
Frequently asked questions
Can I take Clonazepam with Gabapentin?
The interaction is rated: Major. Additive CNS and respiratory depression leading to excessive sedation, dizziness, impaired coordination, and risk of hypoventilation, especially in older adults, those with respiratory disease, or when other CNS depressants are present.
How serious is the interaction between Clonazepam and Gabapentin?
The interaction is rated: Major. Evidence level: Moderate.
How is the interaction between Clonazepam and Gabapentin managed?
Avoid combination when possible. If coadministration is necessary, use lowest effective doses, titrate slowly, adjust gabapentin for renal function, avoid other CNS depressants (e.g., alcohol, opioids), and monitor closely for excessive sedation and respiratory depression; advise against driving or hazardous tasks until individual response is known.
Why do Clonazepam and Gabapentin interact?
Pharmacodynamic interaction: clonazepam enhances GABA-A activity; gabapentin binds the alpha-2-delta subunit of voltage-gated calcium channels reducing excitatory neurotransmission. Combined effects increase CNS depression and suppress respiratory drive. No significant pharmacokinetic interaction.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.