Drug interactions
Gabapentin + Hydrocodone
Severity: Major
Gabapentin and Hydrocodone: major interaction.
Last updated
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
Gabapentin adds to the central nervous system and respiratory depressant effects of hydrocodone. Together they can cause profound sedation, respiratory depression, coma and death, particularly in older patients, those with lung disease, or at higher doses.
What this interaction means in plain words
Gabapentin and Hydrocodone 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.
Gabapentin belongs to Central Nervous System; Hydrocodone belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic CNS and respiratory depression from opioid receptor agonism and gabapentinoid activity.
What to do
Use the lowest effective doses and shortest duration of both drugs, and consider starting gabapentin at a reduced dose. Monitor for sedation and slowed breathing, and counsel patients to avoid alcohol and other sedatives.
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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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Gabapentin
Frequently asked questions
Can I take Gabapentin with Hydrocodone?
MediHelp rates the interaction as major. Gabapentin and Hydrocodone 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. Gabapentin adds to the central nervous system and respiratory depressant effects of hydrocodone. Together they can cause profound sedation, respiratory depression, coma and death, particularly in older patients, those with lung disease, or at higher doses.
How serious is the interaction between Gabapentin and Hydrocodone?
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 shortest duration of both drugs, and consider starting gabapentin at a reduced dose. Monitor for sedation and slowed breathing, and counsel patients to avoid alcohol and other sedatives.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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