Drug interactions
Gabapentin + Remifentanil
Severity: Major
Gabapentin and Remifentanil: 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 combined with opioids increases the risk of profound sedation and respiratory depression. Regulators have warned about this combination, particularly in older patients and those with lung disease.
What this interaction means in plain words
Gabapentin and Remifentanil 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; Remifentanil belongs to Musculoskeletal.
Why it happens
Additive central nervous system and respiratory depression.
What to do
Use the lowest effective doses and monitor sedation and respiratory rate, including after the procedure. Consider reducing the remifentanil dose.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Benzhydrocodone / acetaminophen + Remifentanil Major
- Brexanolone + Remifentanil Major
Other interactions of Gabapentin
Frequently asked questions
Can I take Gabapentin with Remifentanil?
MediHelp rates the interaction as major. Gabapentin and Remifentanil 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 combined with opioids increases the risk of profound sedation and respiratory depression. Regulators have warned about this combination, particularly in older patients and those with lung disease.
How serious is the interaction between Gabapentin and Remifentanil?
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 monitor sedation and respiratory rate, including after the procedure. Consider reducing the remifentanil dose.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
Full monographs, dosing and an interaction checker in the MediHelp app
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