Can You Take Gabapentin & Suboxone Together?

Yes, you can take gabapentin and Suboxone together, but there are potential risks. You should only do so under direct medical supervision.

Medications can interact in unexpected ways, so they should never be mixed without explicit direction from a medical professional. Each medication can have a mechanism of action that can counteract or enhance the other.

If you are taking multiple medications, it can be more complicated to reverse an overdose or deal with the side effects of multiple drugs, meaning that complications and potential risks for each drug are compounded when they are mixed.

Always follow the explicit directions of your medical provider, and be careful when taking more than one drug at a time.

What Is Gabapentin?

Gabapentin is a nerve pain and anticonvulsant medication.[1] It is an alpha antagonist medication, meaning it turns off alpha receptors in the body. Alpha receptors are stimulating, so turning them off can cause sedation and respiratory depression.

Gabapentin is a prescription medication that comes in the following forms:

• Capsules: Medications in capsule form can't be crushed (like tablets can). Capsules also dissolve quickly, so they act fast within the body. 
• Tablets: Medications in tablet form can be cut in half, which is ideal for someone who needs just a small amount of gabapentin each day. 
• Oral solution: Some people struggle to swallow capsules or tablets. A suspension is easy to swallow. 
• Extended-release formats. Some people need a constant stream of gabapentin to keep seizures at bay. Extended-release formats push a small amount of the medication into the body regularly. 

No matter what form you take, it should be used exactly as prescribed by a medical professional.

What Is Suboxone?

Suboxone contains both the partial opioid agonist buprenorphine and the opioid antagonist Naloxone.[2]

• The buprenorphine component partially activates opioid receptors in the brain and depresses the central nervous system. In this way, it reduces cravings for other opioids.
• The naloxone component deters potential misuse and is only activated if Suboxone is misused through injection.

Suboxone is taken as a sublingual tablet or film to be dissolved in the mouth.

How Do Doctors Use Gabapentin & Suboxone?

Gabapentin is often used for conditions like neuropathic pain and epileptic seizures.[1] Gabapentin serves to change brain chemistry and lower abnormal excitement in the brain. 

Gabapentin can alter how your body senses pain, which is why it is also sometimes used as a pain medication.

Suboxone is a medication generally used to treat chronic pain or opioid use disorder (OUD). When taken as prescribed, the medication won't get people with OUD high. Instead, it blocks cravings and lowers relapse risks. 

In people with pain, the medication can ease discomfort while lowering overdose risks

Potential Dangers of Mixing Suboxone & Gabapentin

‍Gabapentin and Suboxone can certainly be used together in appropriate situations. However, in combination, multiple sedating medications increase the risk of respiratory suppression. Thus, it can be dangerous to use non-prescribed gabapentin in conjunction with Suboxone. These two drugs can interact in a potentially lethal way, interfering with breathing and leading to coma or death.[3]

Under the direction of a medical provider, it is possible to take Suboxone and gabapentin together. If you have a reason to use gabapentin and Suboxone together, this can be done safely, but it should always be thoroughly discussed with a medical professional. Please let your doctor know if you are overly sedated when taking these medications together so he or she can adjust your dose appropriately.

Signs of a Gabapentin-Induced Opioid Overdose‍

Opioid overdose is one of the leading causes of accidental death in the United States. Around three-quarters of the over 100,000 drug overdose deaths in the one-year period ending April 2021 involved an opioid drug.[4] Mixing drugs increases the risk of overdose and complications related to each drug.

It is important to seek help immediately if you or a loved one is experiencing any potential life-threatening or serious side effects of gabapentin. These may be signs of a gabapentin-induced opioid overdose:

• Trouble breathing
• Drowsiness and difficulty staying awake
• Unconsciousness
• Cold and clammy skin
• Vomiting
• Limpness
• Lips, nails, or skin that have a bluish tint
• Very low heart rate or blood pressure
• Diarrhea
• Slurred speech
• Double vision
• Mental confusion
• Lack of coordination

Seek professional help immediately if any of these signs are present.

Any misuse of medications, which includes taking one of these drugs without a prescription or outside of the way they are medically directed to be administered, can have serious and even life-threatening consequences.

Again, it is important to always use medications exactly as medically directed. If you need to take Suboxone and gabapentin together, this should only be done under the direction and supervision of a medical provider. 

Talk to your doctor! Open communication is key.

SOURCES

1. Gabapentin. U.S. National Library of Medicine (NLM). https://medlineplus.gov/druginfo/meds/a694007.html. January 2022. Accessed November 2022.
2. Suboxone. Indivior. https://www.suboxone.com/. Accessed November 2022.
3. Gabapentin, Opioids, and the Risk of Opioid-Related Death: A Population-Based Nested Case-Control Study. PLOS ONE. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626029/. October 2017. Accessed November  2022.
4. Drug Overdose Deaths Top Over 100,000 Annually. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm. November 2021. Accessed November 2022.