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Can You Take Gabapentin & Suboxone Together?

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

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

If you are taking multiple medications, it can be more complicated to reverse an overdose or deal with the side effects from 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.

potential dangers of mixing suboxone and gabapentin

What is Gabapentin?

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

Gabapentin serves to change brain chemistry and lower abnormal excitement in the brain. It can alter the way your body senses pain which is why it is also sometimes used as a pain medication.

Gabapentin is a prescription medication that comes in capsules, tablets, an oral solution, and an extended-release form. It should be taken exactly as prescribed by a medical professional.

What Is Suboxone?

Suboxone is a medication that is usually used for either patients with chronic pain or as a treatment for patients with opioid use disorder (OUD). Suboxone contains both the partial opioid agonist buprenorphine and naloxone.[2]

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

The buprenorphine component serves to partially activate opioid receptors in the brain and acts to depress the central nervous system. In this way, it reduces cravings for other opioids. 

The naloxone component deters potential abuse, and it is only activated if Suboxone is misused through injection.

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.

sings of gabapentin induced opioid overdose

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 for overdose and complications related to each drug.

It is important to seek help right away if you or a loved one are experiencing any of the 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.

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

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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