Gabapentinoids/Opioids (Cough & Cold) Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Opioids slow down your GI tract. This may allow your body to absorb more gabapentin and pregabalin. Gabapentin and pregabalin may change how your body reacts to opioids.

What might happen:

The amount of gabapentin or pregabalin in your blood may increase and cause more side effects than expected.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know about all the medicines you take and if you have problems with your kidneys or lungs. Let your doctor know if you experience severe drowsiness. Your doctor may need to adjust the dose of your medicines.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Eckhardt K, Ammon S, Hofmann U, Riebe A, Gugeler N, Mikus G. Gabapentin enhances the analgesic effect of morphine in healthy volunteers. Anesth Analg 2000 Jul;91(1):185-91.
  • 2.Hill R, Dewey WL, Kelly E, Henderson G. Oxycodone-induced tolerance to respiratory depression: reversal by ethanol, pregabalin and protein kinase C inhibition. Br J Pharmacol 2018 Jun;175(12):2492-2503.
  • 3.Gomes T, Juurlink DN, Antoniou T, Mamdani MM, Paterson JM, van den Brink W. Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study. PLoS Med 2017 Oct; 14(10):e1002396.
  • 4.Neurontin (gabapentin) US prescribing information. Pfizer, Inc. September, 2015.
  • 5.Gralise (gabapentin) US prescribing information. Abbott Laboratories August, 2012.
  • 6.Health Canada. Health Canada MedEffect e-Notice: Health Canada advises Canadians to exercise caution when taking gabapentin or pregabalin with opioids. available at: https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2019/71003a-e ng.php Sept 17, 2019.
  • 7.FDA (US Food and Drug Administration). FDA MedWatch Safety Alert: FDA warns about serious breathing problems with seizure and nerve pain medicines gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica). Available at: https://www.fda.gov/drugs/drug-safety-and-availability Dec19, 2019.
  • 8.FDA (US Food and Drug Administration). FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. Available at: https://www.fda.gov/Drugs/DrugSafety/ucm518473.htm August 31, 2016.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.