Drug & supplement interaction

Beta-hydroxybutyrate (bhb) + Gabapentin

Gabapentin brand names: Neurontin, Gralise.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Beta-hydroxybutyrate (bhb) and Gabapentin in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Beta-hydroxybutyrate (bhb) and Gabapentin

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Gabapentin and Beta-hydroxybutyrate (bhb) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Beta-hydroxybutyrate (bhb) at all — not against Gabapentin, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Beta-hydroxybutyrate (bhb) safety at a glance

Beta-hydroxybutyra... overall Use caution Generally tolerated short-term but may cause stomach upset and adds significant minerals or sodium; long-term safety is not well studied.
Pregnancy Avoid Not enough safety data; avoid during pregnancy unless your doctor advises otherwise.
Breastfeeding Avoid Not enough safety data; best to avoid while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Gabapentin and Beta-hydroxybutyrate (bhb)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Beta-hydroxybutyrate (bhb) and Gabapentin May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Stomach upset / Diarrhea / Nausea / Vomiting reported in 6.3% of FDA reports for Gabapentin Additional detail

    Beta-hydroxybutyrate (bhb)

    “Orally, BHB may cause indigestion, diarrhea, nausea, gastrointestinal upset, and vomiting in some patients. In a small crossover study, nausea, diarrhea, and vomiting were reported in 37%, 16%, and 11% of patients, respectively, taking two 0.38 gram/kg doses of BHB salts separated by 45 minutes on a single day.”

    Beta-hydroxybutyrate (bhb) · Natural Medicines adverse-effect record, reported in constipation.

    4 sources cited
    1. 96084. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
    2. 96096. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
    3. 102024. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
    4. 96088. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed

    Gabapentin

    Listed in the ADVERSE REACTIONS section of the FDA label for Gabapentin, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Constipation Additional detail

    Beta-hydroxybutyrate (bhb)

    Recorded for Beta-hydroxybutyrate (bhb) in the same Natural Medicines adverse-effect record shown under Stomach upset / Diarrhea / Nausea / Vomiting above.

    Gabapentin

    Listed in the ADVERSE REACTIONS section of the FDA label for Gabapentin. Read the label on DailyMed ›

Reported for Beta-hydroxybutyrate (bhb) but not commonly for Gabapentin: stomach pain, dehydration and bloating or gas.

Effects for Gabapentin come from the ADVERSE REACTIONS section of its FDA label; effects for Beta-hydroxybutyrate (bhb) come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 361,481 voluntary FDA FAERS reports for Gabapentin that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Gabapentin Is Prescribed For, and What Beta-hydroxybutyrate (bhb) Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Gabapentin is a prescription medicine with approved uses on its FDA label. Beta-hydroxybutyrate (bhb) is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Gabapentin is prescribed for: Gabapentin (brands include Neurontin, Relgaabi, Gabarone, Gralise, and Horizant) is primarily used to manage postherpetic neuralgia (PHN) — the nerve pain that lingers after a shingles outbreak — in adults. Neurontin, Relgaabi, Gabarone, and gabapentin capsules, tablets, and oral solution are also used as add-on therapy for partial onset seizures (a type of epilepsy) in adults and children aged 3 and older. Horizant (gabapentin enacarbil extended-release tablet) has two specific approvals: treatment of moderate-to-severe primary restless legs syndrome (RLS) in adults, and management of postherpetic neuralgia in adults. Horizant is not recommended for people who need to sleep during the day and stay awake at night.

Read the rest of what Gabapentin is prescribed for

Gralise is approved only for postherpetic neuralgia and cannot be substituted for other gabapentin products due to its different release profile.

Beta-hydroxybutyrate (bhb) has been studied for:

  • Epilepsy studied, not established Beta-hydroxybutyrate (bhb) has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Beta-hydroxybutyrate (bhb) for epilepsy

    Although there is interest in using oral BHB for epilepsy, there is insufficient reliable information about the clinical effects of BHB for this condition.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Gabapentin on your own; if you are taking Beta-hydroxybutyrate (bhb) for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Beta-hydroxybutyrate (bhb) or Gabapentin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Beta-hydroxybutyrate (bhb) or Gabapentin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Gabapentin

This page covers Beta-hydroxybutyrate (bhb) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Gabapentin page lists 106 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 82 moderate · 17 minor.

From our pharmacist’s overview on the Gabapentin page

“Gabapentin (Neurontin, Gralise) calms overactive nerves, which means it already slows your nervous system down, and that is exactly what 78 of the 106 supplements on this list also do. So the dominant risk here is sedation stacked on sedation, extra drowsiness at best and dangerously slowed breathing at worst, and with seven entries ra…”

Reviewed by 2 · Jul 18, 2026

Open the Gabapentin interaction page

How much people look this up

Where Beta-hydroxybutyrate (bhb) and Gabapentin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Beta-hydroxybutyrate (bhb)
Steady interest

#1,432 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Gabapentin
Top 5%

#42 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Beta-hydroxybutyrate (bhb) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Beta-hydroxybutyrate (bhb) and Gabapentin records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Beta-hydroxybutyrate (bhb)

What is Beta-hydroxybutyrate (bhb)?

Beta-hydroxybutyrate (bhb)
  • Weight loss and fat burning
  • Boosting energy on a ketogenic diet
  • Athletic and exercise performance
  • Mental focus and clarity
  • Reducing 'keto flu' symptoms

Beta-hydroxybutyrate (BHB) is a ketone body your liver naturally makes when carbs are low, and it is sold as a supplement marketed for weight loss, energy, and athletic performance. Despite bold marketing claims, human evidence that BHB supplements help with weight loss or performance is limited and mixed. If you want to try it, talk with your pharmacist or doctor first, especially if you have kidney, heart, or blood pressure concerns.

Not applicable (a ketone body made by the body or produced as a synthetic salt) · Capsules, powders, drink mixes (often as BHB salts bound to sodium, calcium, magnesium, or potassium; also BHB esters)

An interaction check asks whether these two react with each other — it does not ask whether Beta-hydroxybutyrate (bhb) is a good idea for someone in your situation. Here is what our Beta-hydroxybutyrate (bhb) record says about it on its own.

Beta-hydroxybutyrate (bhb): dosing

There is no official, standardized dose of BHB. Products vary widely in how much BHB they contain and which minerals they are paired with.The best approach is to follow the directions on the product label and not exceed them. Many people start with a smaller amount to see how their stomach reacts before using more.Because mineral content matters, check how much sodium, calcium, magnesium, or potassium each serving provides.

From our Beta-hydroxybutyrate (bhb) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Beta-hydroxybutyrate (bhb) monograph & all interactions
Medication

About Gabapentin

What Is Gabapentin Used For?

Brand names: Neurontin, Gralise

Gabapentin (brands include Neurontin, Relgaabi, Gabarone, Gralise, and Horizant) is primarily used to manage postherpetic neuralgia (PHN) — the nerve pain that lingers after a shingles outbreak — in adults. Neurontin, Relgaabi, Gabarone, and gabapentin capsules, tablets, and oral solution are also used as add-on therapy for partial onset seizures (a type of epilepsy) in adults and children aged 3 and older.

Horizant (gabapentin enacarbil extended-release tablet) has two specific approvals: treatment of moderate-to-severe primary restless legs syndrome (RLS) in adults, and management of postherpetic neuralgia in adults. Horizant is not recommended for people who need to sleep during the day and stay awake at night. Gralise is approved only for postherpetic neuralgia and cannot be substituted for other gabapentin products due to its different release profile.

Most-Reported Side Effects for Gabapentin

From FAERS, the FDA’s public side-effect reporting system (361,481 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 24,972 reports
Nausea 22,728 reports
Diarrhea 18,114 reports
Headache 17,897 reports
Dizziness 16,238 reports
See full Gabapentin drug information
Keep checking

Other Drugs & Beta-hydroxybutyrate (bhb)

Browse every other medication we’ve checked against Beta-hydroxybutyrate (bhb) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Beta-hydroxybutyrate (bhb) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Beta-hydroxybutyrate (bhb) list.

See the full Beta-hydroxybutyrate (bhb) interactions page
See every supplement checked against Gabapentin, ranked by severity
Evidence & sources

Beta-hydroxybutyrate (bhb) References

The 6 references that drive our Beta-hydroxybutyrate (bhb) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Gautschi M, Weisstanner C, Slotboom J, Nava E, Zürcher T, Nuoffer JM. Highly efficient ketone body treatment in multiple acyl-CoA dehydrogenase deficiency-related leukodystrophy. Pediatr Res. 2015;77(1-1):91-8. PubMed
  2. Van Rijt WJ, Heiner-Fokkema MR, du Marchie Sarvaas GJ, et al. Favorable outcome after physiologic dose of sodium-D,L-3-hydroxybutyrate in severe MADD. Pediatrics. 2014;134(4):e1224-8.
  3. Clarke K, Tchabanenko K, Pawlosky R, et al. Kinetics, safety and tolerability of (R)-3-hydroxybutyl (R)-3-hydroxybutyrate in healthy adult subjects. Regul Toxicol Pharmacol. 2012;63(3):401-8. PubMed
  4. Gross EC, Sandor P, Fischer D. Preliminary data on exogenous ketone bodies in migraine prevention. Cephalalgia 2017; 37(1S) 52-171.
  5. Evans M, Patchett E, Nally R, Kearns R, Larney M, Egan B. Effect of acute ingestion of β-hydroxybutyrate salts on the response to graded exercise in trained cyclists. Eur J Sport Sci. 2018;18(3):376-86.
  6. Malhi MS, Duerson F, Salabei JK, Okonoboh P. Starvation Ketoacidosis Induced by Ketogenic Diet and Consumption of Ketone Supplement. Cureus. 2021;13(6):e15778. Published 2021 Jun 20. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Beta-hydroxybutyrate (bhb) and Gabapentin Together: Common Questions

Is it safe to take Beta-hydroxybutyrate (bhb) with Gabapentin?
We do not list a known interaction between Beta-hydroxybutyrate (bhb) and Gabapentin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Beta-hydroxybutyrate (bhb) and Gabapentin have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Beta-hydroxybutyrate (bhb) and Gabapentin used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Beta-hydroxybutyrate (bhb) in each. That is a conversation for your prescriber, especially if Gabapentin is being adjusted to a target.
Does Gabapentin interact with any supplements?
Yes. Gabapentin has documented interactions with 106 supplements in our database — Beta-hydroxybutyrate (bhb) is not one of them. The Gabapentin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Beta-hydroxybutyrate (bhb) monograph Uses, safety profile, and every drug interaction in one place Gabapentin drug information The full plain-English guide to this medication Gabapentin supplement interactions Every supplement checked against Gabapentin, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 6 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.