Drug & supplement interaction

European Mandrake + Gabapentin enacarbil

Gabapentin enacarbil brand name: Horizant.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

European Mandrake has a moderate interaction with Gabapentin enacarbil. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

European Mandrake and Gabapentin enacarbil

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ORAL DRUGS

Why this applies to Gabapentin enacarbil

Gabapentin enacarbil falls under ORAL DRUGS — the group European Mandrake interacts with.

Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First things first: European mandrake is genuinely toxic, and I'd urge you not to take it at all. Setting that aside, here's the idea behind this pairing. Mandrake's tropane alkaloids (like atropine and scopolamine) slow down how fast your gut moves things along. When food and pills linger longer in the intestines, some medicines can get absorbed a bit more completely. So in theory, more of your Horizant (gabapentin enacarbil) could make it into your system.

If that happened, you might feel stronger gabapentin effects, things like drowsiness, dizziness, unsteadiness, or swelling in the legs. I want to be honest though: this is a theoretical concern based on how these compounds behave, not on real patient studies. The bigger issue is mandrake's toxicity itself. Please talk with your pharmacist or doctor before mixing anything new with Horizant.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

European Mandrake Also Interacts With Other Medications

European Mandrake has 2,041 moderate known drug interactions in our database — the Gabapentin enacarbil one above is one of them. If you take anything else, check it against the full list below.

Moderate 2,041 No known interaction 789 (incl. Gabapentin enacarbil)
Taking anything else?

Check Another of Your Medications Against European Mandrake

Covers the 2,830 medications we’ve checked against European Mandrake. Pick one to open its full report.

From our Q&A

Questions About European Mandrake or Gabapentin enacarbil

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers European Mandrake or Gabapentin enacarbil, 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 enacarbil

This page covers European Mandrake only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Gabapentin enacarbil page lists 105 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 · 16 minor.

From our pharmacist’s overview on the Gabapentin enacarbil page

“Alcohol tops the list of supplement and food risks for gabapentin enacarbil (Horizant), a nerve pain and restless legs medicine that already slows the central nervous system. Beer and wine both carry major ratings because their sedation stacks on the drug's own, and 78 of the 105 ingredients on file act the same way, deepening drowsine…”

Reviewed by 2 · Jul 18, 2026

Open the Gabapentin enacarbil interaction page

How much people look this up

Where European Mandrake and Gabapentin enacarbil 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 European Mandrake
Top 25%

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

29 days ago today
Medication Gabapentin enacarbil
Top 25%

#668 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.

Supplement

About European Mandrake

What is European Mandrake?

European Mandrake
  • Insomnia (traditional)
  • Pain relief (historical)
  • Anxiety or depression (folk use)
  • Gout and aches (traditional)
  • Sedation or anesthesia (historical)

European mandrake is a highly toxic plant from the nightshade family that was used in ancient and medieval times as a sedative and pain reliever. It contains powerful poisons that can cause serious harm or death, and there is no proof it safely treats any condition. We strongly recommend you do not consume mandrake in any form.

Read the full European Mandrake monograph & all interactions
Medication

About Gabapentin

What Is Gabapentin Used For?

Brand name: Horizant

Gabapentin products are used for postherpetic neuralgia, which is nerve pain that lingers after shingles. Several gabapentin products (capsules, oral solution and tablets, including Neurontin, Relgaabi and Gabarone) are also used as add-on therapy for partial onset seizures in adults and children 3 years and older with epilepsy.

Horizant (an extended-release tablet) is used for moderate-to-severe primary restless legs syndrome in adults, plus postherpetic neuralgia. Gralise and once-daily gabapentin tablets are used only for postherpetic neuralgia.

See full Gabapentin drug information
Keep checking

Other Drugs & European Mandrake

Browse every other medication we’ve checked against European Mandrake — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
2,041Moderate
0Minor
788No known interaction
2,041 Moderate 788 No interaction
Moderate

2,041 interactions

Showing 60 of 2,041 moderate interactions — see all 2,041 on the European Mandrake page.

No interaction 788 drugs checked — show the list

We also checked European Mandrake against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 788 medications checked with no known interaction — see the full European Mandrake list.

See the full European Mandrake interactions page
See every supplement checked against Gabapentin enacarbil, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
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Pharmacist Counseling Corner

Taking European Mandrake and Gabapentin enacarbil Together: Common Questions

Can you take European Mandrake with Gabapentin enacarbil?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the European Mandrake and Gabapentin enacarbil interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Gabapentin enacarbil and European Mandrake?

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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.