Can You Take Gabapentin And Codeine Together?

Answer

Gabapentin and codeine should be used cautiously together as both are considered CNS (central nervous system) depressants, and combining them can put you at an increased risk of side effects.

There certainly are situations where taking both of these drugs may represent the best course of therapy for you, but it is important to be aware of the risks.

What Are The Risks?

As mentioned, both codeine (an opioid agonist) and gabapentin are CNS depressants. Combining them puts you at a greater risks of side effects, especially serious side effects like respiratory depression.

The FDA has even released a safety communication regarding combining CNS depressants, and includes gabapentin in the warning:

The U.S. Food and Drug Administration (FDA) is warning that serious breathing difficulties may occur in patients using gabapentin (Neurontin, Gralise, Horizant) or pregabalin (Lyrica, Lyrica CR) who have respiratory risk factors. These include the use of opioid pain medicines and other drugs that depress the central nervous system, and conditions such as chronic obstructive pulmonary disease (COPD) that reduce lung function. The elderly are also at higher risk.

The FDA made this announcement as studies have shown that combining opioids and gabapentin increases the risk of opioid-induced deaths. One such study concluded:

In this study we found that among patients receiving prescription opioids, concomitant treatment with gabapentin was associated with a substantial increase in the risk of opioid-related death. Clinicians should consider carefully whether to continue prescribing this combination of products and, when the combination is deemed necessary, should closely monitor their patients and adjust opioid dose accordingly.

Managing The interaction

As a general rule of thumb, drugs like gabapentin and codeine should only be combined if you and your doctor determine that is the best course of therapy and other treatment options are inadequate.

If they are used together, it is important to use the lowest dosages and the shortest duration of therapy as possible. It is also important to be on the lookout for any concerning side effects, such as slowed or difficult breathing and/or excess sedation.

Final Words

Thanks for reaching out to us! I hope you found this helpful.

I do want to say that although this combination of medication needs to be used very cautiously, it's not uncommon that both are used in certain patients. Pain can be extremely difficult to manage, and oftentimes, it requires drugs that have inherent dangers to them.

The important thing is to be aware of the risks, and what to look out for.