4. Drug-Drug Interactions

Patient profiles will be assessed to identify those drug regimens, which may result in clinically significant drug-drug interactions. Drug-drug interactions considered clinically relevant for gabapentin are summarized in Table 4. Only those drug-drug interactions classified as clinical significance severe or those considered life threatening which have not yet been classified will be reviewed: 

Table 4. Gabapentin Drug-Drug Interactions¹

Interacting Drug	Interaction	Recommendation	Clinical Significance Level #
antacids	decreased gabapentin oral availability by approximately 20%	administer gabapentin at least two hours after antacids to avoid bioavailability problems	Moderate (CP)
opioids	Concomitant use of opioid agonists with gabapentin may cause excessive sedation, somnolence, and respiratory depression	Limit the use of opioid pain medications with gabapentin to patients for whom alternative treatment options are inadequate. If concurrent use is necessary, initiate gabapentin at the lowest recommended dose and monitor patients for respiratory depression and sedation.	Major (CP)

Legend:

• #CP = Clinical Pharmacology