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 41-7. Only those drug-drug interactions identified as clinical significance level 1 or those considered life-threatening which have not yet been classified will be reviewed.
Table 4: Gabapentin Drug-Drug Interactions
| 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 (DrugReax) 3-moderate (CP) |
| hydrocodone | potential for decreased hydrocodone peak concentrations and AUC with concomitant gabapentin-hydrocodone administration in dose-dependent fashion; minor increases in gabapentin AUC | observe patients for decreased hydrocodone efficacy or additive drowsiness | 3-moderate (CP) |
| morphine | concurrent administration may result in increased gabapentin serum levels (gabapentin AUC increased by 44% when morphine 60 mg controlled- release given 2 hours prior to gabapentin 600 mg) | monitor patients for increased CNS depression; adjust gabapentin and/or morphine doses as necessary | moderate (DrugReax) 3-moderate (CP) |
Legend:
- #CP = Clinical Pharmacology