Can You Take Gabapentin with Ibuprofen? Understanding the Interactions and Risks

Gabapentin is a prescription drug used for seizure disorders and certain types of nerve pain. It’s often prescribed with other medications, but it’s important to understand the possible risks and drug interactions – including ibuprofen.

Learn more about the possible drug interactions for gabapentin and some precautions you should take with this medication.

What Is Gabapentin?

Gabapentin, also known by the brand name Neurontin, has been in use since the 1990s. It’s prescribed to treat some seizure disorders and post-herpetic neuralgia, which occurs with shingles. It’s also used off-label for treating various types of nerve pain.

In addition to Neurontin, gabapentin is available under the brand Gralise in an extended-release formulation for post-herpetic neuralgia. Horizant, another extended-release formulation, is approved by the FDA for post-herpetic neuralgia and restless leg syndrome.

Gabapentin belongs to the class of drugs known as gamma-aminobutyric acid (GABA) analog.[1] These medications reduce the excitability of nerve cells in the brain, reducing seizure intensity and relieving some types of nerve pain.

Gabapentin has diverse uses and may be combined with other drugs to achieve symptom relief, but there are potential drug interactions to be aware of. Some interactions can cause serious complications and side effects, while others may limit the efficacy of gabapentin.

What Is Ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) pain reliever that’s available over the counter under multiple brands or as a prescription. Ibuprofen may be combined with other drugs in formulations for cold and flu, acting as the active ingredient for pain relief. It’s also been used as an anti-inflammatory ingredient in opioid painkillers like oxycodone and hydrocodone.

Like other NSAIDs, ibuprofen is a COX inhibitor. These drugs interfere with the cyclooxygenase (COX) enzymes to reduce the production of prostaglandins, lipid compounds that cause pain and inflammation.[2] Blocking prostaglandins can provide temporary pain relief for mild to moderate pain.

In addition to prescription options, ibuprofen is widely available over the counter as a medication for arthritis, headaches, muscle aches, menstrual cramps, and other mild pain. It has been on the market since 1974 and is well tolerated and generally safe.

Can You Take Gabapentin with Ibuprofen?

Gabapentin and ibuprofen are different classes of drugs and have different mechanisms of action. There are no established interactions between gabapentin and ibuprofen, but that doesn’t mean they can’t affect each other.[3]

Based on an older study conducted on animals, gabapentin and ibuprofen showed an ability to work together to amplify the pain-relieving effects with no negative effects.[4] More research is needed to determine if these two drugs’ compatibility can be part of an effective pain management protocol together or if adverse reactions may occur.

Potential Interactions with Gabapentin

Gabapentin may not interact with ibuprofen, but it interacts with several common medications and substances:

Opioids

Like ibuprofen, opioids are used to treat pain. However, they work differently. Instead of blocking prostaglandins like ibuprofen, opioids block pain signals to “numb” the body to pain. Some examples of opioids include oxycodone and morphine. Opioids are potent pain relievers, but they’re also controlled substances with a high addictive potential. There are strict regulations for how they’re prescribed to avoid illicit use.

Gabapentin and opioids share some side effects, which can cause dangerous interactions. Both drugs cause drowsiness and slowed breathing. Combining the two drugs can make these side effects more likely and pronounced, potentially depressing breathing to a dangerous level.

Gabapentin can also increase the euphoria gained from the recreational use of opioids. Enhancing the “reward” aspect of opioids can drive repeated use, increasing the risk of overdose and adverse effects.[5]

Antihistamines

Antihistamines are widely available and treat many conditions, including allergies and itching. They block histamine, a chemical that regulates sleep and immune responses to harmful substances. One of the best-known antihistamines is Benadryl, the brand name for diphenhydramine.

Some antihistamines, like diphenhydramine and doxylamine, have sedative effects. Others, such as loratadine, don’t have drowsiness as a side effect. If you combine gabapentin with sedative antihistamines, you can experience dangerous levels of sedation.[7]

Sedatives

Sedatives are a broad group of medications used to treat sleep problems, anxiety, and panic disorders. Sleep medications like zolpidem (Ambien), benzodiazepines like lorazepam (Ativan), and barbiturates like phenobarbital are all sedatives.

The side effects of sedatives can be pronounced, including dizziness, sleepiness, and poor coordination. Gabapentin can have similar side effects, so combining the two can cause dangerous levels of sedation.[8]

Other medications that have sedative-like effects – even if they’re not sedatives – can have similar risks. This includes muscle relaxants and antihistamines or sleep aids.

Alcohol

Alcohol is a depressant that affects many parts of the body, including breathing rate and brain activity. Several medications can interact with alcohol, including gabapentin and other medications that have sedative-like side effects.

This is not a full list of the potential interactions for gabapentin. Be sure to speak to your doctor about the medications you’re taking.

Potential Interactions with Ibuprofen

Though available over the counter, ibuprofen has plenty of potential interactions with other medications:

Blood Thinners

Ibuprofen has mild blood-thinning effects. While this isn’t an issue on its own, combining ibuprofen with blood thinners can increase your risk of bleeding.[9] This could be mild, like bleeding gums after dental care, or life-threatening, like bleeding in the brain.

Some of the common blood thinners to avoid include anticoagulants like warfarin (Coumadin), apixaban (Eliquis), and rivaroxaban (Xarelto). Antiplatelet medications like clopidogrel (Plavix) and ticagrelor (Brilinta) are also a risk.

Aspirin and Other NSAIDs

Aspirin is an over-the-counter medication for mild pain and fever, much like ibuprofen. It’s also taken for heart protection because of its blood-thinning effects, which is where the risk comes in with ibuprofen.

Combining aspirin and ibuprofen can increase the risk of serious bleeding or stomach ulcers because both of these medications have these potential side effects on their own.[10]

Similarly, ibuprofen shouldn’t be combined with other NSAIDs, such as meloxicam, naproxen (Naproxen), indomethacin, or diclofenac (Cambia). You should also be mindful of combination medications that may have NSAID ingredients, such as medications for cold and flu or menstrual pain.

Alcohol

Alcohol can have a lot of adverse effects, including stomach irritation and blood thinning. Combining ibuprofen or other NSAIDs with alcohol can lead to stomach bleeding or ulcers. If you have a higher risk of stomach bleeding or ulcers, it may be best to avoid alcohol altogether while you’re taking an NSAID pain reliever.

This is not a full list of the potential interactions for ibuprofen. Be sure to speak to your doctor about the medications you’re taking.

Be Careful with Medication Interactions

While gabapentin and ibuprofen have no known interactions, both of these drugs can have serious interactions with other drugs – including illicit drugs and common over-the-counter medications. It’s important to discuss all the medications you’re taking with your doctor if you take gabapentin or ibuprofen.