Can You Take Gabapentin And Muscle Relaxers Together?

 

Can you take muscle relaxers with gabapentin? It is a common question that people struggling with severe body pain often wonder for a better analgesic effect. 

One in every five adults in the USA suffers from body pain [1]. Thus potentially raising the prescription use of muscle relaxers in the country. A study evaluating the average visit to a physician in the USA states that the prescription use of skeletal muscle relaxers doubled between 2005 and 2016 [2]. This displays a remarkable solicitude for abuse and the adverse effects of long-term use. 

The use of a muscle relaxer with Gabapentin is a growing concern among physicians for its high abuse potential and significant health risks resulting from these interactions. 

This extensive study on gabapentin and muscle relaxers depicts the pharmacodynamic effects and the safety profile of combining them, thus helping make an informed decision. 

 

Gabapentin And Muscle Relaxers: On Overview

Gabapentin is an anticonvulsant medication (used to prevent or control seizures) that is primarily prescribed for treating neuropathic pain and partial seizures. It is also the first line of treatment for diabetic neuropathy and postherpetic neuralgia [3]. 

 

Off-label uses of Gabapentin- Apart from its medical uses for neuropathic pain and local seizures, the off-label benefits of taking Gabapentin are for treating bipolar disorder, non-neuropathic pain, and anxiety disorder.

Muscle relaxers are medications that affect skeletal muscle function and decrease muscle tone. They are commonly used for alleviating symptoms of muscle spasms and pain. They are centrally acting and help by blocking pain stimulation from reaching the brain from the affected part of the body. 

The common muscle relaxers that physicians often prescribe are Carisoprodol (Soma pill), Cyclobenzaprine (Flexeril), Metaxalone (Skelaxin), Methocarbamol (Robaxin), etc.

 

Off-label uses of Muscle relaxers- Muscle relaxers like the Soma pill can help anxiety, neuropathic pain, temporomandibular disorder, and chronic noncancer pain. It also helps manage period cramps and works within 30 minutes of intake. 

 

Does Gabapentin Interact With Muscle Relaxers? 

When we talk about the Interaction of muscle relaxers with Gabapentin, it cannot be epitomized in a line or two. Several prevalent muscle relaxers in the market today have individual pharmacodynamic characteristics, thus reacting differently with Gabapentin. So, we have summarized Gabapentin's interaction with eight commonly prescribed muscle relaxers. 

Cyclobenzaprine And Gabapentin

Cyclobenzaprine, available under the brand name Flexeril, is a prescription drug for musculoskeletal body pain. Cyclobenzaprine and Gabapentin interactions are moderate, with no reports of severe side effects. 

 

 

This interaction increases the risk of side effects such as confusion, dizziness, drowsiness, and difficulty concentrating. It can also result in additive side effects such as coordination issues and sedation. 

A phase IV clinical study of FDA data on taking Flexeril with gabapentin conducted on 3,726 people, as represented in the graph below, suggests that it results in high blood pressure (194 reports), Dizziness (196 reports), Depression (230 reports), Diarrhea (220 reports), Weakness (240 reports), and fatigue (330 reports).   

 

 

Elderly people may experience impairment in judgment, motor coordination, and thinking.

People Gabapentin and Flexeril together must avoid activities requiring mental alertness, such as operating heavy machinery and driving [5]. 

 

Carisoprodol And Gabapentin

Carisoprodol, marketed as the Soma pill in the United States, is a centrally-acting skeletal muscle relaxant that is approved by the FDA for treating short-term skeletomuscular body pain. 

The interaction between Carisoprodol (Soma) and Gabapentin is moderate, as shown below.

 

Taking Carisoprodol with Gabapentin may increase the possibility of side effects such as drowsiness, difficulty concentrating, confusion, and dizziness. Such people must also limit their alcohol consumption while taking these medications.

A phase IV clinical study of FDA by the website ehealthme, as shown below, reports that the common health risks of Gabapentin and Carisoprodol interaction include Insomnia (10 reports), Gallstones (12 reports), stress and anxiety (16 reports), Osteoarthritis (14 reports), and Osteoporosis (15 reports). 

 

 

Older people are more likely to suffer from thinking and judgment impairments. Such patients must be monitored for prolonged CNS and respiratory depression [6]. 

Robaxin And Gabapentin 

Methocarbamol, also available under the brand name Robaxin, is used in the treatment and management of acute musculoskeletal pain. Approved by the FDA in 1957, it is one of the most potent and effective muscle relaxers of all time. 

Taking Robaxin and Gabapentin together can result in moderate drug interaction, causing depression, intense drowsiness, confusion, suicidal thoughts, lack of focus, and increased risk for injury, as shown below. 

 

 

It is not advisable for elderly people to take Gabapentin and Robaxin together, and they must be administered after consulting a doctor. 

Baclofen And Gabapentin

Baclofen is a skeletal muscle relaxant that aids in relieving nerve discomfort. A 2020 clinical study by Kimberly Reynolds et al. evaluating the effects of exposure to Baclofen and Gabapentin shows that they are taken together for misuse, and cases of abuse have been accelerating in the United States since 2013, as shown below. Thus, proper risk analysis must be considered before co-administering baclofen and Gabapentin. 

 

The interaction between Baclofen and Gabapentin is moderate, as shown below.

 

These drug interactions may cause difficulty concentrating, dizziness, and drowsiness in users. It may also cause impairment of your thinking and decision-making abilities. 

Gabapentin And Vicodin

Hydrocodone or Vicodone is a combination of pain medication Hydrocodone and paracetamol, which is often prescribed to treat moderate to severe body pain. 

A phase IV clinical study by FDA published by the website ehealthme on Gabapentin and Vicodin drug interaction suggests that they result in fatigue (246 reports), weakness (287 reports), drug ineffectiveness (265 reports), difficulty breathing (247 reports), joint pain (243 reports), stress and anxiety (271 reports). 

Apart from the above-mentioned health conditions, the interaction between Gabapentin and Vicodin is major in severity as per Drugs. 

 

 

They may cause significant health risks in people, including central nervous system depression, thus leading to coma and death in severe cases. Thus, it is advised to consult a doctor before taking Vicodin with Gabapentin. 

Xanax And Gabapentin

Alprazolam is a potent tranquilizer of moderate duration and is most commonly prescribed in the management of anxiety disorder. Available under the brand name Xanax, its medical use is approved by the FDA and works within 30 minutes of intake. 

Mixing Xanax and Gabapentin can cause Moderate drug interaction, thus increasing CNS and respiratory depression in patients. 

 

 

It also causes drowsiness, dizziness, confusion, unusual eye movement, jerky movements, difficulty speaking, nausea, and palpitations. Avoiding driving and operating heavy machinery is advisable as such interactions lower mental alertness. 

Gabapentin With Opioids

Both opioid medications and Gabapentin are CNS depressants known to slow down some of the processes and functions of the brain. Therefore, taking opioid analgesics with Gabapentin can result in severe drug interaction.

 

 

It may also increase the risk of abuse, sedation, and respiratory depression. 

Some opioid pain medications that should not be taken with Gabapentin are Tapentadol, Tramadol, oxycodone, and hydrocodone [7]. 

 

Is It Safe To Take Gabapentin And Benadryl Together?

Gabapentin and Benadryl can cause moderate drug interaction, resulting in dizziness, impaired thinking ability, and drowsiness. 

 

 

It is hazardous to perform any activity that requires one to be mentally alert, including driving and operating heavy machinery. 

Gabapentin Interaction With Other OTC Medications 

Apart from muscle relaxers, there are other classes of drugs that can interact with Gabapentin to increase the risk of side effects. Administration of OTC medicines with Gabapentin for pain and allergy is considered safe, with moderate drug interaction. 

 

 

However, such practices should not be done without consulting a doctor. It is critical to be cautious while taking OTC medications such as Unisom, which may cause drowsiness in users. 

 

Ask The Experts: Can You Take Muscle Relaxers With Gabapentin?

Taking Gabapentin and muscle relaxers together can result in sedation and decreased coordination. Its intake of muscle relaxers such as Flexeril and Soma pill can cause weakness, drowsiness, and respiratory depression that can be monitored in patients. However, people with small cell carcinoma (lung tissue cancer) may have a higher health risk and should check with a physician before taking Gabapentin and muscle relaxers, says  Dr. Brian Staiger, PharmD. 

The viewpoint of Dr. Phillip Goebel and Dr. Olav Jaren, on the website Healthtap, on taking Gabapentin with Muscle relaxers is given below. 

 

 

Why Do People Take Muscle Relaxers With Gabapentin?

Combining Gabapentin with muscle relaxers for abuse is uncommon, but it does exist. Both these compounds work on the CNS, thus helping to slow down the brain’s reaction to any form of stimulation.

The six significant factors contributing to people taking muscle relaxers with Gabapentin are shown below.

 

 

Better and faster relief from body pain, somnolence, and better sleep contribute to the physical factors responsible for co-administering Gabapentin with muscle relaxers. However, the other contributing factors responsible for such interactions include-

• Easy availability of muscle relaxers and other medication online without prescription. 

• The low price of the Soma pill makes Carisoprodol a common choice for abuse with Gabapentin.

• Lack of awareness. 

Gabapentin And Muscle Relaxer High

Taking a muscle relaxer with Gabapentin can result in a Sedative and relaxing effect that most abusers seek. Gabapentin has effects similar to Amphetamine rush that may cause a euphoric effect in the user. However, combining them for abuse is not recommended and can result in severe health issues. 

 

Warnings Of Mixing Muscle Relaxers With Gabapentin

Muscle relaxers should be taken with muscle relaxers only under the supervision of the doctor. A few factors that should be considered while taking them together are listed below. 

Senior citizen

Elderly people often suffer from renal disorders that may make it difficult for them to metabolize the compound. Co-administering Gabapentin and muscle relaxers together will make it even more difficult for such people to process the medication. Thus, people over 65 must take Gabapentin and muscle relaxers only after consulting a doctor. 

Depression

Taking Gabapentin with any muscle relaxer may often result in depression. If not given the right attention, it may result in suicidal thoughts. Thus, caution should be maintained while prescribing this therapeutic combination for people with a history of mental health disorders. 

Alcohol

The use of alcoholic beverages with Gabapentin or muscle relaxers is not advisable. Such interactions may cause dizziness and drowsiness, further causing alcohol dependency in users. 

Allergy

Gabapentin interactions often cause allergic reactions in the patient. It may result in itching and rash. Thus, before taking Gabapention with a muscle relaxer, it is best to get an allergic test done. 

Breathing Issue

Using Gabapentin with muscle relaxers and other medications may cause CNS depression, resulting in breathing disorders. Thus, patients with asthma or other breathing issues are advised to take them together after consulting a doctor. 

Renal Or Kidney Disorder

The elimination of Gabapentin is much longer than other analgesics. When co-administered with muscle relaxers such as Carisoprodol and Flexeril, it may remain in the body for much longer. Since the renal system assists in eliminating the compound, its prolonged half-life may affect the normal functioning of the kidney. It is, therefore, considered unsafe for patients with renal dysfunction. Such people should take Gabapentin with muscle relaxers after consulting a doctor. 

 

What Muscle Relaxers Can You Take With Gabapentin? 

Using any form of muscle relaxer is not safe or advisable with Gabapentin. However, people with severe body pain can combine other pain medications after consulting a doctor. 

Analgesics such as ibuprofen, paracetamol, and aspirin are assumed to be safe with no severe interactions and side effects when taken with Gabapentin [8].  

 

Can You Take A Muscle Relaxer With Gabapentin- Our Final Thought 

Now that we have meticulously discussed the outcome of mixing muscle relaxers with Gabapentin, let us have a brief rundown.

To deal with severe acute and chronic pain, most people take muscle relaxers such as Soma with Gabapentin for faster relief from pain. And other times, it is mainly done for the pure sense of abuse. 

Irrespective of the factors contributing to such interactions, the intake of muscle relaxers with Gabapentin is unsafe and is not recommended by most physicians. 

Health risks of Gabapentin and muscle relaxers interaction in a nutshell-

• ​It can affect the CNS to cause respiratory depression, dizziness, and drowsiness. Patients with lung cancer are at a higher risk of experiencing severe adverse effects. 

• The psychedelic and sedative effects of Gabapentin may elevate when taken in conjunction with muscle relaxers and other medications. 

• Its use is not advisable in people over 65 years. 

Side Effects Of Taking Muscle Relaxers With Gabapentin 

A summary of all the side effects of combining muscle relaxers with Gabapentin is listed below. 

• Swollen throat

• Shortness of breathing 

• Eyes turning yellow

• Skin rash

• Weakness

• Swollen face

So, if you are suffering from body pain that does not respond well to muscle relaxers, you can mix them with Gabapentin only after consulting a doctor. We advise all our readers to take any medication mentioned here with a physician’s prescription.