Can You Take Gabapentin with Codeine?
Last reviewed: · Source: US FDA drug label database
Gabapentin combined with codeine or other opioids significantly increases the risk of respiratory depression and death — this pairing carries an official FDA warning.
Is it safe to take Gabapentin with Codeine?
The FDA and UK regulators have issued specific warnings about combining gabapentinoids (gabapentin, pregabalin) with opioids like codeine. Both suppress the central nervous system, and together they can dangerously slow breathing, particularly during sleep. UK overdose deaths involving gabapentinoids almost always also involve opioids. If both drugs are genuinely needed, they must be prescribed together deliberately at the lowest effective doses — never self-combine prescription gabapentin with over-the-counter co-codamol.
How do Gabapentin and Codeine interact?
Opioids depress brainstem respiratory drive via mu-receptor agonism. Gabapentin adds CNS depression and appears to blunt the hypercapnic ventilatory response, while opioids also increase gabapentin absorption. The combination produces synergistic — not merely additive — respiratory depression.
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA Drug Safety Communication 2019 — serious breathing problems with gabapentinoids and opioids.
Who should be careful?
Everyone, but especially people with sleep apnoea, COPD or other lung disease, the elderly, those with kidney impairment (gabapentin accumulates), and anyone also drinking alcohol or taking benzodiazepines.
What if I've already taken Gabapentin and Codeine?
If both were prescribed together deliberately, take exactly as directed and never increase doses yourself. If you've added OTC co-codamol to prescription gabapentin, stop the codeine and speak to a pharmacist. Emergency signs: extreme drowsiness, slow or shallow breathing, blue lips, unresponsiveness — call 999.
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Frequently Asked Questions
Can I take co-codamol with gabapentin?
Not without your prescriber's explicit approval. The codeine in co-codamol plus gabapentin can dangerously suppress breathing.
Why are gabapentin and opioids dangerous together?
Both depress the central nervous system and breathing. Together the effect is synergistic — much greater than either alone, especially during sleep.
What painkillers are safe with gabapentin?
Paracetamol and, for most people, NSAIDs like ibuprofen do not have this interaction. Check with your pharmacist for your situation.
What are the emergency warning signs?
Extreme sleepiness, confusion, very slow or shallow breathing, gurgling or snoring that's hard to rouse from, blue-tinged lips. Call 999 immediately.