MAJOR — Use With Caution
🔴 AVOID — FDA 2019 safety communication: gabapentinoids with opioids risk serious respiratory depression. Use lowest effective doses of both under close medical supervision.
Evidence level: STRONG
The FDA added a warning in 2019 that gabapentin combined with opioids like oxycodone can cause serious breathing problems. Together, these drugs suppress your breathing more than either one alone, and this has caused deaths.
Additive CNS depression. FDA added warning to gabapentinoid labels (2019) about serious breathing difficulties when combined with opioids. Gabapentin may enhance opioid-induced respiratory depression beyond simple additive effects.
If prescribed both, use the lowest effective doses. Be especially careful when starting either medication or increasing doses. Do not take more than prescribed. Avoid alcohol.
Take Oxycodone exactly as prescribed — set alarms for scheduled doses. Gabapentin follows its normal schedule. Opioids slow GI transit, which can affect absorption of other medications. Take with food if nausea occurs. Never combine with alcohol.
Higher risk for: elderly, opioid-naive patients, those with sleep apnea, respiratory conditions, concurrent CNS depressants (benzodiazepines, alcohol), liver impairment, or history of substance use disorder.
Extreme drowsiness, slow or shallow breathing, confusion, bluish lips, unresponsiveness, dizziness
Start gabapentin at low dose when combined with opioids. Educate about respiratory depression signs. Consider whether both drugs are necessary for pain management.
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
The FDA added a warning in 2019 that gabapentin combined with opioids like oxycodone can cause serious breathing problems. Together, these drugs suppress your breathing more than either one alone, and this has caused deaths.
Take Oxycodone exactly as prescribed — set alarms for scheduled doses. Gabapentin follows its normal schedule. Opioids slow GI transit, which can affect absorption of other medications. Take with food if nausea occurs. Never combine with alcohol.
Extreme drowsiness, slow or shallow breathing, confusion, bluish lips, unresponsiveness, dizziness
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
Start gabapentin at low dose when combined with opioids. Educate about respiratory depression signs. Consider whether both drugs are necessary for pain management.
Or browse the full interaction database (121,000+ pairs).