Gabapentin Interactions

Gabapentin and alcohol are both central nervous system depressants. The FDA issued a 2019 Drug Safety Communication warning that gabapentin can cause serious, potentially fatal respiratory depression when combined with CNS depressants including alcohol, particularly in older adults and patients with respiratory disease.

Aluminum and magnesium-containing antacids reduce the bioavailability of gabapentin by approximately 20% when taken simultaneously, and magnesium oxide specifically can reduce gabapentin AUC by up to 43%. The mechanism is reduced intestinal absorption, not pH-related (proton pump inhibitors do not cause the same effect).