Risks of Combining Suboxone and Gabapentin: A Comprehensive Guide

The risk of combining Suboxone and Gabapentin includes slow breathing, dizziness, loss of consciousness, and even death, according to the National Institutes of Health (NIH)¹. These medications can have serious side effects when taken together, since they both slow the central nervous system (CNS).

Suboxone is commonly used to treat Opioid Use Disorder (OUD), but the opioid withdrawal comes with symptoms like anxiety, neuropathic pain, and insomnia². These symptoms are commonly treated with Gabapentin. While Gabapentin is effective in solving these problems, it can also be lethal if taken in doses with Suboxone. In this article, we will discuss the reasons, risks, precautions, and research on taking Suboxone and Gabapentin together². 

ChoicePoint offers an online and in-person Suboxone MAT program for opioid use disorder and Outpatient suboxone treatment in NJ. We offer prescriptions for both Suboxone and Gabapentin (if deemed necessary) under expert medical supervision to minimize any possible side effects. Call 844.445.2565 to schedule an appointment.

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Highlights

• Gabapentin and Suboxone help with withdrawal from OUD, and that is why they are prescribed together. 
• Using these drugs together without close medical monitoring can cause overdose, leading to dizziness, slow breathing, and low blood pressure.
• The patient should take Suboxone and Gabapentin in the lowest doses possible and under strict doctor supervision.
• ChoicePoint has excellent Suboxone Treatment and Opioid Addiction Treatment Programs under the expertise of top-of-the-field doctors to help you recover from opioid addiction.

Why Gabapentin and Suboxone Are Used Together?

Suboxone helps to manage Opioid Use Disorder and reduces its intensity. The withdrawal from opioids has side effects such as nausea and pain. These side effects are effectively managed through Gabapentin, which is why it may be prescribed with Suboxone.⁶ 

What is Suboxone?

Suboxone is an FDA-approved drug that helps reduce and eventually discontinue opioid use. It is a combination of Buprenorphine and Naloxone, an opioid agonist. Suboxone eases opioid withdrawal and cravings. Brand-name Suboxone medication is available as a sublingual film or tablet (orange pill and pink pill).

What is Gabapentin?

Gabapentin is an anti-seizure and anticonvulsant medication designed for seizure and neuropathic pain patients.⁵ It is effective in reducing excitatory neurotransmitter release, and hence, it relaxes the human mind. Its off-label use includes insomnia, anxiety disorders, and opioid withdrawal symptoms management. ⁵

4 Common Risks of Combining Suboxone and Gabapentin

Suboxone and Gabapentin are both CNS suppressants, and they can complement each other’s efficacy and create a CNS shutdown cocktail⁷. The risks are usually higher with unsupervised use or recreational use, such as snorting Gabapentin, which may lead to a Gabapentin high.  Here are a few symptoms of the adverse effects of combining these two medications:

1. Depressed Respiration: Breathing slows down, which is especially dangerous if the person sleeps. Respiratory depression during sleep may be life-threatening.
2. Impaired Cognition: CNS depressants affect the brain and cause loss of complex functions like judgment, control, memory, and concentration. 
3. Drowsiness: The patient consistently appears sleepy and struggles to think clearly, even after several hours of sleep. 
4. Low Blood Pressure: The relaxing effect on the CNS causes low blood pressure from both medications. It can lead to dizziness and fainting. 

Patients with respiratory problems, older patients with blood pressure fluctuation, and liver patients are highly at risk when taking Suboxone and Gabapentin together.¹ 

Did You Know? ChoicePoint prescribes FDA-approved alternatives to Suboxone as well, if Suboxone is not working for you. Connect with your online suboxone doctors in NJ and get evaluated to manage suboxone dosage as well. Call 844.445.2565 for direct guidance or schedule your appointment by filling out this form. 

Know the risks before combining Suboxone and Gabapentin

How to Take Gabapentin and Suboxone While Avoiding Risks?

When taking Gabapentin and Suboxone together, the user should keep the following 4 points in mind:

1. Keep Low Doses: The risk of adverse effects is extremely high if both medications are taken in high doses. Keep the doses as small as possible¹⁰. 
2. Check for CNS Depression: The most common sign of CNS depression is low or irregular breathing. But extreme fogginess, dizziness, drowsiness, and very low blood pressure are all signs of CNS depression you should be aware of.¹⁰
3. Avoid any other medications: Avoid alcohol with Gabapentin; sleeping pills, and any kind of opioids should all be avoided with these two medications. 
4. Know the Signs: When taking these two drugs together, read up on CNS depression and stay very vigilant about these signs. 

These medications are only to be taken as prescribed by a suboxone doctor near you, and the doctor will closely monitor the suboxone dosage. Information about Suboxone use is vital for patient safety.

When to Avoid the Mix of Suboxone and Gabapentin?

The most important precaution is not to mix these two medications in the following scenarios. 

• Respiratory Challenges: If a person has sleep apnea or obstructive pulmonary disease (COPD)¹⁰.
• Older Patients: Older patients have a different metabolism that makes them more sensitive to the adverse effects of medications. 
• Other CNS Depressants: Medications such as Suboxone cannot be taken with alcohol, sleeping pills, benzodiazepines, or any other opioids, or the combination will be fatal.¹⁰ 

Recommended Read: What medications can you not take with Suboxone?

Conclusion

Gabapentin and Suboxone are a good combination to fight opioid withdrawal symptoms effectively, but the combination is high-risk. These two medications, when combined, may result in potential overdoses occurring even when individual doses are low¹⁰. These medications are not for recreational use and should only be taken under very close medical watch. 

Recommendations

• Consult Healthcare Providers: Always discuss with your doctor before starting or combining medications.
• Don’t Change Dosage: Gabapentin and Suboxone doses are extremely sensitive, and even if you are very confident, never change your dose without telling your doctor.
• Monitor for Overdose: As stated above, keep an eye out for signs of CNS depression and do not sleep if you are having CNS depression. 

Safe Practices

• Monitoring: Do not miss a doctor’s appointment when taking these medications. The doctor needs to stay updated on your state and your dosage.
• Stay Updated: Ensure that you understand the risks and signs of overdose.
• Avoid Other Drugs: Do not use any other CNS depressants or any other medication with Suboxone without a doctor’s approval.

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ChoicePoint Suboxone Treatment And Opioid Addiction Treatment Program

ChoicePoint Outpatient Suboxone Treatment in NJ  has a comprehensive opioid addiction treatment program that assesses patients’ withdrawal symptoms individually. The licensed doctors may prescribe Suboxone or Gabapentin if deemed necessary to help manage withdrawal symptoms. The program assists the patient in addiction recovery through treatment planning, monitoring, and medical care. 

If you have any queries related to Gabapentin or the correct Suboxone dosage, please contact 844.445.2565 ChoicePoint’s DEA-certified Suboxone Doctors in NJ. Our in-person and online Suboxone doctors accept major health insurance plans, including Medicaid, Medicare, Blue Cross Blue Shield, UnitedHealthcare, Aetna, and Cigna, to ensure that treatment is accessible to everyone. If a patient does not have insurance, then cash-pay options are available. Verify your insurance to get started!

FAQs Related To Combining Gabapentin and Suboxone

Find answers to the most asked questions about Gabapentin and alcohol

1. What are the risks of combining Suboxone and gabapentin?

The primary risks include increased CNS depression, respiratory depression, cognitive impairment, and potential overdose4.

2. Can you take Suboxone with Xanax and gabapentin?

Yes, but only under strict medical supervision, with careful dosing and monitoring for adverse effects6.

3. Are there alternatives to Suboxone and gabapentin?

Yes, other treatments for opioid addiction and associated symptoms include Subutex, Naltrexone, buprenorphine monotherapy, and non-opioid medications for pain and anxiety management. Always consult with a healthcare provider to determine the most appropriate treatment plan3.

References List

1. Gomes, T., Juurlink, D. N., Antoniou, T., Mamdani, M. M., Paterson, J. M., & van den Brink, W. (2017). Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study. PLoS medicine, 14(10), e1002396. https://doi.org/10.1371/journal.pmed.1002396
2. Ellis, M. S., Xu, K. Y., Tardelli, V. S., Fidalgo, T. M., Buttram, M. E., & Grucza, R. A. (2023). Gabapentin use among individuals initiating buprenorphine treatment for opioid use disorder. JAMA psychiatry, 80(12), 1269-1276.
3. Buttram, M. E., Kurtz, S. P., Ellis, M. S., & Cicero, T. J. (2019). Gabapentin prescribed during substance abuse treatment: The perspective of treatment providers. Journal of Substance Abuse Treatment, 105, 1-4.
4. Velander, J. R. (2018). Suboxone: rationale, science, misconceptions. Ochsner Journal, 18(1), 23-29.
5. Mathieson, S., Lin, C. W. C., Underwood, M., & Eldabe, S. (2020). Pregabalin and gabapentin for pain. Bmj, 369.
6. Ellis, M. S., Xu, K. Y., Tardelli, V. S., Fidalgo, T. M., Buttram, M. E., & Grucza, R. A. (2023). Gabapentin use among individuals initiating buprenorphine treatment for opioid use disorder. JAMA psychiatry, 80(12), 1269-1276.
7. Hahn, J., Jo, Y., Yoo, S. H., Shin, J., Yu, Y. M., & Ah, Y. M. (2022). Risk of major adverse events associated with gabapentinoid and opioid combination therapy: A systematic review and meta-analysis. Frontiers in Pharmacology, 13, 1009950.
8. Buttram, M. E., Kurtz, S. P., Ellis, M. S., & Cicero, T. J. (2019). Gabapentin prescribed during substance abuse treatment: The perspective of treatment providers. Journal of Substance Abuse Treatment, 105, 1-4.
9. Kuehn, B. M. (2022). Growing role of gabapentin in opioid-related overdoses highlights misuse potential and off-label prescribing practices. JAMA, 328(13), 1283-1285.
10. Ahmed, S., Bachu, R., Kotapati, P., Adnan, M., Ahmed, R., Farooq, U., … & Begum, G. (2019). Use of gabapentin in the treatment of substance use and psychiatric disorders: a systematic review. Frontiers in psychiatry, 10, 228.