Gabapentin and tramadol are prescription medications with pain-relieving properties. Although they may be prescribed and taken together for enhanced pain relief in certain cases, concurrent use of these drugs doesn’t come without risk. Therefore, you should only combine them under medical supervision.
This article will explore the interaction between gabapentin and tramadol and explain the risks and dangers associated with this drug combination.
What Is Gabapentin, and What Is It Used For?
Gabapentin is a gamma-aminobutyric acid (GABA) analog that belongs to the class of anticonvulsant medications. It is FDA-approved for the treatment of:
- Seizures, such as those caused by epilepsy
- Restless leg syndrome, a neurological disorder that causes a strong urge to move the legs
- Neuropathic pain caused by postherpetic neuralgia, diabetic neuropathy, and similar conditions
This medication is available as a generic or brand-name product (Neurontin®, Gralise®, Horizant®, Gabarone®), in the form of oral solutions, capsules, and immediate- or extended-release tablets. Gabapentin works by altering the way that nerves send messages to the brain. Although it can effectively treat seizures and nerve pain, it can also cause side effects.
The most common side effects of gabapentin include:
- Nausea
- Vomiting
- Dizziness
- Headache
- Dry mouth
- Drowsiness
- Blurred vision
- Mood changes
- Diarrhea or constipation
In some cases, gabapentin can cause suicidal ideation, mania, and exacerbation of mental health conditions like depression and anxiety. These are more common in patients with pre-existing psychiatric conditions. In case of respiratory depression, allergic reactions, and other serious side effects, seek emergency medical help.
Gabapentin is a prescription drug, but it is not treated as a federally controlled substance in the United States.
Nonetheless, it is classified as a Schedule V drug in some states, including Alabama, Tennessee, and Michigan. Although it is not nearly as addictive as opioids, it should be taken strictly as prescribed; gabapentin misuse increases the risk of dependence, addiction, and overdose.
What Is Tramadol, and How Does It Work?
Tramadol is an opioid analgesic prescribed to manage moderate-to-severe pain that cannot be controlled with non-opioid pain relievers.
It works by interacting with opioid receptors and hindering the transmission of pain signals between the body and the brain. Unlike traditional opioids, it also modulates the reuptake of serotonin and norepinephrine. Due to its dual mechanism of action, tramadol is considered an atypical opioid.
Available in immediate- and extended-release formulations, this medication is marketed under Ultram®, ConZip®, Ryzolt®, and other brands. It is also sold as a generic drug. Tramadol comes in numerous forms, including:
- Tablets
- Capsules
- Suppositories
- Oral suspensions and solutions
Like all medications, it can cause various unwanted effects, such as constipation, nausea, and headaches. In case of tramadol side effects, consult your doctor. Allergic reactions, seizures, and other serious adverse effects may require immediate medical attention.
Given that the risk of tramadol abuse, dependence, and addiction is lower compared to other opioids, this medication has been classified as a Schedule IV controlled substance since 2014. Initially, it was regarded and advertised as a safe alternative to traditional opioids, such as oxycodone or morphine.
Although tramadol is among the least potent opioids, it is habit-forming and can lead to dependence, addiction, and overdose. Tramadol withdrawals can look somewhat different than those of other opioids; since it has a dual-action mechanism, it can cause psychosis, panic attacks, and other atypical withdrawal symptoms upon discontinuation.
If you suspect you might’ve become addicted, it’s in your best interest to seek professional tramadol addiction treatment.
Now that you’re more familiar with both medications, let’s find out if you can take gabapentin with tramadol.
Can You Take Gabapentin and Tramadol Together?
You can only take gabapentin and tramadol together if your doctor determines this treatment is suitable for you. In some cases, mixing these medications can lead to dangerous drug interactions. Therefore, it is generally not recommended; doing so without medical supervision constitutes polysubstance abuse and, at worst, can have fatal consequences.
However, your healthcare provider may prescribe gabapentin and tramadol together in certain cases (e.g., if you suffer from severe pain that doesn’t respond to other treatments and cannot be controlled with gabapentin or tramadol alone).
This drug combination can have a synergistic effect. For example, a study by Hugo F. Miranda et al. suggests that the co-administration of gabapentin and tramadol results in greater mononeuropathic pain relief than taking them on their own. This is likely because these medications act on different pain pathways.
Similarly, researchers from Stanford University School of Medicine found that tramadol with gabapentin provides better relief for thermal hyperalgesia in rats than tramadol alone.
However, this drug combination can only be used under close medical supervision. If you are prescribed gabapentin and tramadol together, be extremely cautious to take them precisely as instructed. Do not increase the dosage, frequency, or duration of use without your doctor’s permission; if you experience any unwanted effects, report them to your doctor immediately.
Next, let’s discuss the risks and dangers of mixing gabapentin and tramadol.
Risks and Dangers of Mixing Gabapentin and Tramadol
The key risks of mixing gabapentin and tramadol are the increased likelihood of side effects, serotonin syndrome, respiratory depression, and overdose.
Here’s a more detailed overview of these risks:
Side Effects
Gabapentin and tramadol can each cause side effects, so taking them together amplifies the risk of adverse reactions that can range from mild to severe.
Most commonly, mixing gabapentin and tramadol causes:
- Headaches
- Drowsiness
- Lightheadedness
- Nausea and vomiting
- Trouble concentrating
Since this drug combination can cause drowsiness and dizziness, you should avoid driving or operating heavy machinery until you know how it affects you.
Combining gabapentin with tramadol can also cause serious adverse effects, such as difficulty breathing. Even though gabapentin is an anticonvulsant medication, taking it with tramadol increases the risk of seizures.
It is critical to inform your doctor about any side effects you experience while taking these medications, whether alone or in combination.
Serotonin Syndrome
Serotonin syndrome is a potentially life-threatening drug reaction that occurs when there is too much serotonin in the system. While tramadol inhibits serotonin reuptake, gabapentin can increase its blood levels. Taking them together puts you at an increased risk of this reaction.
A case study by Murat Şakir Ekşi et al. found that the concurrent use of gabapentin and tramadol can lead to serotonin syndrome in patients undergoing spine surgery. However, the incidence of this condition is likely underestimated, as less severe cases are often misdiagnosed.
Respiratory Depression
Characterized by ineffective breathing, respiratory depression is among the greatest risks of taking gabapentin and tramadol together. Both medications can depress the central nervous system, leading to slow, shallow breathing, and taking them together increases this risk even further.
If you experience difficulty breathing after using these medications, seek medical help. Without treatment, respiratory depression can lead to reduced oxygen levels, brain damage, coma, and death.
Drug Overdose
Although relatively weak, tramadol can cause an opioid overdose, especially when taken in high doses, mixed with other substances, or misused in other ways. Gabapentin, too, can lead to an overdose; it has become increasingly implicated in overdose deaths in recent years. Taking them together increases the risk of a potentially fatal overdose.
While opioid overdoses can be reversed by promptly administering naloxone (Narcan®), those caused by gabapentin do not have an antidote as of yet. Nonetheless, it is critical to call 911 immediately if you or a loved one is displaying signs of a gabapentin and tramadol overdose; timely medical intervention is key to surviving a drug overdose.
Signs and Symptoms of Gabapentin and Tramadol Overdose
The tell-tale signs and symptoms of a gabapentin and tramadol overdose are:
- Pinpoint pupils
- Decreased pulse
- Cold, clammy skin
- Unresponsiveness
- Extreme confusion
- Reduced heart rate
- Low blood pressure
- Nausea and vomiting
- Slowed, shallow breathing
- Gurgling or choking sounds
- Discolored lips, skin, or fingernails
- Profound drowsiness and sedation
Some gabapentin and tramadol overdose symptoms may look similar to medication side effects. Given that overdoses can be lethal without prompt medical help, it’s best to call 911 if you suspect you or someone around you may be overdosing on these drugs. Even if you aren’t 100% sure, it’s better to be safe than sorry.
If your doctor prescribes you gabapentin and tramadol, take them precisely as instructed and carefully track your drug intake to minimize the risk of an overdose. If you miss a dose, skip it and take the next one as usual. Do not mix these medications with alcohol or other drugs without consulting your doctor.
Those struggling with tramadol dependence or addiction face a higher overdose risk. This is because they are more susceptible to opioid abuse, including mixing tramadol with gabapentin or other drugs without medical supervision.
Opioid dependence is nothing to be ashamed of; it can happen to anyone taking these drugs, as they gradually alter brain chemistry, leading to tolerance.
Those dependent on tramadol have to take it just to feel normal and prevent uncomfortable withdrawal symptoms. While dependence is purely physical, it can lead to addiction, also known as opioid use disorder (OUD), if left untreated, causing you to lose control over opioid use.
Luckily, both tramadol dependence and addiction can be treated by seeking professional help.
ANR Treatment for Tramadol Dependence
Accelerated Neuro-Regulation (ANR) is a comprehensive opioid dependence treatment developed by Dr. Andre Waismann. Unlike traditional approaches like rapid detox, this groundbreaking method attacks the root of opioid dependence rather than its symptoms.
ANR stands out as the first and only treatment that re-regulates the endorphin-receptor system imbalance resulting from prolonged opioid use, thereby addressing the underlying causes of opioid dependence. In other words, it reverses the damage opioids cause to the central nervous system, returning the brain to its pre-dependence state.
Thanks to its comprehensive, scientifically based approach, ANR patients don’t need to rely on any potentially addictive medications for opioid withdrawal management. Once the treatment is complete, you can forget about cravings and other withdrawal symptoms.
As of today, ANR has facilitated the recovery of over 25,000 people worldwide.
Benefits of Undergoing ANR Treatment
The key benefits of undergoing ANR treatment include:
- Patient safety. Carried out by highly experienced board-certified healthcare professionals, ANR meets the highest patient safety and care standards. The procedure is performed strictly in an ICU setting of fully accredited hospitals with advanced medical equipment.
- Lasting results. ANR facilitates long-lasting success by targeting the neurobiological root of opioid dependence, thereby eliminating the risk of persistent withdrawal symptoms and relapse.
- Short duration. The average hospital stay for ANR treatment lasts only 36 hours. This innovative approach can help you break free from opioid dependence within a matter of days, regardless of how long you’ve been battling it.
Ready to return to a happy, healthy life without opioids, cravings, and the fear of relapse? We’re here to help you make it happen—contact us today for a free, 100% confidential consultation with no obligation.
Key Takeaways
The bottom line is that mixing gabapentin and tramadol is generally dangerous. Nonetheless, your healthcare provider may prescribe these medications if they determine that the benefits may outweigh the risks. In this case, you should work closely with your doctor to reduce the risk of adverse effects.
Before you leave, let’s summarize the key points we covered today:
- Gabapentin is an anticonvulsant drug that may be prescribed for nerve pain, whereas tramadol is an opioid with a dual mechanism of action used for moderate-to-severe pain.
- The dangers of mixing gabapentin and tramadol include the increased risk of serotonin syndrome, overdose, and other potentially life-threatening conditions.
- ANR is a revolutionary treatment that eradicates opioid dependence together with withdrawal symptoms through endorphin-receptor system modulation.
Gabapentin and Tramadol FAQ
Tramadol is generally stronger than gabapentin. However, gabapentin is often recommended as a first-line treatment for chronic neuropathic pain because it is highly effective in controlling nerve pain. Tramadol, meanwhile, is only prescribed for such pain if other treatments fail or aren’t tolerated.
Gabapentin does not typically make you feel the same as tramadol. However, if abused (e.g., taken in high doses or combined with other substances), it may induce feelings of euphoria and relaxation similar to those of opioids like tramadol. Always take gabapentin as prescribed; misusing it increases the risk of side effects, dependence, addiction, and overdose.
Consult your doctor to find out how many hours after gabapentin you can take tramadol safely, as this may depend on individual factors, such as your health condition.
Gabapentin is not typically used to treat opioid addiction. The only FDA-approved drugs for opioid addiction treatment are buprenorphine, methadone, and naltrexone. However, gabapentin is sometimes prescribed off-label as a medication for opioid withdrawal management alongside other therapies.
