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Key takeaways
Gabapentin is an anticonvulsant and neuromodulator. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID).
Because gabapentin and ibuprofen belong to different drug classes and have different pharmacology, they may be taken together safely.
Common side effects of gabapentin include dizziness, shortness of breath, fatigue, nausea, and blurred vision. Ibuprofen side effects include nausea, vomiting, diarrhea, abdominal discomfort, and heartburn.
Some people experience more pain relief when taking gabapentin and ibuprofen together.
Ibuprofen is an over-the-counter (OTC) nonsteroidal anti-inflammatory (NSAID) that is commonly used to reduce fever and treat mild to moderate pain from headaches, toothaches, arthritis, back pain, and menstrual cramps. Gabapentin, generic for Neurontin, is a prescription anticonvulsant used to treat epilepsy, a brain condition that causes seizures. Gabapentin is also commonly prescribed to help manage postherpetic neuralgia, a burning pain in the nerves and skin that occurs after shingles. In addition to neuropathic pain, the drug may be used to treat restless legs syndrome. Ibuprofen and gabapentin, which are both analgesics (drugs that relieve pain), may be taken together safely.
Can you take ibuprofen with gabapentin?
There are no known drug interactions between ibuprofen and gabapentin, making it safe to take them together.
Paul Pavlov, MD, a family doctor in Biloxi, Mississippi, regularly prescribes gabapentin and ibuprofen. “Gabapentin and ibuprofen together do give better pain relief,” Dr. Pavlov says. He explains that they are safe to take together because they are “two completely different pharmacological substances” with different modes of action.
Ibuprofen is an NSAID, meaning that it’s not a steroid. It works by reducing inflammation through the inhibition of cyclooxygenase (COX), or prostaglandin-endoperoxide synthase (PTGS), a type of enzyme. Gabapentin, on the other hand, is a neuromodulator, a kind of drug that alters the way nerves communicate with each other.
“They are pain relievers, but in different ways,” says Craig Bowron, MD, a St. Paul, Minnesota hospitalist. Dr. Bowron explains that ibuprofen works “through suppressing excess inflammation,” whereas gabapentin works by “toning down the nerves that are either directly or partly responsible for your pain.”
With gabapentin and ibuprofen, as with any medication, the drug must match the type of pain or problem, according to Scott Nass, MD, a family doctor in Palm Springs, California.
For example, if a patient has pain due to inflammation, Dr. Nass would recommend ibuprofen because it decreases inflammation.
“If that inflammation is also causing long-term chronic nerve pain, then gabapentin might be a good addition to the ibuprofen to attack the problem from two angles and hopefully have additive effects,” Dr. Nass adds. “I have patients who feel better from taking both medicines rather than just one or the other.”
Dr. Bowron says that some patients have such chronic pain that they need both medications. However, if the nerve is the primary mechanism triggering the pain, it’s generally best to prescribe gabapentin, and ibuprofen may not be needed. An animal study found that gabapentin can inhibit hyperalgesia, a heightened sensitivity to pain. The study concluded that it can be used as a treatment for chronic muscle pain.
What happens if you take gabapentin and ibuprofen together?
Taking gabapentin and ibuprofen together is deemed to be safe and may even be beneficial for some patients. There are no known interactions between the two drugs. The patient must consult their healthcare provider about whether taking ibuprofen with gabapentin will work for their unique situation. Both gabapentin and ibuprofen carry side effects, both independently and when taken together.
Potential side effects of gabapentin include:
- Drowsiness
- Dizziness
- Brain fog
- Diarrhea
- Headache
- Blurred vision
- Dry mouth
- Weight gain
- Mood changes
- Suicidal thoughts
Ibuprofen has a lower side effect profile than gabapentin. Common ibuprofen side effects include:
- Upset stomach
- Stomach ulcer
- Abdominal pain
- Headache
- Dizziness
- Nausea
- Constipation
- Heartburn
- Trouble breathing
- Increased blood pressure
Older adults with a lung condition, such as asthma or chronic obstructive pulmonary disease (COPD), are at an increased risk for breathing problems when taking gabapentin. Dr. Bowron says that people with underlying neurological issues, such as mild cognitive impairment or dementia, may be more prone to the drug’s side effects.
Opioids suppress the respiration center, causing an individual to breathe more slowly. “If you add gabapentin on top of that, those two together can kind of compromise someone’s breathing,” Dr. Bowron explains, adding that people should be very careful when mixing gabapentin with opioids. Taking ibuprofen will not affect the effectiveness of gabapentin, he adds.
Research shows that only an estimated 1% of the general population misuse gabapentin. Dr. Pavlov says that while gabapentin has a very low addiction potential, some people may experience a slight withdrawal when they stop it. “But, that’s not common,” he adds. Although gabapentin is not considered to be a controlled substance at the federal level, it is in some states.
How long should I wait to take ibuprofen after taking gabapentin?
Dr. Pavlov says that it’s safe to take gabapentin and ibuprofen orally at the same time. The standard dose of gabapentin is 300 milligrams three times a day.
“Every person has a different response to it,” Dr. Pavlov explains. “I have patients who take up to 900 milligrams three times a day.”
Doctors may prescribe up to 2,400 milligrams of gabapentin per day. At higher dosages, adding more milligrams tends to increase the risk of side effects without offering much benefit, according to Dr. Bowron. “You might get a little more help, but your side effects start to go up sharply,” he adds.
It’s unpredictable what side effects a patient will have from the medications until they take them. This is why doctors generally start with a low dose and gradually increase the dosage if needed.
The standard dose of ibuprofen is typically 400 milligrams every four hours. Prescription-strength ibuprofen generally is 600 milligrams every six hours. “Rarely, we might prescribe 800 milligrams every eight hours, but because of the risk for the stomach, we tend not to,” Dr. Nass explains.
If the patient has stomach ulcers or acid reflux, they need to be careful with NSAIDs, Dr. Pavlov cautions. Long-term ibuprofen use may increase the risk of bleeding and ulcers.
“Ibuprofen is not sedating,” Dr. Pavlov says. “Some people get sleepy with [gabapentin]. More commonly, they feel funny, lightheaded, or dizzy.”
Gabapentin can interact with drugs that can increase its sedative effect, including opioids, antihistamines, and benzodiazepines. Doctors also recommend avoiding alcohol when taking gabapentin because of the impact on the central nervous system.
“Alcohol would be a risk with it,” Dr. Pavlov warns. “Other sedating medications like sleeping pills increase the risk of adverse effects. Anything sedative can accentuate it, maybe even Benadryl if you take enough of it.”
Dr. Nass says that if someone is taking either gabapentin or ibuprofen and it’s not doing the trick, they should talk with a healthcare professional about the most optimal dose.
“If that is not going to resolve the issue, then see if adding the other [medication] would be appropriate,” Dr. Nass says. “Gabapentin is going to be for, typically, pain related to nerves, and so if you have a long-term, chronic problem related to the nerves, then that would be your reason to add gabapentin.”
Dr. Nass will also often start a patient on gabapentin and then add ibuprofen if necessary for additional pain relief.
Is it safe to mix gabapentin and ibuprofen?
Gabapentin and ibuprofen can be safely mixed. However, it should be done under the guidance of a healthcare provider. Patients who take gabapentin and add ibuprofen may experience the additive effect of increased pain relief. Good candidates for using both drugs include those with chronic nerve damage, chronic muscle tension, and diabetic neuropathy.
Each drug carries side effects, both independently and when mixed. If a patient is experiencing adverse side effects, they should discuss with their doctor about adjusting the dosage or trying a different medication.
Sources
- Gabapentin misuse, abuse, and diversion: A systematic review, Addiction (2016)
- Gabapentin decreases microglial cells and reverses bilateral hyperalgesia and allodynia in rats with chronic myositis, European Journal of Pharmacology (2017)