Can You Take Gabapentin With Tylenol? Risks and Side Effects

Gabapentin is a prescription anticonvulsant that’s used to treat nerve pain and seizure disorders. It’s often used to complement treatment protocols that include other medications, such as Tylenol, the brand name for acetaminophen.

Gabapentin and Tylenol work differently to relieve pain and treat different kinds of pain, so taking them together can alleviate pain more effectively. However, this combination may not be safe for everyone, and it’s important to be aware of the risks.

What Is Gabapentin?

Gabapentin, sold under the brand Neurontin, is a prescription medication that has been used to treat nerve pain and seizure disorders since the 1990s. It’s also used off-label for other types of nerve pain. The extended-release version, Horizant, may be prescribed for restless leg syndrome. Gralise, another extended-release version, is used to treat pain associated with post-herpetic neuralgia.

Gabapentin is a gamma aminobutyric acid (GABA) analog drug.[1] This class of drugs works by reducing the activity of the nerve cells in the brain to help with nerve pain and lessen the intensity, duration, and frequency of seizures.

There are side effects and adverse reactions with gabapentin, as well as possible drug interactions that can carry serious risks.

What Is Tylenol?

Tylenol is a recognizable brand name for acetaminophen, a pain-relieving medication used to treat mild to moderate pain, such as headaches, muscle pain, and menstrual cramps.

Tylenol is generally safe and works to relieve pain quickly, which is why it’s a popular household pain reliever. The drug works on the central nervous system and is believed to raise the pain threshold and change how the body perceives pain.[2] Tylenol can also reduce fever by influencing the heat-regulating area of the brain to reduce temperature.

Is It Safe to Combine Gabapentin and Acetaminophen?

Though they both relieve pain, gabapentin and Tylenol are in two different drug classes, work differently, and relieve different types of pain. There are no known interactions between gabapentin and acetaminophen, but that doesn’t mean none exists.[3]

If you have different types of pain, combining gabapentin and Tylenol may provide relief. Studies have shown that a combination of these drugs can reduce pain after a surgical operation. In the study from Yale University, study participants were given both drugs before chest surgery, and they didn’t need as high doses of opioid painkillers after surgery as those who didn’t have either medication.[4]

How to Take Gabapentin and Tylenol Together

Gabapentin has dosages based on a set schedule to treat different conditions. Tylenol is used as needed for pain, so it’s not taken regularly. If you take the two drugs together, there’s no need to space out your doses.

That said, Tylenol has limits on how frequently you can take the drug or how much you can take in 24 hours, so always follow the instructions on the drug label or talk to your doctor.

What Drugs Interact with Gabapentin?

Tylenol may be safe with gabapentin, but plenty of other drugs are not. Here are some possible drug interactions:

Opioids

Opioids, or narcotic painkillers, are prescribed to treat pain. They work differently from gabapentin, however, and block pain signals to numb the body to pain. Because of their addiction potential, opioids are usually only prescribed for severe, chronic pain that hasn’t been relieved by other medications.

Gabapentin and opioids have similar side effects, so it’s possible to experience amplified side effects like depressed breathing, severe drowsiness, and loss of consciousness if you combine them.

Gabapentin enhances the depressant effects of opioids and may cause a greater euphoria. Therefore, the drug can be abused with opioids and other drugs. Taking opioids, especially at high doses, increases the risk of opioid overdose and adverse effects.[5] The FDA warned the public in 2019 about the risks of combining gabapentin and opioids.[6]

Antihistamines

Antihistamines are drugs used to treat allergies and itching by blocking histamine, which regulates the immune response. Many antihistamines have drowsiness as a side effect, so combining them with gabapentin can sedate your body to dangerous levels.[7]

Sedatives

Sedatives include a variety of medications that can treat anxiety, insomnia, and other sleep disorders, such as barbiturates, benzodiazepines, and z-drugs. Like antihistamines, sedatives combined with gabapentin can cause severe levels of sedation.[8]

Alcohol

Alcohol is a central nervous system depressant that slows breathing and brain activity. There are many drugs that shouldn’t be combined with alcoholic beverages, including other depressants like benzos and opioids, or drugs with a sedative effect like gabapentin. If you drink alcohol while taking gabapentin, you may slow your body’s functions to life-threatening levels.

These are some of the most dangerous drug interactions for gabapentin, but other interactions may exist. Always tell your doctor about other medications you’re taking.

What Drugs Interact with Tylenol?

Tylenol is accessible and sold over the counter, in combination medications, and in prescription-strength versions. However, there are dangerous interactions for acetaminophen, including:

Other Acetaminophen-Containing Drugs

Because acetaminophen is used in so many medications, including migraine medications like Excedrin Migraine or combination cold and flu medications like DayQuil and Nyquil, it’s possible to accidentally take too much of the drug.

High doses of acetaminophen can have serious risks, including possible liver damage or overdose.[9] The symptoms of an acetaminophen overdose may include vomiting, nausea, constipation, and possible organ damage or death.[10]

Alcohol

Alcohol impacts the entire body, including the heart and brain, but most people know that the liver is one of the most affected organs. Chronic, excessive alcohol use can cause liver damage over time – and so can acetaminophen in high doses.

If you are taking acetaminophen, combining safe doses of acetaminophen with safe amounts of alcohol may be okay on occasion.[11] Always talk to your doctor, however, and limit your drinking amounts to avoid possible liver damage.

Warfarin

Warfarin is an oral anticoagulant (blood thinner) that’s used to treat and prevent blood clots. Acetaminophen may amplify the effects of warfarin, increasing the risk of serious bleeding.[12] Talk to your doctor if you take warfarin to know if acetaminophen is safe for you.

These are some of the most dangerous drug interactions for acetaminophen, but other interactions may exist. Always tell your doctor about other medications you’re taking.

Be Aware of Gabapentin Drug Interactions and Risks

Gabapentin and acetaminophen have no known interactions and may even be beneficial for treating pain when taken together. However, not all drug combinations are okay for everyone, so talk to your doctor about the safety of taking acetaminophen while on gabapentin.