Interactions between Gabapentin and Viagra
No drug interactions found, but 29 warnings to review for the following 2 drugs:
- gabapentin
- Viagra (sildenafil)
Drug interactions
There were no interactions found between gabapentin and Viagra. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
gabapentin Food/Lifestyle
Applies to: gabapentin
Generally avoid
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
Management
Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
sildenafil Food/Lifestyle
Applies to: Viagra (sildenafil)
Generally avoid
Coadministration with grapefruit juice may slightly increase the oral bioavailability and delay the onset of action of sildenafil. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In a randomized, crossover study with 24 healthy male volunteers, ingestion of 250 mL of grapefruit juice one hour before and concurrently with a 50 mg dose of sildenafil increased the mean area under the plasma concentration-time curve (AUC) of sildenafil and its pharmacologically active N-desmethyl metabolite by 23% and 24%, respectively, compared to water. Peak plasma concentrations (Cmax) were unaltered, but the time to reach sildenafil Cmax was prolonged by 0.25 hour. The observed increase in sildenafil bioavailability is unlikely to be of clinical significance in most individuals. However, pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability and may be significant in the occasional susceptible patient. Indeed, one subject in the study had a 2.6-fold increase in sildenafil concentrations.
Management
It may be advisable to avoid administration of sildenafil with grapefruit juice to prevent potential toxicity and delay in onset of action.
References (1)
- Jetter A, Kinzig-Schippers M, Walchner-Bonjean M, et al. (2002) "Effects of grapefruit juice on the pharmacokinetics of sildenafil." Clin Pharmacol Ther, 71, p. 21-29
Disease interactions
27 potential interactions Applies to: 25 conditions, including Depression, Seizures, Hypotension, Psychosis, and Tinnitus.
Alcoholism
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Alcoholism.
Alcohol consumption may intensify the pressure-lowering effects of mild vasodilators, such as phosphodiesterase 5 (PDE5) inhibitors. Therefore, patients that consume alcohol should be warned to limit alcohol intake while receiving these agents.
Bleeding Associated with Coagulation Defect
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Bleeding Associated with Coagulation Defect.
The safety of sildenafil in patients with bleeding disorders or active peptic ulceration is unknown. In clinical studies, the incidence of bleeding (i.e., epistaxis) was increased in patients with pulmonary arterial hypertension secondary to connective tissue disease and in patients on concomitant therapy with an oral vitamin K antagonist. There have been postmarketing reports of bleeding events in patients treated with sildenafil for erectile dysfunction.
Bleeding Disorder
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Bleeding Disorder.
The safety of sildenafil in patients with bleeding disorders or active peptic ulceration is unknown. In clinical studies, the incidence of bleeding (i.e., epistaxis) was increased in patients with pulmonary arterial hypertension secondary to connective tissue disease and in patients on concomitant therapy with an oral vitamin K antagonist. There have been postmarketing reports of bleeding events in patients treated with sildenafil for erectile dysfunction.
Cardiovascular Conditions and Disorders
Major:
Viagra
The sildenafil in Viagra has a major potential interaction with Cardiovascular Conditions and Disorders.
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
Cerebral Vascular Disorder
Major:
Viagra
The sildenafil in Viagra has a major potential interaction with Cerebral Vascular Disorder.
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
Depression
Moderate:
gabapentin
Gabapentin has a moderate potential interaction with Depression.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Drug Dependence
Major:
gabapentin
Gabapentin has a major potential interaction with Drug Dependence.
Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.
Hearing Loss
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Hearing Loss.
Use of phosphodiesterase-5 (PDE5) inhibitors has been associated with sudden decrease or loss of hearing, which may be accompanied by tinnitus or dizziness. Patients with hearing problems should stop taking these agents and seek prompt medical care.
Hemodialysis
Moderate:
gabapentin
Gabapentin has a moderate potential interaction with Hemodialysis.
Gabapentin is removed by hemodialysis and should be administered after dialysis.
History - Cerebrovascular Disease
Major:
Viagra
The sildenafil in Viagra has a major potential interaction with History - Cerebrovascular Disease.
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
History - Myocardial Infarction
Major:
Viagra
The sildenafil in Viagra has a major potential interaction with History - Myocardial Infarction.
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
Hypotension
Major:
Viagra
The sildenafil in Viagra has a major potential interaction with Hypotension.
The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.
Liver Disease
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Liver Disease.
Phosphodiesterase 5 (PDE-5) inhibitors are cleared predominantly by hepatic metabolism. The pharmacokinetic disposition of these agents has not been assessed in patients with severe hepatic impairment. No dosage modification is recommended for patients with mild to moderate hepatic impairment, however, therapy with these agents should not be administered to patients with severe hepatic impairment. In patients with mild hepatic impairment a lower dose of these agents should be used as initial therapy.
Myeloproliferative Disorders
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Myeloproliferative Disorders.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.
Optic Nerve Disorder
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Optic Nerve Disorder.
Sildenafil for the treatment of erectile dysfunction (ED) should be used with caution and only if the benefit outweighs the risk in patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION) or with retinitis pigmentosa. Use of sildenafil for the treatment of pulmonary arterial hypertension is not recommended in patients with retinitis pigmentosa. Advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking sildenafil; patients taking sildenafil for ED should immediately stop treatment. Most patients who developed NAION during therapy with sildenafil had underlying anatomic or vascular risk factors, including low cup to disc ratio ("crowded disc").
Penis Disorders
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Penis Disorders.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.
Peptic Ulcer
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Peptic Ulcer.
The safety of sildenafil in patients with bleeding disorders or active peptic ulceration is unknown. In clinical studies, the incidence of bleeding (i.e., epistaxis) was increased in patients with pulmonary arterial hypertension secondary to connective tissue disease and in patients on concomitant therapy with an oral vitamin K antagonist. There have been postmarketing reports of bleeding events in patients treated with sildenafil for erectile dysfunction.
Peyronie Disease
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Peyronie Disease.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.
Psychosis
Moderate:
gabapentin
Gabapentin has a moderate potential interaction with Psychosis.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Renal Dysfunction
Major:
gabapentin
Gabapentin has a major potential interaction with Renal Dysfunction.
Gabapentin is primarily eliminated unchanged by the kidney. Therapy with gabapentin should be administered cautiously in patients with impaired renal function. Dosage adjustments and titration should be made in accordance with product package labeling and individual patient response.
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Renal Dysfunction.
Exposure to sildenafil is increased in patients with renal dysfunction. Lower starting doses of sildenafil for the treatment of erectile dysfunction (ED) are recommended in patients with severe renal impairment (CrCl less than 30 mL/min). When sildenafil is used for the treatment of pulmonary arterial hypertension, no dose adjustment is recommended for any degree of renal impairment.
Retinitis Pigmentosa
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Retinitis Pigmentosa.
Sildenafil for the treatment of erectile dysfunction (ED) should be used with caution and only if the benefit outweighs the risk in patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION) or with retinitis pigmentosa. Use of sildenafil for the treatment of pulmonary arterial hypertension is not recommended in patients with retinitis pigmentosa. Advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking sildenafil; patients taking sildenafil for ED should immediately stop treatment. Most patients who developed NAION during therapy with sildenafil had underlying anatomic or vascular risk factors, including low cup to disc ratio ("crowded disc").
Seizures
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Seizures.
The use of phosphodiesterase 5 (PDE-5) inhibitors has been associated with seizures. Therapy with these agents should be administered cautiously in patients with preexisting seizure disorders.
Sickle Cell Anemia
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Sickle Cell Anemia.
The safety and efficacy of sildenafil for the treatment of pulmonary hypertension secondary to sickle cell disease has not been established; vaso-occlusive crises requiring hospitalization were more commonly reported in this population.
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Sickle Cell Anemia.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.
Tinnitus
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Tinnitus.
Use of phosphodiesterase-5 (PDE5) inhibitors has been associated with sudden decrease or loss of hearing, which may be accompanied by tinnitus or dizziness. Patients with hearing problems should stop taking these agents and seek prompt medical care.
Visual Defect/Disturbance
Moderate:
Viagra
The sildenafil in Viagra has a moderate potential interaction with Visual Defect/Disturbance.
Sildenafil for the treatment of erectile dysfunction (ED) should be used with caution and only if the benefit outweighs the risk in patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION) or with retinitis pigmentosa. Use of sildenafil for the treatment of pulmonary arterial hypertension is not recommended in patients with retinitis pigmentosa. Advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes while taking sildenafil; patients taking sildenafil for ED should immediately stop treatment. Most patients who developed NAION during therapy with sildenafil had underlying anatomic or vascular risk factors, including low cup to disc ratio ("crowded disc").
More resources
gabapentin
A total of 273 drugs are known to interact with gabapentin.
- Gabapentin is in the drug class Gabapentinoids.
-
Gabapentin is used to treat the following conditions:
- Alcohol Use Disorder (off-label)
- Alcohol Withdrawal (off-label)
- Anxiety (off-label)
- Back Pain
- Benign Essential Tremor (off-label)
- Bipolar Disorder (off-label)
- Burning Mouth Syndrome (off-label)
- Carpal Tunnel Syndrome (off-label)
- Chronic Kidney Disease-Associated Pruritus (off-label)
- Chronic Pain
- Cluster-Tic Syndrome (off-label)
- Cough (off-label)
- Diabetic Peripheral Neuropathy (off-label)
- Epilepsy
- Erythromelalgia (off-label)
- Fibromyalgia (off-label)
- Hiccups (off-label)
- Hot Flashes (off-label)
- Hyperhidrosis (off-label)
- Insomnia (off-label)
- Lhermitte's Sign (off-label)
- Migraine (off-label)
- Nausea/Vomiting, Chemotherapy Induced (off-label)
- Neuropathic Pain (off-label)
- Occipital Neuralgia (off-label)
- Pain (off-label)
- Periodic Limb Movement Disorder (off-label)
- Peripheral Neuropathy (off-label)
- Postherpetic Neuralgia
- Postmenopausal Symptoms (off-label)
- Primary Orthostatic Tremor (off-label)
- Pruritus (off-label)
- Pudendal Neuralgia (off-label)
- Reflex Sympathetic Dystrophy Syndrome (off-label)
- Restless Legs Syndrome (off-label)
- Seizures
- Small Fiber Neuropathy (off-label)
- Spondylolisthesis (off-label)
- Syringomyelia (off-label)
- Transverse Myelitis (off-label)
- Trigeminal Neuralgia (off-label)
- Vulvodynia (off-label)
Viagra
A total of 396 drugs are known to interact with Viagra.
- Viagra is in the drug class impotence medications.
- Viagra is used to treat Erectile Dysfunction.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.