From the Guidelines
It is generally safe to take magnesium and gabapentin together, but caution is advised due to potential interactions and side effects, and consulting a healthcare provider is recommended before combining these medications. Gabapentin is commonly prescribed for nerve pain, seizures, and certain mood disorders, while magnesium supplements are used for various health purposes including muscle function and bone health. According to the 2024 clinical practice guideline for the management of headache 1, magnesium is suggested for the prevention of migraine, but there is insufficient evidence to recommend for or against its use in combination with other medications like gabapentin.
Key Considerations
- Timing may be important as magnesium supplements can potentially affect the absorption of some medications, so consider taking magnesium supplements at least 2 hours apart from gabapentin.
- Both substances can cause digestive side effects like diarrhea, and both may have mild sedative effects in some people, so combining them might enhance drowsiness.
- If you have kidney problems, extra caution is needed since both substances are eliminated through the kidneys, and impaired kidney function could lead to accumulation of either substance, as magnesium can produce vasodilation and may cause hypotension if administered rapidly 1.
- Always inform all your healthcare providers about all medications and supplements you're taking to ensure comprehensive care.
Potential Interactions and Side Effects
- The combination of magnesium and gabapentin may increase the risk of digestive side effects and drowsiness.
- Kidney function should be monitored closely when taking both substances, especially in patients with pre-existing kidney problems.
- The 2024 clinical practice guideline for the management of headache 1 suggests against the use of gabapentin for the prevention of episodic migraine, which may be relevant when considering its use in combination with magnesium.
From the FDA Drug Label
Antacid (Maalox®) (aluminum hydroxide, magnesium hydroxide) Antacid (Maalox®) containing magnesium and aluminum hydroxides reduced the mean bioavailability of gabapentin (N=16) by about 20%. This decrease in bioavailability was about 10% when gabapentin was administered 2 hours after Maalox.
Magnesium and Gabapentin Interaction: The FDA drug label indicates that antacids containing magnesium and aluminum hydroxides, such as Maalox®, can reduce the bioavailability of gabapentin by about 20%. However, this does not necessarily mean that magnesium itself cannot be taken with gabapentin. To minimize the interaction, it is recommended to take gabapentin at least 2 hours after taking an antacid containing magnesium. 2 Key Points:
- Magnesium can decrease the bioavailability of gabapentin
- Take gabapentin at least 2 hours after taking an antacid containing magnesium to minimize the interaction.
From the Research
Interaction between Magnesium and Gabapentin
- The interaction between magnesium and gabapentin has been studied in several research papers 3, 4.
- A review of gabapentin misuse, interactions, contraindications, and side effects found that magnesium oxide is one of the substances that interact with gabapentin 3.
- A study on the impact of concomitant antacid administration on gabapentin plasma exposure and oral bioavailability found that concomitant magnesium oxide decreased the gabapentin exposure through the reduction of intestinal absorption extent and rate 4.
- The study found that the C(max), T(max), and AUC(0-∞) of gabapentin + MgO were significantly lower than that of gabapentin alone and gabapentin + omeprazole 4.
- Another study investigated the effect of various agents, including magnesium, on acute mountain sickness, but found that magnesium was not efficacious 5.
Effects of Gabapentin
- Gabapentin is an antiepileptic drug widely used for the management of neuropathic pain, but it can cause side effects such as somnolence and dizziness 6.
- A study found that melatonin supplementation rapidly and significantly improved daytime sleepiness side-effect of gabapentin 6.
- However, another study found that gabapentinoids did not reduce pain compared with placebo at 1 month and 2 to 4 months after treatment, and showed no clinically important difference in sleep interference compared with placebo 7.