Should I continue taking gabapentin before surgery?

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Last updated: September 18, 2026 • View editorial policy

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Should You Continue Gabapentin Before Surgery?

Yes, you should generally continue gabapentin before surgery, as there is no specific recommendation to discontinue it preoperatively, and abrupt discontinuation can precipitate serious withdrawal complications including seizures. 1

Key Considerations

Do Not Stop Abruptly

The FDA labeling explicitly warns against stopping gabapentin suddenly, as this can cause:

  • Status epilepticus (continuous seizures) in patients with epilepsy
  • Serious withdrawal symptoms
  • Return of underlying symptoms 1

If you are taking gabapentin chronically for seizures or neuropathic pain, continue it through your surgical period unless your anesthesiologist specifically instructs otherwise.

What the Guidelines Say

The 2021 SPAQI consensus statement on perioperative analgesic management 2 does not include gabapentin in their list of medications requiring preoperative discontinuation. This is notable because the guideline specifically addresses which analgesics to hold (like ergotamine and butalbital) but makes no mention of stopping gabapentin.

Important Safety Warnings for Surgery

While continuing gabapentin is generally appropriate, be aware of these perioperative risks:

Central Nervous System Depression:

  • Gabapentin causes somnolence (drowsiness) and dizziness 1
  • These effects are additive with anesthetic agents and other sedatives used during surgery
  • Your anesthesia team needs to know you're taking it to adjust dosing accordingly

Specific Risks in Older Adults: If you are 65 or older, recent evidence shows perioperative gabapentin use is associated with:

  • 28% increased risk of postoperative delirium 3
  • Increased risk of pneumonia and new antipsychotic use
  • Higher risks in patients with chronic kidney disease or multiple comorbidities 3

This doesn't mean you should stop it abruptly, but your surgical team should be aware for enhanced monitoring.

What to Tell Your Surgical Team

Inform your anesthesiologist that you take gabapentin, including:

  • Your daily dose
  • Why you're taking it (seizures, neuropathic pain, etc.)
  • How long you've been on it
  • Any kidney problems you have (gabapentin is renally cleared) 1

Drug Interactions to Watch

Avoid taking antacids (Maalox, Mylanta, Gaviscon) within 2 hours of your gabapentin dose, as they reduce absorption 1

Morphine and other opioids used perioperatively can increase gabapentin levels, requiring potential dose adjustments 1

Clinical Bottom Line

Continue your home gabapentin through surgery unless your anesthesiologist gives you specific alternative instructions. The risks of abrupt discontinuation (seizures, withdrawal) outweigh the manageable perioperative risks, which your surgical team can address through appropriate monitoring and anesthetic adjustments. The key is communication—make sure everyone on your surgical team knows you're taking it.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.