Is Gabapentin an NSAID?
No, gabapentin is not an NSAID—it is an anticonvulsant medication that works through a completely different mechanism by binding to voltage-gated calcium channels in the nervous system. 1
Drug Classification
Gabapentin belongs to the anticonvulsant class of medications, specifically categorized as a "gabapentinoid" along with pregabalin. 1 These drugs inhibit nociceptive neurons primarily through binding to subunits of the N-type voltage-gated calcium channel, which is fundamentally different from how NSAIDs work. 1
Mechanism Distinction
- Gabapentin's mechanism: Binds to calcium channel subunits, reduces excitatory neurotransmission in the spinal cord, and may affect glial cells 1, 2
- NSAID mechanism: Inhibits cyclooxygenase (COX) enzymes to reduce prostaglandin synthesis and inflammation 1
These are entirely separate pharmacological pathways with no overlap in their primary mechanisms of action.
Clinical Use Context
While both gabapentin and NSAIDs can be used for pain management, they serve different purposes:
- Gabapentin is FDA-approved for postherpetic neuralgia and certain neuropathic pain conditions 1
- NSAIDs are effective for inflammatory pain, arthritis, and musculoskeletal conditions 1
- Guidelines explicitly distinguish between these drug classes when recommending multimodal analgesia strategies 1
Combination Therapy
Gabapentin and NSAIDs can be used together synergistically. Research demonstrates that gabapentin combined with naproxen (an NSAID) produces synergistic antihyperalgesic effects, confirming they are distinct drug classes with complementary mechanisms. 3 Guidelines recommend using gabapentin as a coanalgesic with NSAIDs for certain pain conditions, particularly when neuropathic components are present. 1
Common Pitfall
The confusion may arise because both medications are used for pain management and can appear together in multimodal analgesic protocols. However, their classification, mechanism, side effect profiles, and FDA-approved indications are completely different. 1