From the FDA Drug Label
Gabapentin can cause anaphylaxis and angioedema after the first dose or at any time during treatment. Signs and symptoms in reported cases have included difficulty breathing, swelling of the lips, throat, and tongue, and hypotension requiring emergency treatment
- Hypotension is listed as a sign or symptom of anaphylaxis and angioedema caused by gabapentin.
- Gabapentin can cause hypotension as part of an allergic reaction, specifically anaphylaxis and angioedema, which requires emergency treatment 1.
From the Research
Gabapentin and Hypotension
- Gabapentin has been shown to reduce blood pressure in various studies, suggesting a potential link to hypotension 2, 3.
- A study published in Acta Cardiologica Sinica found that gabapentin markedly attenuated blood pressure in hypertensive rats, with the nucleus tractus solitarii playing a key role in this effect 2.
- Another study published in Hypertension found that acute administration of gabapentin lowered blood pressure and heart rate in conscious spontaneously hypertensive rats, with the hypotensive effect accompanied by a reduction in peripheral sympathetic nerve transmission 3.
- Additionally, a study published in the European journal of anaesthesiology found that gabapentin reduced cardiovascular responses to laryngoscopy and tracheal intubation, with a significant decrease in heart rate and arterial pressure observed in patients receiving 800 mg of gabapentin before surgery 4.
Mechanisms and Effects
- The exact mechanisms of gabapentin's effects on blood pressure are not fully understood, but studies suggest that the drug may modulate central blood pressure and heart rate control through the nucleus tractus solitarii and the nitric oxide synthase signaling pathway 2.
- Gabapentin's effects on voltage-gated calcium channels may also play a role in its hypotensive effects, with the drug binding to the alpha2delta subunit of calcium channels in the pancreas potentially leading to hypoglycemia 5.
- While the majority of the evidence suggests that gabapentin can cause hypotension, it is essential to note that the drug's effects can vary depending on the individual, dosage, and administration route.
Clinical Implications
- The potential for gabapentin to cause hypotension should be considered in clinical practice, particularly in patients with pre-existing cardiovascular conditions or those taking other medications that may interact with gabapentin 3, 6, 4.
- Healthcare professionals should monitor patients taking gabapentin for signs of hypotension, such as dizziness, lightheadedness, or fainting, and adjust the dosage or administration route as needed to minimize the risk of adverse effects.