Drugs
Drug Interactions: Is it Safe to Take Gabapentin and Tylenol Together?
Medically Reviewed By
Written By
Last medically reviewed May 12, 2025
Drugs
Medically Reviewed By
Written By
Last medically reviewed May 12, 2025
If you’ve been prescribed gabapentin you may be wondering: Can I take ibuprofen or Tylenol with gabapentin? For many people, these over-the-counter remedies are on hand for every headache and back twinge. However, it’s important to check that your everyday pain relief solutions won’t interact with your prescription medication.
Make sure you tell your doctor about any drugs you take on a regular basis and ask them about potential interactions. You can also read our medication safety guide that explains the drug interaction between gabapentin and Tylenol.
Gabapentin, sometimes sold under the brand name Neurontin, is a prescription medication approved by the United States Food and Drug Administration (FDA). It’s used to reduce nerve pain, treat seizure disorders, and reduce the impact of restless leg syndrome. It can also be prescribed for postherpetic neuralgia, a painful nerve condition that can develop after someone has had shingles (herpes zoster). [1]
The medication may work by increasing the volume of gamma-aminobutyric acid in the brain — a chemical that directly impacts the central nervous system (CNS). [2]
Understanding the side effects of gabapentin can help you know if you’re having a normal reaction to the medication or if there’s a problem to investigate. Common mild side effects include [3]:
If you’re concerned that these side effects are impacting your day-to-day life, talk to your prescribing physician.
More serious side effects that should prompt you to seek immediate medical attention include [3]:
If you have any symptoms that could indicate an allergic reaction, such as hives, swollen tongue, or difficulty breathing, reach out for emergency medical care. [3]
The combination of gabapentin and different kinds of antihistamines like cetirizine and Benadryl (diphenhydramine) can increase the severity of the sedative effect. Benzodiazepines can also make you more dizzy or drowsy while taking gabapentin. [4]
Some medications lead to serious health conditions when taken with gabapentin. Hydrocodone, for example, can cause respiratory distress when combined with gabapentin. You must always tell your healthcare provider if you’re taking any other medications — even over-the-counter remedies. [5]
Tylenol is the brand name for a painkiller, and the off-label name is acetaminophen. It’s available as an over-the-counter pain reliever and affects the CNS via the brain and the spinal cord. [6] Tylenol is used for many different types of pain, such as headache, back pain, or other muscular aches and pains. It can also help reduce a fever. However, it’s not so effective for nerve pain or ongoing chronic pain. [7]
Tylenol must be taken at the recommended dose to avoid undesirable side effects. Even at the correct dose, mild side effects may include [8]:
These side effects are classed as common, which means that of people who have reported side effects of Tylenol, 1 to 10% experienced one or more of the above symptoms.
More serious, and rarer, side effects include [8]:
When Tylenol is taken at a very high dose, it can cause permanent liver damage and even death. Tylenol overdose is very dangerous — if you think you’ve taken too much Tylenol, seek medical help immediately.
There are, fortunately, no known drug interactions between Tylenol and gabapentin. That doesn’t mean that there are no possible drug interactions, only that no significant ones have been recorded. If you notice any side effects not mentioned in the patient safety leaflet or believe you have interacted, contact your physician immediately.
Some studies show that combining gabapentin and Tylenol could have positive effects. There’s a concern that some surgical procedures could lead to opioid dependency due to the use of opioid-based pain medications throughout the process. Utilizing a combination of gabapentin and Tylenol before surgery could reduce the reliance on opioids for pain relief, lowering the risk of addiction. [9]
While Gabapentin and Tylenol don’t have any significant reaction, it’s still critical to let your doctor know any time you may need to mix medications. You should also be open and honest about any illicit substances you’re using, as these could dramatically alter the effects of both over-the-counter and prescription medications. If you have concerns about drug use or misuse, including opioid use, alcohol use or dependence, or related topics, reach out to the experts at Southeast Addiction Center.
There are no known adverse reactions caused by taking Tylenol or Tylenol Extra Strength at the same time as gabapentin. However, there is always the chance of an adverse reaction. Speak to a medical professional before mixing any medications.
You should always refer to a medical professional for the best advice on pairing medications. Most painkillers exhibit no known reactions with gabapentin, but that doesn’t mean that you’re guaranteed not to have a reaction. You should also consider the other effects of painkillers. For example, aspirin is a popular pain relief solution but is also an anticoagulant (a blood thinner like warfarin), so may not be suitable for those on heart medication. Ask your doctor what you can take and for information on the right dosage.
Some antihistamines, benzodiazepines, and drugs like hydrocodone all interact negatively with gabapentin or may impact the strength of the dose you’ve taken. That’s why it’s critical to let your doctor know exactly what medications you’re taking, including any supplements or over-the-counter remedies.
Tylenol is an excellent choice for daily wellness as it helps manage low-level pain and reduce fever. Drugs that can interact with Tylenol include barbiturates, lidocaine and similar anesthetics, and common supplements like echinacea. [10]
[1] American Academy of Family Physicians – AAFP; Aaron Sagul et al (October 2017). American Family Physician – Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Retrieved from https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html on 2025, March 20.
[2] National Library of Medicine – Kejia Cai et al (August 2012). Neuropsychopharmacology – The Impact of Gabapentin Administration on Brain GABA and Glutamate Concentrations: A 7T 1H-MRS Study. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC3499716/ on 2025, March 20.
[3] Melisa Puckey, BPharm via Drugs.com (September 2024). Drugs A-Z – Gabapentin. Retrieved from https://www.drugs.com/gabapentin.html on 2025, March 20.
[4] National Library of Medicine – Abisola Olopoenia et al (June 2022). The Lancet Regional Health – Americas – Adverse outcomes associated with concurrent gabapentin, opioid, and benzodiazepine utilization: A nested case-control study. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9904085/ on 2025, March 20.
[5] Drugs.com (March 2025). Interactions – Drug Interactions between gabapentin and hydrocodone. Retrieved from https://www.drugs.com/drug-interactions/gabapentin-with-hydrocodone-1147-0-2874-0.html on 2025, March 20.
[6] National Library of Medicine – Nobuko Ohashi and Tatsuro Kohno (November 2020). Frontiers in Pharmacology – Analgesic Effect of Acetaminophen: A Review of Known and Novel Mechanisms of Action. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7734311/ on 2025, March 20.
[7] Drugs.com (October 2023). Acetaminophen – Reviews – For Sciatica – Acetaminophen for Sciatica User Reviews. Retrieved from https://www.drugs.com/comments/acetaminophen/for-sciatica.html on 2025, March 20.
[8] Drugs.com (July 2024). Drugs A-Z – Tylenol – Side Effects. Retrieved from https://www.drugs.com/sfx/tylenol-side-effects.html on 2025, March 20.
[9] National Library of Medicine – Robert Qiu et al (April 2018). Romanian Journal of Anaesthesia and Intensive Care – Effect of preoperative gabapentin and acetaminophen on opioid consumption in video-assisted thoracoscopic surgery: a retrospective study. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5931182/ on 2025, March 20.
[10] Drugs.com (March 2025). Tylenol – Interactions – Drug – Tylenol Drug Interactions Checker. Retrieved from https://www.drugs.com/drug-interactions/acetaminophen,tylenol-index.html on 2025, March 20.Â