Major
Established
Deskripsi
Gabapentin and oxycodone together produce enhanced CNS and respiratory depression beyond what either drug causes alone, with risk of fatal overdose.
Mekanisme
Gabapentin inhibits voltage-gated calcium channels and enhances GABA-ergic inhibition; opioids suppress brainstem respiratory centers via mu receptors — synergistic CNS depression results.
Signifikansi Klinis
Epidemiological data from Canada and the UK show a significant increase in opioid-related overdose deaths when gabapentinoids are co-prescribed.
Penatalaksanaan
Avoid combination unless clearly indicated; use lowest effective doses, monitor respiratory rate and sedation level.