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