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Can you take Neurontin® with Xanax®?

Evidence-based interaction check between Neurontin® and Xanax®

MajorEditorially reviewed · last updated April 15, 2025

High risk — avoid this combination unless there is no good alternative.

Profound drowsiness, slowed or shallow breathing, dizziness, confusion, and increased risk of falls. The combination has caused serious, sometimes life-threatening respiratory depression — particularly in older adults, those with reduced lung function, and people also taking opioids. The FDA issued a Drug Safety Communication in December 2019 requiring updated Warnings/Precautions language on gabapentinoid labels for this risk.

Why this happens (mechanism)

Both drugs depress the central nervous system through different routes — alprazolam (Xanax) enhances GABA-A receptor activity, gabapentin modulates calcium channels and increases overall GABAergic tone. Stacked, the depressant effects on breathing, alertness, and coordination add up.

What to monitor

  • Sedation level — can the patient be roused easily?
  • Respiratory rate (especially overnight)
  • Coordination and fall risk; consider home safety review in older adults
  • Avoid driving or operating machinery until effect is known

Dose adjustment

Use the lowest effective dose of EACH drug; if both must be continued, start one at a clearly subtherapeutic dose and titrate while monitoring. Avoid concurrent opioids entirely.

Safer alternatives to consider

Non-benzodiazepine anxiety options (CBT, SSRIs, buspirone)

Avoids the additive CNS depressant load.

Single-agent gabapentin or single-agent benzodiazepine

Either drug alone carries far less respiratory risk.

Always discuss alternatives with your prescriber before making any change. The right choice depends on your other medications, conditions, and what is working for you today.

Evidence and sources

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1 interaction found

Major

Additive sedation and respiratory depression. Avoid alcohol entirely; use benzodiazepines with extreme caution and only with medical supervision.

View Neurontin® View Xanax®

What this means

This summary is based on published interaction data from FDA prescribing information and clinical literature. It does not account for individual health factors, dosages, or other medications you may be taking. Always consult a qualified healthcare provider before making changes to your medication regimen.

Frequently Asked Questions

Is it safe to take Neurontin® with Xanax®?

High risk — avoid this combination unless there is no good alternative. Profound drowsiness, slowed or shallow breathing, dizziness, confusion, and increased risk of falls. The combination has caused serious, sometimes life-threatening respiratory depression — particularly in older adults, those with reduced lung function, and people also taking opioids. The FDA issued a Drug Safety Communication in December 2019 requiring updated Warnings/Precautions language on gabapentinoid labels for this risk. Always discuss your full medication list with your prescriber.

What happens if you take Neurontin® and Xanax® together?

Both drugs depress the central nervous system through different routes — alprazolam (Xanax) enhances GABA-A receptor activity, gabapentin modulates calcium channels and increases overall GABAergic tone. Stacked, the depressant effects on breathing, alertness, and coordination add up.

What should I monitor if I take both?

Sedation level — can the patient be roused easily?. Respiratory rate (especially overnight). Coordination and fall risk; consider home safety review in older adults. Avoid driving or operating machinery until effect is known.