NAFDAC Warns of Drug-Poisoning Risk When Gabapentin, Pregabalin Are Combined With Certain Medicines

The National Agency for Food and Drug Administration and Control (NAFDAC) has alerted healthcare professionals and the public to an increased risk of drug poisoning associated with the concurrent use of gabapentinoids, particularly gabapentin and pregabalin, with certain other medicines.

In Public Alert No. 039/2026, released on August 18, 2026, NAFDAC highlighted emerging evidence linking the concurrent use of gabapentinoids with opioids and benzodiazepines to an increased risk of hospitalisation for drug poisoning.

The alert cites a study by researchers at University College London (UCL), which found that among patients taking gabapentinoids, concurrent benzodiazepine use was associated with approximately a two-fold increase in the risk of hospitalisation for drug poisoning, while concurrent opioid use was associated with an increase of about 30%.

Higher risk with opioids and benzodiazepines

Gabapentinoids are medicines that include gabapentin and pregabalin. NAFDAC said they are commonly prescribed for neuropathic pain, epilepsy and anxiety disorders and are increasingly used as alternatives to opioids for pain management.

However, the agency's warning focuses on the potential safety risks when these medicines are used alongside other medicines, particularly those that can affect the central nervous system.

According to NAFDAC, the risk may be higher among elderly patients, people with respiratory disorders, patients receiving opioids, benzodiazepines or other central nervous system depressants, and people with a history of substance abuse.

Possible adverse effects identified in the alert include excessive drowsiness, respiratory depression, impaired consciousness and drug poisoning.

What the evidence shows

The UCL research cited by NAFDAC examined the association between gabapentinoid treatment, concurrent medication use and hospitalisation for drug poisoning.

The findings provide important context for understanding the regulatory alert. The researchers reported an increased risk of drug poisoning during periods of gabapentinoid treatment, with the risk particularly elevated when gabapentinoids were used concurrently with opioids or benzodiazepines.

However, the findings should not be interpreted as evidence that gabapentin or pregabalin inevitably causes drug poisoning. The study examined associations between medicine exposure and poisoning events and therefore needs to be interpreted in the context of patients' underlying conditions and other medicines.

This distinction is important because gabapentinoids remain medicines with established clinical uses. NAFDAC's alert is focused on reducing medication-related risks associated with concurrent use rather than advising patients to stop prescribed treatment.

NAFDAC advises patients to avoid unauthorised combinations

NAFDAC advised people taking gabapentin or pregabalin to use the medicines only as prescribed by a healthcare professional.

The agency also urged patients to inform their healthcare providers about all medicines they are taking and to avoid self-medication or unauthorised combinations of medicines.

Patients who develop unusual drowsiness, difficulty breathing or loss of consciousness while taking these medicines should seek immediate medical attention.

Implications for pharmacy practice

The alert highlights the importance of medication review and pharmacovigilance when patients are receiving gabapentinoids.

Pharmacists and other healthcare professionals should be aware of concurrent use of gabapentin or pregabalin with opioids, benzodiazepines and other central nervous system depressants, particularly in patients who may have additional risk factors.

A complete medication history can help identify potentially problematic combinations and support appropriate monitoring and counselling.

The alert also reinforces the role of pharmacovigilance in identifying and communicating emerging medicine-safety concerns. NAFDAC encouraged healthcare professionals and patients to report suspected adverse events or side effects associated with medicinal products or medical devices.

Reports can be submitted through NAFDAC's adverse-event reporting platforms, the Med Safety application, or by contacting the agency through its pharmacovigilance channels.

Source: National Agency for Food and Drug Administration and Control (NAFDAC), Public Alert No. 039/2026, “Alert on the Risk of Drug Poisoning Associated with Concurrent Use of Gabapentinoids and Other Medicines”, released August 18, 2026.