Can you use gabapentin and naproxen together for sciatica?

In this blog post, we are going to talk about the concomitant use of gabapentin and naproxen for the treatment of sciatica. Both of these medicines are involved in pain relieving action. 

We will discuss the safety and efficacy of these two meds and will also discuss the proper use in order to maximise the beneficial effects, while minimising the side effects. 

Can you use gabapentin and naproxen together for sciatica? 

Yes, you can use gabapentin and naproxen together for the treatment and management of sciatica. There are no known interactions between these two drugs. However, gabapentin itself is considered more effective for the treatment of sciatica, as compared to naproxen, when given individually. 

A 2002 study indicated that gabapentin can enhance the analgesic effects of naproxen and the combination can be used to help relieve the persistent pain, burning sensation and inflammation. 

Another research study revealed the combination of gabapentin and naproxen can be used at low doses or the doses at which the individual drug can never work when given alone. 

This can help prevent the side effects produced by each drug and gabapentin can enhance the effectiveness of naproxen. Experts believe that this way, a better safety and efficacy can be achieved, that is not possible when these drugs are used individually. 

This indicates that the concomitant use of gabapentin and naproxen can be quite effective for the treatment of sciatica. However, one thing to bear in mind is that this combination will not produce the exact same effects in every other individual. 

It may become unbearable in some either because of the possibility of an allergic reaction or some underlying health condition that might not do well with the combination.

Make sure you only use this combination if prescribed by your healthcare provider. It is not recommended to start using any medication without your doctor’s approval. 

What is the difference between gabapentin and naproxen? 

Gabapentin is a gamma aminobutyric acid (GABA) analog. Gabapentin mimics the actions of GABA, which is an inhibitory neurotransmitter. GABA works by inhibiting the excessive neuronal firing in the brain which reduces the frequency of epileptic seizures. 

Gabapentin is also used to reduce the intensity of neuropathic pain by inhibiting nociceptors (pain receptors). This medication is a prescription medication and should be taken only at doses determined by your healthcare professional. 

Naproxen, on the other hand, is a non-steroidal anti-inflammatory drug (NSAID). It actively blocks the cyclooxygenase I and II pathway, called COX I and COX II. This prevents the synthesis of prostaglandins, which act as a mediator of pain and inflammation. 

This is how naproxen helps tone down your pain and inflammation. This is indeed a very good pain relieving medication. However, some people can not tolerate it or it may interact negatively with some of the pre-existing diseases like peptic ulcer etc. 

What are the side effects associated with the use of gabapentin and naproxen? 

Like every other medication, both gabapentin and naproxen are also associated with some side effects. The most common side effects of gabapentin include:

• Xerostomia or dry mouth 
• Weight gain 
• Dizziness 
• Somnolence
• Swollen hands and feet
• Headache
• Vision problems 
• Cloudy mind
• Fatigue
• Tremors 
• Confusion
• Joint pain 
• Difficulty in remembering things
• Abdominal pain 
• Unsteadiness
• Muscle twitching 
• Constipation 
• Back pain
• Increased appetite 
• Fever

Gabapentin can cause some serious side effects. These include:

• Suicidal behavior 
• Impaired motor coordination 
• Thrombocytopenia or decreased levels of platelets
• Water retention
• Rhabdomyolysis, a condition associated with abnormal breakdown of muscles
• Convulsions 
• Swelling or tenderness in different parts of the body.
• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 

The side effects of naproxen include:

• Nausea 
• Vomiting 
• Diarrhoea 
• Flatulence 
• Constipation 
• Acid reflux 
• Heartburn 
• Dizziness or lightheadedness 
• Drowsiness 
• Insomnia or inability to fall asleep 
• Tingling or pins-and-needles sensation in arms and legs 
• Difficulty in hearing 
• Tinnitus 
• Symptoms associated with cold and flu 
• Headache 
• Excessive thirst or Polydipsia 

Some serious and rare side effects include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Risk of bleeding 
• Vision problems 
• Unexplained weight gain 
• Swelling or tenderness in different parts of the body.
• Fatigue 
• Arrhythmia 
• Severe back pain
• Pale colored skin or eyes
• Confusion 
• Discoloured or bloody urine

These side effects can vary from person to person. It is impossible to predict how your body will react once it is exposed to these medications. Some people get away with mild side effects, while others suffer terribly. 

What are the clinical features of sciatica? 

Sciatica is the throbbing pain that originates from your sciatic nerve. The sciatic nerve starts from your lower back and its branches run along the length of your legs and your buttocks. Sciatic pain is known to be so severe that it can easily affect your everyday life activities. 

Some people can’t even seem to stand up straight because of the shooting pain down their legs. It also comes with swelling and tingling sensation, which is sometimes described as pins-and-needles sensation. Usually, sciatica occurs at only one side of the body. 

It commonly occurs when some deformity affects or presses your sciatic nerve. When the nerve is pressed, it starts to ache pretty badly. Common causes include herniated disk or bone deformity which makes sharp edges of the bone that can damage your sciatic nerve. The symptoms include:

• Throbbing pain, usually in your back, hips, buttocks, the back of your thighs and your calves. 
• Numbness or tingling sensation 
• Muscle weakness 
• Burning sensation 
• Feels like an electric shock 

However, you can definitely prevent sciatica and eliminate the risk factors as this is partly in your hands. There are a few lifestyle changes that can help you do that:

• Work out regularly. Keep your body moving and do strength training occasionally which can really strengthen your back muscles and your spine and prevent any deformative changes that may affect your sciatic nerve. 

• Sit straight, especially if you have a job that requires prolonged sitting duration. Sitting straight can prevent structural changes of your spine that may press your sciatic nerve.

• Keep your body movements good. Do not let it stay in one position for a long time. If you have been sitting for a while, get up and try to move a little. You can either walk or stretch your leg and back muscles. If you have been standing for a while, sit down. Do not stay in one position. 

• Eat a healthy diet. There are plenty of fruits and vegetables which contain essential vitamins and minerals that can help promote your bone, muscle and nerve health. Eating junk foods or starving yourself not only increase the risk of sciatica, but several other health conditions. 

How to ensure the proper use of gabapentin and naproxen? 

Immediately talk to your healthcare provider if you experience unusual side effects while taking gabapentin and naproxen. Do not recommend this drug to someone else and use them as long as your doctor has advised. 

Inform your doctor if you’re pregnant or trying to conceive. It is extremely important to ensure safety of your meds during your pregnancy. Some meds can cross placenta and are capable of causing unwanted side effects in the growing fetus. 

Inform your doctor if you’re a breastfeeding mother. Gabapentin and naproxen may be capable of passing into the breastmilk and may cause side effects in newborns. 

Do not stop gabapentin abruptly. If it’s time for you to stop this med, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

Make sure you use this medication or any other medication only when your doctor has advised it. Using medications which can affect your brain is not something ideal and should not be encouraged unless it is absolutely necessary to do so. 

Make sure you discuss everything in detail with your healthcare provider and ask if you’re at the best possible dose of gabapentin and naproxen. Also inform your doctor if you’re taking any other medication. 

Drug interactions should be an important consideration before taking two or more medicines together. Yes, drugs in combination are often used to achieve better therapeutic response but this is not the case with every interaction. 

Some drugs are highly incompatible with one another. They often cancel out each other’s effects or antagonise them. Some drugs are so incompatible that they end up changing the entire chemical composition of one another. 

Some interfere with metabolism or bioavailability (the rate and extent at which the active drug moiety enters systemic circulation/blood). This can lead to drug accumulation in different parts of the body. 

It is always advised to inform your healthcare provider of any medicine you take before getting a new prescription. Your doctor will make sure not to prescribe any such drug which might interfere with those you are already taking. 

Conclusion 

In this blog post, we have discussed the concomitant use of gabapentin and naproxen for the treatment of sciatica. Both of these medicines are involved in pain relieving action. There are no known interactions between these two drugs. 

However, gabapentin itself is considered more effective for the treatment of sciatica, as compared to naproxen, when given individually. Make sure you use this medication or any other medication only when your doctor has advised it. 

Using medications which can affect your brain is not something ideal and should not be encouraged unless it is absolutely necessary to do so. 

FAQs: gabapentin and naproxen for sciatica

Can gabapentin and naproxen be used together?

Yes, you can use gabapentin and naproxen together for the treatment and management of sciatica. There are no known interactions between these two drugs. The combination of gabapentin and naproxen can be used at low doses or the doses at which the individual drug can never work when given alone. This can help prevent the side effects produced by each drug and gabapentin can enhance the effectiveness of naproxen. 

Which is better for pain gabapentin or naproxen?

Gabapentin is a gamma aminobutyric acid (GABA) analog. Gabapentin mimics the actions of GABA, which is an inhibitory neurotransmitter. GABA works by inhibiting the excessive neuronal firing in the brain. Naproxen, on the other hand, is a non-steroidal anti-inflammatory drug (NSAID). 

It actively blocks the cyclooxygenase I and II pathway, called COX I and COX II. This prevents the synthesis of prostaglandins, which act as a mediator of pain and inflammation. Both medications are good to relieve pain. However, gabapentin is considered more effective for the treatment of sciatica, as compared to naproxen, when given individually. 

What anti-inflammatory can I take with gabapentin?

You can take Non-steroidal anti-inflammatory drugs with gabapentin. You can also use paracetamol with this medication. 

How long does it take for gabapentin to work for sciatica pain?

Gabapentin can take up to 2-4 weeks to help relieve the pain associated with sciatica. However, it starts to relieve some of the other physiological symptoms like insomnia or inability to sleep and the drug will start controlling your anxiety within a few days.

Does gabapentin provide immediate relief?

Gabapentin does not usually provide immediate relief and can take up to 2-4 weeks to noticeably tone down your nerve pain. However, it starts to relieve some of the other physiological symptoms like insomnia or inability to sleep and the drug will start controlling your anxiety within a few days. 

How much gabapentin is needed for nerve pain?

The starting dose of gabapentin is usually 300mg/day. The dose is later escalated to 600mg and the frequency of administration is also increased. However, the dose should not exceed 1800mg/day. Make sure you discuss everything in detail with your healthcare provider and ask if you’re at the best possible dose of gabapentin. Also inform your doctor if you’re taking any other medication.

References 

• Robert W Hurley et al. Anesthesiology. (2002) – Gabapentin and pregabalin can interact synergistically with naproxen to produce antihyperalgesia https://pubmed.ncbi.nlm.nih.gov/12411814/
• Yasuhiro Narai et al. Anesth Analg. (2012) – Gabapentin augments the antihyperalgesic effects of diclofenac sodium through spinal action in a rat postoperative pain model https://pubmed.ncbi.nlm.nih.gov/22467888/ 
• Gloria R Grice et al. Pharmacotherapy. (2008) – Gabapentin as a potential option for treatment of sciatica https://pubmed.ncbi.nlm.nih.gov/18294119/
• National Library of Medicine – Gabapentin https://medlineplus.gov/druginfo/meds/a694007.html 
• National Library of Medicine – Naproxen https://medlineplus.gov/druginfo/meds/a681029.html