Are there any known pharmacological interactions between phenelzine and gabapentin?/nAnalgesic trea

Fråga: Are there any known pharmacological interactions between phenelzine and gabapentin?

Analgesic treatment with gabapentin is considered in a woman already receiving phenelzine for depression.

Sammanfattning: There are no known pharmacological interactions between phenelzine and gabapentin. According to in vitro findings, the drugs may have opposite effects on monoaminergic neurotransmission, with a hypothetic risk of a pharmacodynamic interaction. However, this possibility should not be considered a contraindication to co-medication, due to its speculative nature and the fact than such an interaction, should it exist, would expose the patients to no dangers other than reduced pharmacological effect.

Svar: No reports of pharmacological interactions between gabapentin and phenelzine, or any other mono-amino oxidase (MAO) inhibitor, were found in Drugline, Medline or standard pharmacological literature.

Gabapentin carries structural similarities to the endogenous neurotransmitter GABA (gamma-aminobutyric acid), but its mode of action is still largely unknown. In vitro, it causes a slight decrease in monoaminergic neurotransmitters release. If this holds true in vivo, gabapentin could possibly attenuate the effects of phenelzine, which are mediated by an increased monoaminergic neurotransmission (1).

Phenelzine is mainly metabolised through acetylation, whereas gabapentin is excreted unchanged in the urine (1,2). On theoretical grounds, there are no obvious reasons to expect pharmacokinetic interactions between the two drugs. Neurontin. Summary product characteristics (Pfizer) Dollery C Sir, editor. Therapeutic drugs. 2nd ed. Edinburgh: Churchill Livingstone; 1999. P75.