Does Spinach Interact with Gabapentin or Make It Less Effective?

There is no evidence that spinach directly interacts with gabapentin or makes it less effective. Gabapentin’s absorption is only slightly influenced by food overall, and spinach does not appear to reduce its effectiveness. ^[1] Food produces about a 14% increase in gabapentin exposure (AUC and Cmax), which is small and not clinically concerning. ^{[1] [2]}

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Key Takeaway

• Spinach itself does not reduce gabapentin’s absorption or effect. ^{[1] [2]}
• Antacids containing magnesium or aluminum can lower gabapentin absorption by about 20–40%; this is a known interaction and more important than typical foods. ^{[3] [4]}
• You can take gabapentin with or without meals; timing matters mainly if you also use antacids. ^{[5] [1]}

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How Food Affects Gabapentin

Gabapentin’s label indicates that food has only a slight effect on the rate and extent of absorption (around a 14% increase in exposure), which suggests routine meals including spinach are unlikely to cause a meaningful change in how the medication works. ^[1] This finding is consistent across multiple official product labels. ^{[2] [6]}

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The Real Concern: Antacids

While spinach isn’t a problem, certain over‑the‑counter antacids are. Antacids containing magnesium and aluminum (such as Maalox or magnesium oxide) can reduce gabapentin’s bioavailability by roughly 20–40%, lowering blood levels and potentially efficacy. ^{[3] [4]} In a controlled study, co‑administration with magnesium oxide dropped peak levels (Cmax) and overall exposure (AUC) by about one‑third to nearly one‑half. ^[4] Because of this, it’s generally recommended to separate antacids from gabapentin by at least 2 hours. ^[5]

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Spinach, Vitamin K, and Other Medications

Spinach is rich in vitamin K, which can affect medications like warfarin, but gabapentin does not have a known interaction with vitamin K. ^[7] Warfarin users should keep vitamin K intake consistent, but this advice does not apply to gabapentin. ^{[8] [9]}

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Practical Tips

• Keep your usual diet: You can eat spinach while taking gabapentin without expecting a reduction in effectiveness. ^{[1] [2]}
• Watch antacid timing: If you use magnesium/aluminum antacids, take them at least 2 hours before gabapentin to avoid lowering gabapentin levels. ^{[5] [3] [4]}
• Consistent dosing: Take gabapentin as prescribed; small food-related changes in absorption are generally not clinically significant. ^{[1] [2]}

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Summary Table: What Affects Gabapentin Absorption?

Item	Effect on Gabapentin	Practical Guidance
Regular food (including spinach)	Slight increase (~14%) in exposure; not clinically significant	Take with or without food as preferred. [1] [2]
Magnesium/aluminum antacids (e.g., Maalox, magnesium oxide)	Reduces bioavailability by ~20–40%	Separate by ≥2 hours from gabapentin. [3] [4]
Vitamin K in spinach	No known interaction with gabapentin	No special action needed (warfarin users should keep intake consistent). [7] [8]

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Bottom Line

Spinach does not interact with gabapentin or make it less effective. The main dietary consideration is to avoid taking gabapentin at the same time as antacids containing magnesium or aluminum, which can lower the drug’s absorption; keep a 2‑hour gap to minimize this interaction. ^{[3] [5] [4]}