Flexeril and RLS

[Chocolatelover1211]

I have been off of all RLS Rx for about 3 months after stopping Trazodone and had no more RLS symptoms. My doctor prescribed Flexeril about the same time I stopped the Trazodone to help me sleep and relax muscle spasms. It definitely helped my sleep. I had been sleeping 5 1/2 to 6 hours a night before the Flexeril and now sleep 8+ hours a night. But about 3 weeks ago the RLS symptoms started again moderately. Does anyone know if Flexeril causes RLS? At the same time I’ve finally convinced my doctor to prescribe Gabapentin. She wasn’t aware of the new top of the line treatment. I printed off the new guidelines for her and she appreciated it. I should be starting that tonight. She gave me 300 mg a day. How long should I give the 300 mg to work before I ask for an increase in the dosage?

[Joolsg]

mytherapyapp.com/medication...

I would stop the flexeril. The FDA make clear it should only be used SHORT term.

It has a similar makeup to Amitriptyline and has anti cholergenic properties. Therefore it is highly likely to make RLS symptoms worse. Reduce it slowly over about 2 to 3 weeks.

Gabapentin will aid sleep. But your doctor has only given you a starter dose.

Increase by 100mg every few days up to 900mg and monitor results before increasing. Gabapentin should be taken in spilt 600mg doses, 2 hours apart.

Read any reply by SueJohnson and it sets out how to take Gabapentin correctly.

[Chocolatelover1211 in reply to Joolsg]

Thank you so much for responding. I will slowly titrate off the Flexeril.

[SueJohnson]

Flexeril will not make RLS worse from my research.

On the gabapentin it takes 3 weeks to be fully effective. You can increase it up to 900 mg before that but I would not increase it any more before then. Since it is not fully effective before 3 weeks you might increase it more than you need. After 3 weeks increase it by 100 mg every couple of days until your RLS is controlled.

Take it 1 to 2 hours before bedtime as the peak plasma level is 2 hours. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime.

Most of the side effects will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin ."

If you take magnesium even in a multivitamin, don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of gabapentin and don't take calcium nor calcium-rich foods within 2 hours for the same reason .

[Chocolatelover1211 in reply to SueJohnson]

Thank you Sue for responding. I know you have been responding to questions like mine over and over. You are so kind to graciously answer each time.

[Wanman4]

My experience with Flexeril was a nightmare, it put my legs into high gear. It’s like the older medications that were used to treat depression like Amitriptyline, which also drove me crazy. I also couldn’t tolerate Gabapentin, as it too made my symptoms worse. I have found Baclofen 20 mg in divide doses beginning around 4 pm, 8:30 pm, 10 mg at 12 midnight, and 20 mg at 4 am. FYI: If you take to much Baclofen it will cause you to jerk. I take mine to treat PLMD, as I have RLS also.

[Chocolatelover1211 in reply to Wanman4]

Thank you. I’m going to slowly titrate off the Flexeril.

[Marzipana]

Hello Chocolatelover. I'm sorry I didn't respond sooner, but maybe that's good, as I just had a Zoom appointment on Tuesday with a doctor in Sleep Medicine at Mayo clinic in Rochester, MN. The plan is to increase Gabapentin by 300mg until I get to 1800 mg, the maximum dose allowed. I have been taking 900mg (3 capsules) per night for about 6 months, as that was the only prescription drug I had for RLS after trying every drug different doctors prescribed after I was weaned off my years old nightly cocktail of Ropinerole and Gabapentin, which worked, but then I augmented and all he'll broke loose.I am now at 1200mg for a week, then will increase by 300 mg til I get to 1800mg.

After that, if it doesn't work for me, they will try some sort of Oxycodone that is specially formulated for RLS. The doctor I "saw" is Dr. Tyler Herzog, who is a pulminologist working in the Sleeo Med dept under Dr. Silber (sp. ?), who was one of the doctors who came up with the Mayo Algorithm! I finally feel I'm in good hands, as they will keep trying drugs til (God willing!), they find something that will help.

It's been a long 2 years of using meds that haven't helped me get a decent amount of sleep.

I hope as your Gabapentin usage increases, you'll get some relief from RLS!!!