Horizant and dizziness

[RLShelpforme]

Has anyone experienced vertigo or dizziness on Horizant? I take 600 mg (2 pills) and on day 9 I start getting dizzy. I stopped taking Horizant in January after 9 days when I started feeling dizzy and started taking it again this month. Again I got dizzy on day 9 of taking it. I'm not sure if I should keep taking it to see if I feel better over time or maybe I have to try something else. Thanks for your insight.

[ChrisColumbus]

Gabapentin enacarbil (Horizant [US], Regnite [Japan]) is not licensed for use here in the UK.

Have you discussed this reaction with your prescriber?

Dizziness on gabapentin enacarbil is common enough that this warning is given on Horizant.com:

"IMPORTANT SAFETY INFORMATION

Do not drive after taking your dose of HORIZANT until you know how it affects you, including the morning after you take it.

Do not operate heavy machinery or do other dangerous activities until you know how HORIZANT affects you.

HORIZANT can cause sleepiness, dizziness, slow thinking, and can affect your coordination. Ask your healthcare provider when it is okay to do these activities.

Do not take other medicines that make you sleepy or dizzy while taking HORIZANT without talking to your healthcare provider. Taking HORIZANT with these other medicines may make your sleepiness or dizziness worse."

Whether/how quickly this side effect will wear off depends on your personal reaction to the drug and any other medications that you're taking: all drugs have side effects, and there is often a period while the body adjusts - sometimes this can take weeks.

Hopefully other users will come along and give their experience: while this is a UK based forum we have members from all over the world, many from the US.

[RLShelpforme in reply to ChrisColumbus]

Thanks. Maybe I’ll ask the pharmacist and see what he/she thinks.

[Joolsg]

Gabapentinoids are known to cause dizziness and drowsiness.These symptoms do wear off after 2 months.

You could try gabapentin or pregabalin. Often the side effects of one med do not happen with another.

I had terrible diarrhoea on gabapentin- but not on pregabalin.

Also, horizant is a long acting med and therefore more likely to cause daytime side effects.

So- consider switching to pregabalin or gabapentin and titrate up slowly.

[SueJohnson]

You need to give it some time to see if it wears off.

I know you had restlessness in your arms on gabapentin and I suggested you switch to pregabalin. Did you try that?

[RLShelpforme in reply to SueJohnson]

The dizziness stopped after, stopping Horizant -5hours worth of dizziness. I am worried the dizziness would get worse if I stayed on it, but maybe I need to see if the dizziness improves overtime. Not sure if I can wait several months though. But I need something so I can sleep.

I didn't try pregabalin yet. Horizant seemed to have less side effects the second time around until the dizziness presented itself after day 9. I'm going to try Horizant again tonight and see if the dizziness gets worse and if it's something I can tolerate to see if it fades overtime. I am going to call my pharmacist too.

[SueJohnson in reply to RLShelpforme]

It shouldn't take several months. It should go away after a few weeks. It is strange that it doesn't start until 9 days. I think pregabalin might be the better choice though.

[Moonwalker1967]

I take 600 mg Gabapentin and about 30 mins after taking those I can't walk in a straight line and am super dizzy. It's like being drunk. I have taken those for over a year now and this it has not got better. I cycle home from work in the evening and just about manage that. Definitely not able to drive a car. Seeing a neurologist this week and trying to aim to go to low opioids. Even worse on Pregabalin by the way.

[RLShelpforme in reply to Moonwalker1967]

Thanks for sharing. RLS sucks!

[SueJohnson in reply to Moonwalker1967]

Are you taking it at night and it affects you cycling home at night?

[Moonwalker1967 in reply to SueJohnson]

Yes, Sue! I take it at 20.30 hrs when still in work and about 30 mins to an hour symptoms set in. I finish work at 21.00 hrs. Usually, I stay this dizzy 🥴 all night. Glad, I'm in a small bungalow.

[SueJohnson in reply to Moonwalker1967]

Don't take it at work. Wait until you are home.

I certainly hope you are able to get a low dose opioid because obviously gabapentin is not for you.🤞🤞🤞

[BoxerDogLover89]

I take pregabalin (same class of drug) and have issues of dizziness, fainted twice, once giving me a huge carpet burn up my elbow. My GP however doesn’t think it’s due to the medication for some reason, ran lots of test which came back fine and will revisit it with me in a few weeks if it still continues. I halved my dosage but it hasn’t helped (thankfully still take tramadol other wise, back to taking more as a result). Going to try persuade my GP to speak to neurology to change me from tramadol to another opiate as I’ve been on it 10+ years and believe it’s causing augmentation (rare I know) but have went from 1 tablets to now 4 per evening.

[RLShelpforme in reply to BoxerDogLover89]

Thanks for sharing. RLS sucks!

[SueJohnson in reply to BoxerDogLover89]

You might want to try switching to gabapentin. Although they are basically the same drug except you need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Multiply the pregabalin amount by 6 to get the correct dose. 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. If you take magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If you take calcium don't take it within 2 hours for the same reason.

I would recommend buprenorphine or methadone as they are long lasting. Most of the others last only 4 to 6 hours and need to be taken that often or you will have mini withdrawals. If you are prescribed one of the others be sure you are given enough to take them that often.

[BoxerDogLover89 in reply to SueJohnson]

Thank you Sue, for some reason the neurologists never gave me the option of gabapenton only pregabalin or DA’s - they said pregabalin had less side effects, not sure if it’s because I already take tramadol. Asked so many times to change from tramadol due to potential augmentation (been on it 10+ years, went from 50mg to 200mg sometime more). I’m back to just 100mg normally with the pregabalin occasionally 150mg.

My local area doesn’t really promote opiates for RLS but hopefully they will be more willing given the new update NICE guidelines. I even asked to try codiene but was told it won’t work as it’s not as strong as tramadol - was like at least let me try it. When they last took my blood recently they didn’t even check my ferritin as my iron was fine - my iron was fine before when I had low ferritin, I really feel defeated.

However with that been said my dizziness has improved, back taking 200 of pregabalin, had physio for lower back issues which involved squatting plus lots of glute, leg and back strengthening. My physio person is great they advised the squatting daily likely helped improve my dizziness so hopefully this continues.

Considering signing up to private health care via my work this month it’s £90 per month and be worth its weight in gold if I actually get to see a knowledgable neurologist.

Thanks so much for the response you really are amazing with your advice. Taking iron with vit C again also so maybe that’s also helping my potentially low ferritin, will never know as they didn’t test and refuted my concerns when asked.

[SueJohnson in reply to BoxerDogLover89]

What city do you live in? I may be able to give you the name of a good neurologist you could see privately for around £250 - £350

[BoxerDogLover89 in reply to SueJohnson]

I stay in Perth, Scotland so I think the only place there would potentially be one is near is Edinburgh or Glasgow? Maybe Dundee (doubtful) or even one that does online consultations.

I started listening to an audiobook ‘Navigating Life with Restless Leg Syndrome’ so far it’s interesting - you maybe know everything it teaches already but thought I’d mention 🙂

[SueJohnson in reply to BoxerDogLover89]

That's the one by Dr Andrew Spector that was mentioned awhile back and is excellent. healthunlocked.com/rlsuk/po... and healthunlocked.com/rlsuk/po...

Dr Graham A Mackay is a Consultant Neurologist at the Aberdeen Royal Infirmary in Aberdeen. Islay9 sees and said he was willing to listen. I would suggest you message Islay9 and ask him about Dr. Mackay

Dr Colin 0'Leary is a neurologist in Glasgow that Scottie99 saw. I have no idea how satisfied he was with him or how knowledgeable he was. Again I suggest you message Scottie99 and ask and if you do so, let me know what he says.

I have 2 names of doctors you don't want to see: Dr Kevin Fernando near Edinburgh and Dr David P Breen in Glasgow

[BoxerDogLover89 in reply to SueJohnson]

Thank you and sorry for the late response I don’t use this too much so often miss notifications. I’ll go try figure out how to find a profile and give them a message for their input. Will let you know if I use them how I get on. Thanks again much appreciated

[Islay9 in reply to SueJohnson]

Hi Sue

Unfortunately my neurologist is NHS and doesn’t work privately I don’t think. So probably only of use for people in the “NHS Grampian” area.

Boxerdoglover and I are chatting now though.

Thanks though, always happy to help anyone.

[SueJohnson in reply to Islay9]

I guess he could call and ask.

[JustVisiting23]

For the first year, I experienced infrequent, but significant, episodes of dizziness. While this has decreased, episodes do still occur. However, Horizant has been essential to controlling my RLS.

[RLShelpforme]

Thanks for sharing. RLS sucks!