Gabapentin is Used to Treat Restless Legs Syndrome

Gabapentin (Neurontin) is FDA approved to treat epilepsy and a type of nerve pain caused by shingles (postherpetic neuralgia).

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder.

 

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless legs syndrome; however, they suspect that genes play a role. Nearly half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

  • Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinson’s disease, kidney failure,diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from RLS symptoms.
  • Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergymedications containing sedating antihistamines, may worsen symptoms.
  • Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Treatment for Restless Legs Syndrome

Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms.

Other non-drug RLS treatments may include:

Leg massages
Hot baths or heating pads or ice packs applied to the legs
Good sleep habits
A vibrating pad called Relaxis
Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:

  • Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain.
  • Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed.
  • Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
  • Narcotic pain relievers may be used for severe pain.
  • Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Gabapentin ( Neurontin ), and Horizant.

Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.

Usual Adult Dose for Restless Legs Syndrome

Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM

Is it Safe to use Fioricet During Pregnancy?

There haven’t been enough strong clinical studies looking at Fioricet and its effects on pregnancy, so it’s not completely known how safe it is during pregnancy. A study found that Fioricet could potentially raise the risk of heart problems in unborn babies. In addition, there has been a report of a newborn experiencing withdrawal seizures at birth. This is likely related to the fact the mother took a medication with butalbital during the last two months of pregnancy. If you’re pregnant or planning on becoming pregnant, discuss the risks and benefits of using Fioricet with your provider.

What Is Fioricet?

Fioricet is the brand for a combination medication with FDA approval to treat some types of tension headaches. It helps relax muscle contractions involved with tension headaches and has been used extensively off-lave; for migraines. Fioricet contains a blend of:

  • Butalbital (50mg): A type of barbiturate that helps with muscle relaxation
  • Acetaminophen (300mg): An over-the-counter analgesic that helps to relieve pain
  • Caffeine (40mg): Added to enhance the effects of acetaminophen

Some types of Fioricet also contain codeine, a potent narcotic and opioid used to treat pain.

What are the risks and warnings for Fioricet?

Do not use Fioricet if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

You should not use Fioricet if you are allergic to it, if you have porphyria, or if you have recently used alcohol, sedatives, tranquilizers, or other opioids.

To make sure Fioricet is safe for you, tell your doctor if you have ever had:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • kidney disease;
  • stomach ulcer or bleeding;
  • a history of skin rash caused by any medication; or
  • a history of mental illness or suicidal thoughts.

It is not known whether Fioricet will harm an unborn baby. If you use butalbital while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Acetaminophen, butalbital, and caffeine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Fioricet is not approved for use by anyone younger than 12 years old.

 

 

The pregnancy, breastfeeding and fertility warning while taking gabapentin

Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy. Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down).

Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.

Gabapentin and pregnancy

Gabapentin is not generally recommended in pregnancy as there is not enough information about whether it’s safe for your baby.

However, from the small amount of information that is available, there’s no clear evidence that it’s harmful. It should only be taken if the benefits of the medicine outweigh the risks.

If you take gabapentin for epilepsy, it’s important that this is well treated during pregnancy, as seizures can harm you and your baby. Keep taking gabapentin, but talk to your doctor urgently. They may recommend you change to a different medicine.

If you’re trying to get pregnant or have become pregnant while taking gabapentin, it is recommended to take a high dose of folic acid (5mg a day). You can get this from your doctor or midwife.

Ideally you’ll take high dose folic acid for 3 months before you start trying to get pregnant and for the first 12 weeks of pregnancy. Do not worry if you have not taken it before you get pregnant, but start taking it as soon as possible once you know that you are pregnant. It helps your baby to grow normally.

If you take gabapentin around the time of giving birth, your baby may need extra monitoring for a few days after they’re born. This is because they may have withdrawal symptoms from gabapentin.

We do not know what the long term effects of taking gabapentin in pregnancy may be on childhood learning and development. For safety, you’ll usually be advised to take it only if the benefits of the medicine outweigh the risks. Talk to your doctor about the benefits and risks.

Gabapentin and breastfeeding

If your doctor or health visitor says your baby is healthy, you can take gabapentin while breastfeeding. It’s important to keep taking gabapentin to keep you well.

Gabapentin passes into breast milk in small amounts. It has not been known to cause any side effects in breastfed babies.

If your baby is not feeding as well as usual, seems unusually sleepy, has a stomach upset, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

Gabapentin and fertility

There’s no evidence to suggest that taking gabapentin reduces fertility in either men or women. However, discuss your pregnancy plans with a doctor. They may wish to review your medicine and prescribe a higher dose of folic acid for you to take (5mg a day) before you become pregnant.

Speak to a pharmacist or your doctor before taking gabapentin if you’re trying to get pregnant.