Horizant Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Horizant Tablet (gabapentin enacarbil) is a prescription extended-release tablet that the body converts into gabapentin after it is absorbed. It belongs to the gabapentinoid class of medicines and is used to treat restless legs syndrome and nerve pain that follows shingles in adults. It is taken with food and should not be substituted for other gabapentin products.

What is Horizant Tablet

Horizant is a prescription extended-release tablet that the body converts into gabapentin after it is absorbed. It is used to treat restless legs syndrome and nerve pain that follows shingles.

Horizant Tablet uses

• Treatment of moderate-to-severe primary Restless Legs Syndrome (RLS) in adults
• Management of postherpetic neuralgia (nerve pain that follows healing of shingles) in adults

Benefits of Horizant Tablet

• Helps relieve restless legs symptoms
• Reduces uncomfortable leg sensations
• Helps manage nerve pain after shingles
• May improve sleep affected by restless legs
• Helps reduce leg discomfort at night

How Horizant Tablet works

Horizant is converted by the body into gabapentin. It's not exactly known how gabapentin helps with restless legs syndrome or nerve pain, but it has a structure similar to a natural calming brain chemical called GABA, and it may affect nerve signals involved in these conditions.

Horizant Tablet dosage

Take HORIZANT tablets with food. Swallow tablets whole; do not cut, crush, or chew them. For restless legs syndrome, take once daily in the evening at about the same time each day. For postherpetic neuralgia, take once in the morning for the first few days, then switch to twice daily as directed by your doctor. If you miss a dose, skip it and take your next dose at the regular time; do not take two doses at once. Do not stop taking this medicine suddenly without talking to your healthcare provider first; it should be tapered off. This medicine is not interchangeable with other gabapentin products such as Neurontin or Gralise.

Available forms and strengths

• Extended-release tablets, 600 mg

Side effects of Horizant Tablet

Common

• Sleepiness/drowsiness
• Dizziness
• Headache
• Nausea
• Fatigue/tiredness
• Swelling in arms, feet, or ankles
• Trouble sleeping
• Dry mouth
• Weight gain
• Increased appetite
• Blurred vision
• Irritability
• Depression

Serious

• Suicidal thoughts or actions
• Serious or life-threatening allergic reactions (DRESS/multiorgan hypersensitivity) affecting skin, liver, or blood cells
• Severe sleepiness, dizziness, slowed thinking, and impaired coordination, especially affecting driving ability
• Dangerously slow or shallow breathing, especially when combined with other sedating medicines or alcohol
• Signs of allergic reaction such as hives, swelling of lips/tongue, trouble breathing
• Unusual bruising or bleeding
• Yellowing of skin or eyes
• Severe fatigue or weakness
• Severe muscle pain
• Frequent infections

Warnings and precautions

• This medicine may increase the risk of suicidal thoughts or actions in a small number of people, about 1 in 500. Watch for new or worsening depression, anxiety, agitation, or unusual changes in mood or behavior, and tell a healthcare provider right away if they occur.
• This medicine can cause a serious, possibly life-threatening allergic reaction affecting the skin or organs like the liver or blood cells, which may or may not include a rash.
• This medicine is not the same as other gabapentin products and should not be substituted for them, since the same dose can produce different levels of the drug in the body.
• Do not stop taking this medicine suddenly, as doing so may cause withdrawal effects such as seizures. Your doctor will tell you how to taper off safely.
• This medicine can cause dangerously slow or shallow breathing, especially when combined with alcohol or other sedating medicines, or in people with breathing conditions like COPD.
• It is not known whether this medicine could harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant so you can decide together whether to use this medicine.
• This medicine turns into gabapentin, which passes into breast milk. It isn't known if this can harm a nursing baby, so talk with your doctor about whether to breastfeed or take this medicine.
• People with kidney problems, including those on dialysis, need a different dose of this medicine because it is removed from the body by the kidneys.
• Do not drink alcohol while taking this medicine. Alcohol causes the medicine to be released from the tablet too quickly, which can increase the risk of side effects like severe dizziness, sleepiness, and nausea.
• Do not drive or operate heavy machinery until you know how this medicine affects you, since it can cause significant impairment, sleepiness, dizziness, and slowed thinking — even the morning after taking a dose.

Storage

• Store at 25°C (77°F); brief exposure to 15°-30°C (59°-86°F) is allowed
• Protect from moisture
• Do not remove the moisture control packs (desiccants) from the bottle
• Keep tightly closed in the original bottle
• Keep out of the reach of children

When to see a doctor

• Get emergency help right away for signs of a severe allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call a healthcare provider right away if you notice thoughts of suicide or dying, a suicide attempt, new or worse depression or anxiety, agitation, panic attacks, trouble sleeping, irritability, aggression, or other unusual changes in mood or behavior.
• Call a healthcare provider right away for signs of a serious reaction affecting the skin or organs, such as rash, hives, fever, swollen glands, swelling of lips or tongue, yellowing of skin or eyes, unusual bruising or bleeding, severe fatigue or weakness, severe muscle pain, or frequent infections.
• Get emergency medical help if you think you have taken too much of this medicine.
• A caregiver should seek emergency help if you have slow breathing with long pauses, bluish-colored lips, or are hard to wake up.

Alternatives

• Rotigotine
• Pregabalin
• Gabapentin