Table of ContentsView AllTable of ContentsHow It Is UsedHow It WorksDosageSide EffectsSafetyOther Treatments
Table of ContentsView All
View All
Table of Contents
How It Is Used
How It Works
Dosage
Side Effects
Safety
Other Treatments
Gabapentinis a prescription drug sold under the brand name Neurontin, Horizant, and others that is used to treat symptoms ofrestless legs syndrome (RLS)as well aspartial seizuresandpostherpetic neuralgia.Gabapentin belongs to a class of drugs known asanticonvulsants.
RLS is a nerve-related disorder that causes unpleasant sensations in your legs, making you want to move and shake them constantly.
Horizant (gabapentin enacarbil) is the version approved for the treatment of RLS,while Neurontin (gabapentin) is the version sometimes used off-label to relieve RLS symptoms.
This article explains what gabapentin is, its approved and off-label uses, and how the drug works to treat restless legs syndrome and other medical conditions. It also describes the possible side effects and risks and lists other drugs and treatments that may help ease RLS symptoms.
PhotoAlto / Fredric Cirou / Getty Images
Approved and Off-Label Uses
While both Neurontin and Horizant can be used to treat restless legs syndrome, only Horizant is FDA-approved for such treatment. This is because Horizant is an extended-release formulation that has proven more effective in providing sustained relief of RLS symptoms.
On the other hand, only Neurontin is approved for the treatment ofpartial seizures(a form ofepilepsyoriginating from a single location in the brain).
Off-Label Uses
Gabapentin is often used off-label to treat conditions like:
According to a 2019 review published in the journalSubstance Abuse,as many as 95% of prescriptions for gabapentin are for off-label uses.
How Gabapentin Works
Gabapentin is an anticonvulsant belonging to a class of drugs calledgabapentinoids, It is the synthetic version of a naturally occurring compound calledgamma-aminobutyric acid(GABA)that tempers the overactivity (“excitement”) of nerve cells in the brain.
Gabapentin acts directly on targets in the brain called adenosine receptors. These receptors releaseneurotransmitters(chemical messengers) calleddopamineandglutamatethat have an opposite effect to GABA, causing nerve excitement.
By blocking the release of dopamine and glutamine, the overactivity of nerves that cause RLS, seizures, and postherpetic pain can be muted.
How Long Does Gabapentin Take to Work?
Numerous studies have evidenced the effectiveness of gabapentin for the treatment of restless legs syndrome. A comprehensive review in 2020 concluded that gabapentin was “the most effective treatment for RLS” in people withend-stage kidney disease(in whom RLS is common).
In other contexts, gabapentin has shown equal effectiveness in treating moderate to severe RLS compared to other drugs used to treat RLS, including Mirapex (pramipexole), ropinirole hydrochloride, and Neupro (rotigotine).
Gabapentin is relatively fast-acting and can start to ease symptoms within one to two hours.
Horizant comes in tablet form and is taken once daily in a single 600-milligram (mg) dose. To avoid side effects like dizziness and upset stomach, it is taken with your evening meal.
Neurontin is available as a capsule, tablet, and oral solution. When used for RLS, it can be taken as needed in 100-mg to 300-mg doses, with a maximum daily dose of 1800 mg.
Possible Side Effects
As with any drug, gabapentin can cause side effects. Many are relatively mild and transient, easing as your body adapts to treatment, while others may be longer lasting. Some people may experience no side effects at all.
Possible side effects of gabapentin include:
Safety Warnings
The only absolute contraindication for gabapentin is a known allergy to gabapentin or any of the inactive ingredients in the drug.
In rare cases, gabapentin has been known to trigger a severe whole-body allergy calledanaphylaxisand a multi-organ hypersensitivity reaction calleddrug reaction with eosinophilia and systemic symptoms (DRESS). Both are potentially deadly.
Other rare but potentially serious side effects include
Call your healthcare provider immediately if any of these occur.
With that said, never stop treatment until you speak with your healthcare provider. Stopping abruptly can lead to withdrawal symptoms, including anxiety, insomnia, nausea, sweating, tremors, hallucinations, or seizures.
When to Call 911Call 911 or seek immediate care if you experience signs of anaphylaxis or DRESS, including:Sudden outbreak of rash or hivesSudden feverSwollen lymph nodesYellowing of the eyes or skinShortness of breathWheezingRapid or irregular heartbeatsDizziness or lightheadednessSudden severe diarrheaSwelling of the face, neck, or throatA feeling of impending doom
When to Call 911
Call 911 or seek immediate care if you experience signs of anaphylaxis or DRESS, including:Sudden outbreak of rash or hivesSudden feverSwollen lymph nodesYellowing of the eyes or skinShortness of breathWheezingRapid or irregular heartbeatsDizziness or lightheadednessSudden severe diarrheaSwelling of the face, neck, or throatA feeling of impending doom
Call 911 or seek immediate care if you experience signs of anaphylaxis or DRESS, including:
What Other Medications Treat RLS?
Gabapentin is one of the most effective treatments for restless legs syndrome, but it is not the only one. These include three other drugs FDA-approved for the treatment of RLS which are similarly effective and well tolerated:
Other medications used off-label to treat RLS (or support RLS treatment) include:
Drugs are not the only option for treating RLS. You can also help ease symptoms with simple lifestyle changes, such as:
You can also ask your healthcare provider about foot wraps or vibration pads specially designed for people with RLS.
Summary
Gabapentin is a prescription drug used to treat restless leg syndrome (RLS). Horizant is the extended-released version that is FDA-approved for RLS, while Neurontin is the immediate-release version that can be used off-label for such. Common side effects include dizziness, upset stomach, diarrhea, or constipation.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Calandre EP, Rico-Villademoros F, Slim M.Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use.Expert Rev Neurother. 2016:16(11):1263–1277. doi:10.1080/14737175.2016.1202764National Library of Medicine.Gabapentin.National Institute of Neurological Disorders and Stroke.Restless legs syndrome.GlaxoSmithKline.Horizont (gabapentin enacarbil) extended-release rablets for oral use.Pfizer.Neurontin (gabapentin) capsules, for oral use.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse.2018;12:1178221818801311. doi:10.1177/1178221818801311Goodman CW, Brett AS.A clinical overview of off-label use of gabapentinoid drugs.JAMA Intern Med.2019;179(5):695-701. doi:10.1001/jamainternmed.2019.0086Liu Z, Guan R, Pan L.Exploration of restless legs syndrome under the new concept: a review.Medicine (Baltimore).2022 Dec 16;101(50):e32324. doi:10.1097/MD.0000000000032324Huang CW, Lee MJ, Wang LJ, et al.Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis.Nephrol Dial Transplant.2020 Sep 1;35(9):1609-1618, doi:10.1093/ndt/gfz097Sun Y, van Valkenhoef G, Morel T.A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome.Curr Med Res Opin, 2014;30(11), 2267–2278. doi:10.1185/03007995.2014.946124Manconi M, Garcia-Borreguero D, Schormair B, et al.Restless legs syndrome.Nat Rev Dis Primers.2021;7:80. doi:10.1038/s41572-021-0031
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Calandre EP, Rico-Villademoros F, Slim M.Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use.Expert Rev Neurother. 2016:16(11):1263–1277. doi:10.1080/14737175.2016.1202764National Library of Medicine.Gabapentin.National Institute of Neurological Disorders and Stroke.Restless legs syndrome.GlaxoSmithKline.Horizont (gabapentin enacarbil) extended-release rablets for oral use.Pfizer.Neurontin (gabapentin) capsules, for oral use.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse.2018;12:1178221818801311. doi:10.1177/1178221818801311Goodman CW, Brett AS.A clinical overview of off-label use of gabapentinoid drugs.JAMA Intern Med.2019;179(5):695-701. doi:10.1001/jamainternmed.2019.0086Liu Z, Guan R, Pan L.Exploration of restless legs syndrome under the new concept: a review.Medicine (Baltimore).2022 Dec 16;101(50):e32324. doi:10.1097/MD.0000000000032324Huang CW, Lee MJ, Wang LJ, et al.Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis.Nephrol Dial Transplant.2020 Sep 1;35(9):1609-1618, doi:10.1093/ndt/gfz097Sun Y, van Valkenhoef G, Morel T.A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome.Curr Med Res Opin, 2014;30(11), 2267–2278. doi:10.1185/03007995.2014.946124Manconi M, Garcia-Borreguero D, Schormair B, et al.Restless legs syndrome.Nat Rev Dis Primers.2021;7:80. doi:10.1038/s41572-021-0031
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Calandre EP, Rico-Villademoros F, Slim M.Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use.Expert Rev Neurother. 2016:16(11):1263–1277. doi:10.1080/14737175.2016.1202764National Library of Medicine.Gabapentin.National Institute of Neurological Disorders and Stroke.Restless legs syndrome.GlaxoSmithKline.Horizont (gabapentin enacarbil) extended-release rablets for oral use.Pfizer.Neurontin (gabapentin) capsules, for oral use.Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse.2018;12:1178221818801311. doi:10.1177/1178221818801311Goodman CW, Brett AS.A clinical overview of off-label use of gabapentinoid drugs.JAMA Intern Med.2019;179(5):695-701. doi:10.1001/jamainternmed.2019.0086Liu Z, Guan R, Pan L.Exploration of restless legs syndrome under the new concept: a review.Medicine (Baltimore).2022 Dec 16;101(50):e32324. doi:10.1097/MD.0000000000032324Huang CW, Lee MJ, Wang LJ, et al.Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis.Nephrol Dial Transplant.2020 Sep 1;35(9):1609-1618, doi:10.1093/ndt/gfz097Sun Y, van Valkenhoef G, Morel T.A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome.Curr Med Res Opin, 2014;30(11), 2267–2278. doi:10.1185/03007995.2014.946124Manconi M, Garcia-Borreguero D, Schormair B, et al.Restless legs syndrome.Nat Rev Dis Primers.2021;7:80. doi:10.1038/s41572-021-0031
Calandre EP, Rico-Villademoros F, Slim M.Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use.Expert Rev Neurother. 2016:16(11):1263–1277. doi:10.1080/14737175.2016.1202764
National Library of Medicine.Gabapentin.
National Institute of Neurological Disorders and Stroke.Restless legs syndrome.
GlaxoSmithKline.Horizont (gabapentin enacarbil) extended-release rablets for oral use.
Pfizer.Neurontin (gabapentin) capsules, for oral use.
Peckham AM, Evoy KE, Ochs L, Covvey JR.Gabapentin for off-label use: evidence-based or cause for concern?Subst Abuse.2018;12:1178221818801311. doi:10.1177/1178221818801311
Goodman CW, Brett AS.A clinical overview of off-label use of gabapentinoid drugs.JAMA Intern Med.2019;179(5):695-701. doi:10.1001/jamainternmed.2019.0086
Liu Z, Guan R, Pan L.Exploration of restless legs syndrome under the new concept: a review.Medicine (Baltimore).2022 Dec 16;101(50):e32324. doi:10.1097/MD.0000000000032324
Huang CW, Lee MJ, Wang LJ, et al.Comparative efficacy and acceptability of treatments for restless legs syndrome in end-stage renal disease: a systematic review and network meta-analysis.Nephrol Dial Transplant.2020 Sep 1;35(9):1609-1618, doi:10.1093/ndt/gfz097
Sun Y, van Valkenhoef G, Morel T.A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome.Curr Med Res Opin, 2014;30(11), 2267–2278. doi:10.1185/03007995.2014.946124
Manconi M, Garcia-Borreguero D, Schormair B, et al.Restless legs syndrome.Nat Rev Dis Primers.2021;7:80. doi:10.1038/s41572-021-0031
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