Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

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meiatflask
Posts: 22
Joined: Sat Aug 10, 2019 10:29 pm

Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by meiatflask »

After struggles with ropinirole, my doctor just switched me to gabapentin. Starting at 100mg, with plans to increase as needed until effective, up to 600 max. I went to the Walgreens and picked up the pills, I believe a generic version, little white capsules with IP 101 on them.

Looking at webmd and other internet sources, I see two versions of gabapentin: neurotin, listed as gabapentin, and horizant, listed as gabapentin enacarbil. The first, regular gabapentin does not list RLS as a use, while the latter, horizant, lists RLS as the primary use. I read about the difference between the two is primarily related to (in very simple terms) how effectively the body absorbs the drug. Looking at my pills and probing the internet, I am pretty sure they are are generic version of the regular/neurotin gabapentin, not the enacarbil/horizant version.

Are the two (three, actually with the generic) equivalent for RLS? The internet suggests otherwise. Should I just go ahead taking what I have in hand? Or should my doctor have prescribed the enacarbil/horizant version? (I have not physically seen the writing on the prescription as it was phoned over to the pharmacy) Or is there really a difference? Should I go back to the pharmacy to see if they just substituted the generic believing equivalence? (Doctor not back in the office until Monday, Walgreens open every day). Is there a big cost difference between the two?

stjohnh
Posts: 1164
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by stjohnh »

Lyrica, Horizant, gabapentin and Neurontin are EFFECTIVELY the same after absorption. Gabapentin is the generic name for Neurontin. Lyrica and Horizant are chemical variations of gabapentin, designed for better absorption or longer action than plain gabapentin. Horizant is the only one that the FDA lists as indicated for RLS, but this is only because the manufacturer has paid to have studies done showing it is effective for RLS.

Generic gabapentin has a VERY wide absorption range, varying from patient to patient. I absorb it well and a dose of 100mg makes me feel like a zombie, 50mg helps my sleep. Gabapentin dosing goes up to 3000mg per day or so, depending on the patient. The 600mg limit your doctor recommended is quite low. If it seems to be doing nothing at 600mg, it is probably because of poor absorption in the intestine and your doc should feel free to prescribe higher doses without problems. There are members here that use doses much above 1000mg per day with good results.

Gabapentin is VERY cheap. Don't know the price of Neurontin, I actually haven't heard of anybody buying brand name Neurontin in the past few years, costs more, is otherwise identical.

Lyrica and Horizant cost MUCH more, especially Horizant. There is no reason to use them unless there is a problem with generic gabapentin.
Blessings,
Holland

meiatflask
Posts: 22
Joined: Sat Aug 10, 2019 10:29 pm

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by meiatflask »

THANKS! I especially appreciate the insight on the FDA studies comment. Makes sense to me. I will continue with the cheap generic, knowing that the effective dose for me could be high or low, depending on my own body’s ability to absorb.

Do you know if when you take the medication affects absorption? I was told to take it shortly after dinner; I am taking it 30 minutes to an hour after eating, so on a pretty full stomach. Would taking it immediately after dinner, or much later In the evening make any difference? Or is the main thing to take it at the same time every day?

stjohnh
Posts: 1164
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by stjohnh »

meiatflask wrote:...
Do you know if when you take the medication affects absorption? I was told to take it shortly after dinner; I am taking it 30 minutes to an hour after eating, so on a pretty full stomach. Would taking it immediately after dinner, or much later In the evening make any difference? Or is the main thing to take it at the same time every day?
I don't think meals make much difference. When I took gabapentin (don't need it now, IV Iron has been wonderful for me), I took it mainly for sleep (not urge to move) and took it 2 hours before bed and a booster dose between midnight and 2AM.
Blessings,
Holland

Rustsmith
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Location: Colorado Springs, Colorado

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by Rustsmith »

I don't think that the issue with timing is so much about adsorption as it has to do with timing the drowsiness effect of the medication with your bedtime. Taking it after dinner may be appropriate timing most of the time, but if you had a special event that was going to delay bedtime, then I would guess that adjusting when you take it based upon bedtime is more important than when you last ate.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Brynmr
Posts: 80
Joined: Sat Jul 21, 2018 3:15 pm

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by Brynmr »

meiatflask wrote:Do you know if when you take the medication affects absorption? I was told to take it shortly after dinner; I am taking it 30 minutes to an hour after eating, so on a pretty full stomach. Would taking it immediately after dinner, or much later In the evening make any difference? Or is the main thing to take it at the same time every day?
When do you begin having symptoms? Mine begin around dinner and run til 4 or 5 in the morning. I've leveled off (for the moment) at 1800mg of Gabapentin a day so I take 600mg at 5, again at 9 and another 600 at midnight. That carries me through the night about 90+% of the time. The 10% is when the drug doesn't get into my system properly so I wake up around 3 or 4 with symptoms. Another 300mg and a glass of wine takes care of that.

I also run into problems if I'm late on my 5 o'clock. By 7 I'm wondering what's wrong with me then I go, 'Oh crap!'

meiatflask
Posts: 22
Joined: Sat Aug 10, 2019 10:29 pm

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by meiatflask »

Mine start 7:30 ish. So taking after dinner at 6:30 gives an hour for the medicine to kick in, which works well for me. I know about the “crap I forgot to take my pill” frustration.

Stainless
Posts: 176
Joined: Tue Dec 01, 2015 9:30 pm

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by Stainless »

I'm surprised that gabapentin and Lyrica are basically the same. 300 mg. did nothing to help the 2 mg. clonazepam I'm on, but 150 mg. Lyrica has considerably improved symptoms.

stjohnh
Posts: 1164
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by stjohnh »

Stainless wrote:I'm surprised that gabapentin and Lyrica are basically the same. 300 mg. did nothing to help the 2 mg. clonazepam I'm on, but 150 mg. Lyrica has considerably improved symptoms.
That probably means you do not absorb plain gabapentin well.
Blessings,
Holland

Polar Bear
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Location: N. Ireland

Re: Gabapentin: Neurotin or Horizant (gabapentin enacarbil)

Post by Polar Bear »

My understanding is that Lyrica is more efficient and stronger than Gabapentin. With Gabapentin being so very much cheaper than Lyrics providers will prefer we try Gabapentin first.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

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