Transitioning from Mirapex to Horizant

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Aipulu
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Transitioning from Mirapex to Horizant

Post by Aipulu »

I am transitioning from Mirapex to Horizant (Gabapentin Encarbil) due to augmentation and impulse control problems. However I just learned that Horizant will cost me $65 per month. But it is the only gabapentin drug approved for RLS and is recommended in the Clinical Treatment of RLS book. I am wondering how others are doing if using Horizant or Lyrica or Neurontin as the main medicine. Are you using any of these for monotherapy? I am also considering adding some Mirapex (o.25 mg) back in after 3 months, thinking that both may be superior than monotherapy. Adding 300 mg of Neurontin to my 1 mg of Mirapex certainly increased the quality of my sleep. So I am assuming that adding a little Mirapex to Horizant might be similarly effective. But I am not sure and would appreciate any insights on this issue.

Rustsmith
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Transitioning from Mirapex to Horizant

Post by Rustsmith »

I believe that I have answered this question on the first page of Just Joined forum's discussion on "Getting ready to sue" dated May 4.

viewtopic.php?f=2&t=9148
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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veldon75
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Re: Transitioning from Mirapex to Horizant

Post by veldon75 »

Hi: I havent commented in a while, I've been on Mirapex .75 for about 10 yrs, I have augmented for a while. Recently its getting worse, I try to take Oxycodone 10 when I'm at work, I have had a sit down job for 6 mths and its not working because my legs are jerking during the mornings sometimes. The Oxy doesnt help much, I take it for chronic pain. I noticed the Pramipexole is taking longer to work especially at night. I have tried to stop it several times. My pain Dr. gave me Horizant, but its not working either. I need to stop the Mirapex, but I work so I cant work without sleep, or sit down to do the job. Very frustrated! :(

ViewsAskew
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Re: Transitioning from Mirapex to Horizant

Post by ViewsAskew »

veldon75 wrote:Hi: I havent commented in a while, I've been on Mirapex .75 for about 10 yrs, I have augmented for a while. Recently its getting worse, I try to take Oxycodone 10 when I'm at work, I have had a sit down job for 6 mths and its not working because my legs are jerking during the mornings sometimes. The Oxy doesnt help much, I take it for chronic pain. I noticed the Pramipexole is taking longer to work especially at night. I have tried to stop it several times. My pain Dr. gave me Horizant, but its not working either. I need to stop the Mirapex, but I work so I cant work without sleep, or sit down to do the job. Very frustrated! :(


It often seems we have so few options...
Ann - Take what you need, leave the rest

Managing Your RLS

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.

veldon75
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Joined: Sun Sep 21, 2014 3:45 pm

Re: Transitioning from Mirapex to Horizant

Post by veldon75 »

I was given Horizant by my pain Dr. I don't think it works very well for me, it makes me
pretty drowsy I am supposed to take 300 mg twice a day for pain. The dose for RLS is 600 in
the evening. I also have Gabapentin which I took in the past but I had to take up to 1200 mg for it to work. Gabapentin is cheaper and to me it works the same Horizant is just extended released.

badnights
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Re: Transitioning from Mirapex to Horizant

Post by badnights »

I think you need to focus your energy on doing whatever it takes to end the pramipexole/Mirapex. Cleary, you won't sleep and therefore won't be able to work during the first while, so you have to plan for that. Have you discussed augmentation with your pain doc? Does he/she know that augmentation and pramipexole withdrawal for WED/RLS patients consist of exceptionally intense and prolonged symptoms that prevent sleep? That opioids are the only effective treatment for this? That once it's all over, the total medication needed going forward is usually much less?

I realize you feel that you're caught in a trap you can't escape from, and that stopping pramipexole is not an option right now, but I seriously think that you need to drop everything else in your life, even be willing to lose your job if you have to, to get off of the pramipexole. It's the only way to get your life back.

I doubt you it would come down to losing your job, though. Please investigate if there is any sick leave you could take, or special unpaid leave of some kind. At the same time, get a doctor on board who will treat the withdrawal. Once you've made those preparations, plunge into the withdrawal, always remembering what's on the other side - a real life again.
Beth - Wishing you a restful sleep tonight
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Sojourner
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Re: Transitioning from Mirapex to Horizant

Post by Sojourner »

What is the recommended dosage range on the Horizant?
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ViewsAskew
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Re: Transitioning from Mirapex to Horizant

Post by ViewsAskew »

gabapentin encarbil - 300-600 mg once daily according to Clinical Management of Restless Legs Syndrome.
Ann - Take what you need, leave the rest

Managing Your RLS

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.

Sojourner
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Re: Transitioning from Mirapex to Horizant

Post by Sojourner »

ViewsAskew wrote:gabapentin encarbil - 300-600 mg once daily according to Clinical Management of Restless Legs Syndrome.


Thanks. Horizant is/was a potentially new med for me to try. However, the cost of the med is significant and one that I probably could not sustain over the long haul. I'm debating giving it a try for one/two months to see if it would be beneficial. At least I would have some idea if the co-pay on the drug should drop sometime in the future. Again, thanks.

Hope all who visit here find some peace this night.
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ViewsAskew
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Re: Transitioning from Mirapex to Horizant

Post by ViewsAskew »

As I understand it, it only works better than gabapentin for certain people. So, it may not be necessary for you.

An interesting read about it: http://thoughtbroadcast.com/2011/04/08/ ... abapentin/
Ann - Take what you need, leave the rest

Managing Your RLS

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.

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