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Horizant (gabapentin enacarbil) is a medication that requires careful consideration due to several associated risks and necessary precautions. It is important to understand these warnings to ensure safe use and to know how to respond if adverse effects occur. Please review the following key points and discuss any concerns with your healthcare provider:

• Cognitive and Motor Effects: This medication may cause dizziness, sleepiness, and difficulty concentrating, which can impair your ability to perform tasks requiring mental alertness, such as driving. These effects may diminish over time but could be exacerbated if taken with other sedative medications, including benzodiazepines, muscle relaxants, or sleep aids. Avoid alcohol as it can enhance these effects.

• Mental Health Risks: Horizant may increase the risk of suicidal thoughts or behaviors, potentially as soon as one week after starting the medication. Be vigilant for signs of depression, anxiety, or unusual mood changes, and seek immediate medical attention if these symptoms occur.

• Respiratory Concerns: The use of Horizant in combination with medications like benzodiazepines, opioids, or alcohol can lead to dangerously slow breathing (respiratory depression). If you notice symptoms such as difficulty breathing or bluish lips or extremities, seek emergency help immediately.

• Allergic Reactions: Severe allergic reactions, including facial swelling and anaphylaxis, may occur, though they are rare. Serious skin reactions, such as DRESS syndrome, are also possible. Discontinue use and seek medical attention if you experience fever, facial swelling, breathing difficulties, or skin changes like rash or blisters.

• Withdrawal Symptoms: Abruptly stopping Horizant can lead to withdrawal symptoms such as nausea, anxiety, and irregular heart rhythms. If you need to discontinue the medication, consult your prescriber to safely taper the dosage.

Currently, there are no specific contraindications listed for Horizant. However, individual health conditions and concurrent medications should be discussed with your healthcare provider to ensure this medication is safe for you.

When taking this medication, some individuals may experience common side effects such as drowsiness, dizziness, headache, nausea, and fatigue. These effects are generally mild and often subside over time. However, if they persist or worsen, it is advisable to consult with a healthcare provider. Additionally, some users may experience swelling in the arms, feet, or ankles, and trouble sleeping, which should also be discussed with a healthcare provider if concerning.

While serious side effects are rare, they demand immediate medical attention. These serious side effects include dry mouth, weight gain, larger appetite, blurry vision, and feelings of irritability or depression. It is crucial to seek urgent medical care if you notice these symptoms. Moreover, a small number of individuals using anticonvulsants may experience significant mental health changes, such as depression, suicidal thoughts, or other mood disorders. Immediate medical consultation is necessary if there are sudden changes in mood, thoughts, or behavior, including any thoughts of self-harm.

In extremely rare cases, a severe allergic reaction may occur. Symptoms include fever, swollen lymph nodes, rash, itching or swelling, particularly of the face, tongue, or throat, severe dizziness, and trouble breathing. Immediate medical help is needed if you experience these symptoms. Always stay informed about how your body responds to medication and keep open communication with healthcare providers for any concerns.

Horizant (gabapentin enacarbil) has the potential to interact with various medications and substances. It is essential to inform your doctor and pharmacist about all other medications and supplements you are taking, including those prescribed, over-the-counter, vitamins, and herbal products.

Taking Horizant with certain drugs may increase the risk of severe side effects such as drowsiness and breathing difficulties. Some medications that may cause these effects include opioid pain relievers like codeine and hydrocodone, sleep or anxiety medications such as Alprazolam and Lorazepam, muscle relaxants like Carisoprodol and Cyclobenzaprine, and antihistamines such as Cetirizine and diphenhydramine. Alcohol, marijuana, and some cough and cold products may also increase these risks. Therefore, it's crucial to check the labels of all your medicines and consult your pharmacist for safe usage.

Horizant should not be taken with other medications that contain gabapentin, as this can lead to increased side effects. Additionally, it may interfere with certain laboratory tests, such as urine protein tests, potentially causing inaccurate results. Be sure to inform all healthcare providers and lab personnel that you are using Horizant.

In some cases, using Horizant with other medications might be necessary, but it is usually not recommended. If both medications are required, your doctor may adjust the doses or frequency of either drug. It's important to have a thorough discussion with your healthcare provider about the potential interactions and risks associated with using Horizant.