Gabapentin Enacarbil Dosing for Restless Legs Syndrome

Standard Dosing Protocol

• The FDA-approved dose of gabapentin enacarbil for Restless Legs Syndrome is 600 mg once daily, taken at approximately 5 PM with food, as recommended by the American Academy of Sleep Medicine 1, 2

Pre-Treatment Requirements

• The American Academy of Sleep Medicine recommends checking iron studies, including morning fasting ferritin and transferrin saturation, before initiating gabapentin enacarbil, and addressing iron deficiency if ferritin ≤75 ng/mL or transferrin saturation <20% 1, 2
• The American Academy of Sleep Medicine also recommends reviewing and discontinuing exacerbating medications, including antihistamines, serotonergic agents, antidopaminergics, alcohol, and caffeine, before initiating gabapentin enacarbil 1, 2
• Screening for untreated obstructive sleep apnea is also recommended by the American Academy of Sleep Medicine, as it can worsen Restless Legs Syndrome symptoms 1, 2

Special Populations

• The American Academy of Sleep Medicine recommends considering pregnancy-specific safety profiles when treating Restless Legs Syndrome in pregnant women 1

Advantages Over Dopaminergic Agents

• The American Academy of Sleep Medicine strongly recommends alpha-2-delta ligands, including gabapentin enacarbil, as first-line therapy over dopaminergic agents for Restless Legs Syndrome, as they do not cause augmentation 1, 2