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Topic: Pred/Verap Combo (Read 379 times) |
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Pred/Verap Combo
« on: Oct 9th, 2003, 6:11pm » |
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My uneducated primary care physician wrote a script as I requested, based on research here. He was reluctant due to Prednisone may cause "hip replacement" in 5 or 10 years and the Verapamil may cause low blood pressure (below 110 he says is emergency room time). He wrote and I am taking 60 mg Pred daily (3 tablets of 20 mg each at a time w/ food) and 160 mg of Verapamil (2 tablets 80 mg each). He has me on the Pred at this level for two weeks, then a tapered dose prescription from there. The Verap I have been on for 3 weeks at 160 mg and just waiting and taking. Ironic or not (Pred), it's been a full night sleep and no CH yet today, just the stiff neck and hangover type feel of fear in my head. Praying once again.
Gregg in Las Vegas
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Wishing all a Pain Free 2008!
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violet
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Re: Pred/Verap Combo
« Reply #1 on: Oct 9th, 2003, 10:21pm » |
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Hi Greg,
I have been taking Verapamil for year, and I am up to 605 mg a day. I also use steroids during a bad headache that won't break. I usually go to the ER, and they give me a shot of Medrol. It works like a charm for me.
Good Luck,
Vi
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Major_Headcase
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Re: Pred/Verap Combo
« Reply #2 on: Oct 14th, 2003, 9:22am » |
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You may have already read Svenn's advice, but I'll copy it here for easy reference ... it works for me! I think your Verapamil dosage is too low to help much.
... here's Svenn's recommendation:
Here it is,at least for me it is:
Verapamil Retard 120mgX5-7/daily during cycle
Oxygene alone at 10ltm for at least 15 minutes on a nonbreathermask or combined with imitrex-shots does miracles.The shots should start working in 6-9minutes.a few seconds after that you are almost painfree
Prednisolone in high doze for 10 days 80mg
then over a 3 weeks periode step down like 60-40-30-20-10-5mg every 3dh day
Tapering down the verap im on full dozage 7 days after my last hit,then over the next 5 weeks im down to 1/daily.
after 1 week on Verap retard 120mgX1 and still no hits i can quit that to
The very best from Svenn
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Bob P
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Shut up Bob!
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Re: Pred/Verap Combo
« Reply #3 on: Oct 14th, 2003, 11:25am » |
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Gregg,
The pred. always stops my headaches in their tracks. No attacks with the first day I take the stuff. Problem is that when I taper the dose the attacks return around the 20 mg level.
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Mrs. Barlow, I never, and I repeat never, ever pissed in your steam iron.
"SHUT UP HUB!"
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Bob_Johnson
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Re: Pred/Verap Combo
« Reply #4 on: Oct 14th, 2003, 1:10pm » |
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If you don't have access to an experienced headache doc I suggest you get one of these books. First one would be excellent to share with your doc. He must be educated!
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MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $49 at Amazon.Com. This volume is better organized and easier to read for nonprofessionals compared to Saper's book. It covers all types of headache and is primarily focused on medications. While the two chapters on CH total 42-pages, the actual relevant material is longer because of multiple references to material in chapters on migraine, reflecting the overlap in drugs used to treat. I'd suggest reading the chapters on migraine for three reasons: he makes references to CH & medications which are not in the index; there are "clinical pearls" about how to approach the treatment of headache; and, you gain better perspective on the nature of headache, in general, and the complexities of treatment (which need to be considered when we create expectations about what is possible). Finally, women will appreciate & benefit from his running information on hormones/menstrual cycles as they affect headache. Chapter on headache following head trauma, also. Obviously, I'm impressed with Robbins' work (even if the book needs the touch of a good editor!) (Somewhat longer review/content statement at 3/22/00, "Good book...."
HEADACHE HELP, Revised edition, 2000; Lawrence Robbins, M.D., Houghton Mifflin, $15. Written for a nonprofessional audience, it contains almost all the material in the preceding volume but it's much easier reading. Highly recommended.
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Quoting from a recent review on cluster treatment:
"Cluster treatment is unusual in that polypharmacy [using several meds at the same time] is not discouraged and extremely high dosages of medications are the norm." And, "A well-recognized trait of cluster patients is that they can tolerate medications much better than non-cluster patients."
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Bob Johnson
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Re: Pred/Verap Combo
« Reply #5 on: Oct 14th, 2003, 2:54pm » |
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Would the info contained in these books be found within this or OUCH or another relevant website?
The combo I described when I started this post is now working. PF for about 48 hours, 2 CH at night (aborted by o2 the 3 nights prior.
Going to the neuro Thursday afternoon at the Univ of Nevada School of Medicine, Division of Neurology. My guess is they won't know a damn thing about CH's and will need to bring a printed file from the web.
Gregg in Las Vegas
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Re: Pred/Verap Combo
« Reply #6 on: Oct 14th, 2003, 3:32pm » |
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For those on Verpapmil....After you believe your cycle has ended; a few days, a week, two weeks, etc PF, when do most of you on Verapamil start to wean off or do you continue to take year round?
Gregg in Las Vegas
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Re: Pred/Verap Combo
« Reply #7 on: Oct 17th, 2003, 5:39pm » |
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Went to neuro office yesterday and prescribed a 240 mg (therapeutic minimal) dose of Verapamil. This is previously upped from my Primary Care Physician Idiot Doesn't return Calls Respond to Faxes Even From ER or Quickcare Doctor, a little tangent sorry. The neuro office says that if I need to jump up to 360 mg or even 480 mg that's fine. Recommended each 120 mg pill (total 240, 360 or 480) be tried for two weeks at a time to evaluate. Have been on 160 mg for three weeks now in combo with Pred 60 mg daily. Fearful of tapering the Pred down starting Tuesday of next week, but afterall it is often prescribed as only a 1 to 2 week preventative. Not sure if it is the Verap or Pred, but I have gained a lot of water weight and I am sensitive to the sun. Regardless, the neuro says w/ the Verap it is important to watch blood pressure not to go lower than 110. And a preventative of keeping stable blood pressure is to exercise (cardio) at least 30 minutes daily. Better get to the gym.
Gregg in Las Vegas
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Re: Pred/Verap Combo
« Reply #8 on: Oct 17th, 2003, 5:44pm » |
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Also was told keep Verap dose as is for two weeks after cycle ends, then start weaning down 120 mg pill at a time (two weeks for each 120 mg pill) and when I have only 1 pill left daily (120 mg) either stop or break it in half for a week, then stop.
Any agreements, disagreements?
Gregg in Las Vegas
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Prense
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Re: Pred/Verap Combo
« Reply #9 on: Oct 17th, 2003, 9:43pm » |
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At 480mg daily of verap, my BP has dropped from around 135/70 to 130/70. It varies, but those numbers have been fairly consistent for before and after verap for me. I hope I get it increased to 720mg in a couple of weeks. It still isn't working for me.
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K.
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Re: Pred/Verap Combo
« Reply #10 on: Oct 17th, 2003, 9:46pm » |
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Hi
I am episodic too and what I usually do is the prednisone taper starting from 60mg along with Verapamil. Everytime I am in cycle I usually learn something new which is odd considering I've been a clusterhead for almost 19 years now...anyway....
It's true that you start getting hit again when you start tapering down on the pred. Next cycle, I'm not taking prednisone because it makes me feel terrible and the CH come back anyway. Verapamil only works for me when I take 480mg. You will get used to having your blood pressure low...mine gets to 90/50 but I think your body compensates after awhile. Also, 02...I couldn't live without it.
Verapamil 480mg daily, and 02!!!!! When you've gone about two weeks without CH then you could experiment with dropping your Verapamil dose down a little..then stay on that dose for two weeks and if no CH then drop down again.
Sorry this is so long...I didn't mean it to be but that is what works for me. I hope you find something that will keep you PF.
Good Luck
Karen
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LasVegas
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Episodic CH since 11 yrs old, now 39.
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Re: Pred/Verap Combo
« Reply #11 on: Oct 20th, 2003, 2:36am » |
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Thanks for the tip on these two drugs. I fear tapering off Pred in 3 days. I still have 2 CH's every middle of the night. Don't know if Pred or Verap is/may be causing this but starting to feel arthritic symptoms in my hands, also sweatingmore than normal, especially at night while sleeping my pillow iscold and soaked against my head and when I flip it over to the dry side my pillow is burning hot and dry. Also the circulation in my arms and legs seem poor, hands falling asleep couple time daily. Are these symptoms of 10 days of Pred 60 mg/day? What about symptoms for recently upping Verap from 160mg to 240 mg? Getting concerned.
Gregg in Las Vegas
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Hai
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You Only Have One Life to Live - Why Not Try IT!
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Re: Pred/Verap Combo
« Reply #12 on: Oct 21st, 2003, 8:28am » |
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Gregg in Las Vegas,
I got your email a few days ago, hope to meet up with you at the Las Vegas headache group meets you mentioned. Not sure what insurance you have but a very good doctor to see is
Dr. Karl Fazagus (Headache Clinic of Paradise Valley)
(702) 732-2277
You can call that number after 8AM in the morning and usually get him directly on the phone. He accepts culinary and a wide variety of insurances, heck he even charged me only 20 bux an appointment when I had no insurance, and worked me with sample packs years ago when I first found out about him.
I will be finally seeing him after many years when he is back in town today/tommrow (Can't wait!). I am not even sure if he is a neurologist, but many Neuro's know who he is ....and respect him (is also listed under the Headache Foundation list of doctors). He is up to date on the most cutting edge treatments, and is always there for his patients in the drop of a hat.
Just my tip,
Larry
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| « Last Edit: Oct 21st, 2003, 8:32am by Hai » |
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