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Topic: Inderal/Propranolol dosage (Read 916 times) |
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lisacollins10
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Inderal/Propranolol dosage
« on: Jan 1st, 2004, 11:00am » |
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Happy New Year, all! I wonder how many spent midnight dancing the dance like I did! Anyway, this bout started 12/19 and I was put on 60mg Proporanolol 2x/day. I got relief up until 3 days ago and now the HAs are the worst they've ever been ('been a sufferer for over 25 years). Out of sheer desperation in not being able to get a hold of my doctor, I increased the Propranolol dosage to 80mg last night and took that amount this morning, too. I have shadows but all in all, I feel OK. I'm now worried I may overdose on this amount of Propranolol and was wondering what other's were taking. Frankly though, a few more of the HAs I've been having and suicide would seem like a reasonable option! Is 80mg 2x/day an acceptable amount? I'm going to try to get in to see my Dr. tomorrow. Many Thanks, Lisa Collins
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hunterdon04
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Re: Inderal/Propranolol dosage
« Reply #1 on: Jan 1st, 2004, 11:33am » |
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well if it makes ya feel any better i did the dance last nite and am doin one right now!!!!! the nose is dripping and the leg is shakin....sorry cant give ya advice on the inderal, just wanted ya to knoe yur not alone
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lisacollins10
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Re: Inderal/Propranolol dosage
« Reply #2 on: Jan 1st, 2004, 11:53am » |
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Thanks, Hunterdon. I'll keep you in my thoughts! Lisa 
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Prense
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Re: Inderal/Propranolol dosage
« Reply #3 on: Jan 1st, 2004, 12:13pm » |
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Well, it is a beta blocker BP medication. If your BP hasn't fallen too low, and if you are not having any cardiac issues, I would say that you would be ok on that dosage. It sounds to me that whatever doc prescribed it for you is treating migraines or has no idea how to treat CH. Calcium channel blockers (verapamil) is the preventative of choice for CH. That is not to say that it works for everyone, but statistically, it is the best preventative.
Chris
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lisacollins10
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Re: Inderal/Propranolol dosage
« Reply #4 on: Jan 1st, 2004, 12:49pm » |
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I did try Verapamil for one bout years ago and it did absolutely nothing for me. Which is not to say trying it again - even in a different dosage - wouldn't help this time. (...It's been my experience that what works one time may not work the next and vice versa!) Anyway, I sure hope my Dr is in tomorrow, 1/2. I, however, don't seem to be experiencing any cardiac side effects and even better, although I've had shadowing and pressure for several hours, the headache hasn't hit. Thanks for your advice. Lisa
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Giovanni
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Re: Inderal/Propranolol dosage
« Reply #5 on: Jan 1st, 2004, 1:07pm » |
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Hi Lisa,
Sounds like to me that you need some abortative RX for individual headaches. Are you taking imitrex injections or the like. Imitrex works for a good percentage of us. Also, O2. Good luck.
Giovanni
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lisacollins10
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Re: Inderal/Propranolol dosage
« Reply #6 on: Jan 1st, 2004, 1:44pm » |
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Yes, I use 50mg Imitrex per HA and after 4 HA/day, take Percocet, which, of course, just masks the beast slightly but any relief is always appreciated!
This is the first bout (in 25 years) where a preventitive (Inderal/Propranolol) has actually helped. It is also the first bout where every single solitary HA was NOT a KIP 9 or 10. ....Talk about "Life is Beautiful" when the pain is only a 7 or 8 - it seemed like a miracle to me! In any case, the 80mg seems to be helping (I still have that severe pressure - but no HA) and I'm not dead yet - but I am Very Cold. Thanks, kindly, for your concern. Lisa
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LSUnut
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Re: Inderal/Propranolol dosage
« Reply #7 on: Jan 2nd, 2004, 1:57am » |
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I've been hanging around the board for almost a year now, and I usually only chime in when I have something relevant to say. I've only been suffering from CH for slightly less than two years now but I do know quite a bit about meds (It's what I do). Chris (Prense) always seems to get belligerent or annoyed when somebody mentions propranolol, claiming it to be for migraines (as if it might not work for CH). The fact is, is that there are no drugs on the market targeted specifically for CH and most of the meds we try were originally found to be effective against migraines. Verapamil and Propranolol are both antihypertensive agents that on the whole, produce the same global effects. According to most of the texts I have at work, Propranolol and Verapamil were both instituted around the same time as preventative treatments for HA's, which makes sense. There are some differences between the two that may cause beneficial or not-so-beneficial effects in different people. Verapamil is a calcium channel blocker that decreases blood pressure by slowing the action potential and decreasing cardiac output. However, everyone is different and one person may be more sensitive to or express more calcium channels in cardiac muscles than another person. This could lead to undesirable effects, such as light-headedness, dizziness, or palpitations (as in my case). The same could also hold true for Propranolol for certain people. However, Propranolol is a beta-blocker (beta adrenergic receptors are found in the heart and smooth muscles of the blood vessels) it typically has a more profound effect on the vessels rather than the heart. For this reason, many physicians find it to be a safer alternative. This is not to downplay Verapamil, though. I know many people here find great relief from it and kudos, go with what works (remember, physicians are not invulnurable to popular trends and word of mouth. They don't always follow the bylaws of what they've been taught, especially when effective treatments are found serendipitously). There is also an unproven but popular thinking trend that states some of Verapamil's effectiveness may lie in its ability to change membrane potentials through its calcium ion blocking abilities, which may be extremely important to the passage of biological transmitters and messengers. So FYI, both are commonly used and the other is usually tried when the first fails are causes bad side-effects. To answer your original question, many people take as much as 120-240mg/day of Propranolol, but they are commonly the high bp people. If your bp is normal, those doses may be a bit high. For people with only HA's and not high bp, the most commonly reported dosages are 20-80mg per night or even 2x/day. The trouble with Propranolol is the way that other drugs affect its concentration. Many of the H2 blockers used for acid indigestion (tagament, pepcid, zantac...etc) and some other meds like Zyflo (which is no longer on the market) tend to increase the serum levels and decrease the clearance time of Propranolol by almost double. So, let your doctor know if you take any of these meds and all other meds you take, for that matter. Also, a little bit of Propranolol can help with tremors, but too much can cause hyperkalemia (too much potassium), which can lead to parasthesia (tremors). I hope this helps, and good luck. PFDAN, Go Tigers.
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lisacollins10
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Re: Inderal/Propranolol dosage
« Reply #8 on: Jan 2nd, 2004, 9:27am » |
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Dear LSUnut - Thanks so much for writing. I can't tell you how much I appreciate all the info you provided me.
I do think the 80mg is helping although I got hit with a whopper at 12:51am which, after taking 50mg Imitrex at 12:51 and 3:06am, the HA was still present at 4:30am. BUT, it wasn't a "10" thank God -- it just seemed like it at times!
I have a Drs appt today although I just found out the Dr I've grown to love left the practice on Wednesday to do Admin work. I don't know anything about the new Dr I'll be seeing so I'm feeling I'll once again be facing someone who doesn't have a clue.
I shall keep you posted.
Many, MANY Thanks again! Lisa
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Prense
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Re: Inderal/Propranolol dosage
« Reply #9 on: Jan 2nd, 2004, 10:04am » |
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on Jan 2nd, 2004, 1:57am, LSUnut wrote:| Chris (Prense) always seems to get belligerent or annoyed when somebody mentions propranolol, claiming it to be for migraines (as if it might not work for CH). |
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Absolutely!
Annoyed? Yes, and frustrated... Many surveys (including the one from this board) will show that verapamil is 2nd only to prednisone in preventing CH. Inderal doesn't even specifically make the survey... When you consider the side effects, verapamil is the preventative of choice. Hrmmm, seen that written somewhere before. As many here will attest, verapamil dosages can get very high before results are seen...sometimes the addition of another med (topamax, depakote, lithium) is needed for relief. For some reason, doctors do not know this. I even had a GP tell me that she could not prescribe any dosage amount higher than 480mg. There is no one med that prevents for everyone. I had no idea that Lisa had previously used verapamil.
Lisa, you might have better (quicker) results with imitrex injections. If you look into this option, check out the "imitrex tip" link on the left side of this page. For me, the injections are about 85-90% effective and work in about 10 minutes or so. There has been some claims here that imitrex usage (specifically injections) increased the frequency of attacks. I can say that isn't true for me. Additionally, look into O2...
Keep us informed please!
Regards...
Chris
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CJohnson
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Re: Inderal/Propranolol dosage
« Reply #10 on: Jan 2nd, 2004, 10:49am » |
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Inderal, by virtue of its beta blocking action, has a number of effects which would appear to have some positve effect against clusters. However one interesting effect is that beta blockers can interfere with catecholamine-induced lipolysis. Noctournal lipolysis has been shown to be reduced in people suffering from cluster headaches.
Here is a bunch of stuff about what inderal does:
http://www.parkinsons-information-exchange-network-online.com/drugdb/111 .html
PFDANs
-Curtis
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| « Last Edit: Jan 2nd, 2004, 10:51am by CJohnson » |
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CJohnson
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Re: Inderal/Propranolol dosage
« Reply #11 on: Jan 2nd, 2004, 5:44pm » |
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Inderal also inhibits the production of melatonin.
PFDANS
-Curtis
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lisacollins10
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Re: Inderal/Propranolol dosage
« Reply #12 on: Jan 3rd, 2004, 11:23am » |
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You guys are great and I'm so thrilled to have found this web site!
I'm going to take your advice and get a prescription for injections on Monday. Dividing the needle dose doesn't sound too difficult and I'm sure it will make sense once I actually see what I'm using. The 50mg pills used to work faster than they are now - about 75 minutes - and, although this is the first bout where the pain is not all "10s," they are still excruciating and the longer relief takes, the more I start becoming panic-stricken.
But this is what's been happening... I did see a Dr yesterday. She wasn't thrilled that I increased my meds (Propranolol) without supervision but said 80mg 2x/day was OK (although being 5'3, 125lbs, I'm NOT to increase it to 100mg if I'm not getting relief! BP yesterday was 95/80). She also wrote out a script for the timed-release version, so I was happy to read the Pharmacology Curtis provided. ...I haven't had that filled as I seem to remember reading in several places, the TR version didn't work for many CH sufferers. So I've decided to take 40mg @ 9am, 40mg @ 3pm, and then 80mg at 9pm, before bed.
Oh, I started taking Melatonin a few nights ago. I don't know if it will have any effect but last night my husband said I was clearly talking in my sleep - yelling at the kids to Go To Bed - and a bunch of other things! (Humm?!?). I had a killer HA at 11pm and then went to bed around 1am. It's 11:30am now and I just started to feel that aura coming on. ...but I did skip the early morning HA!
I didn't mean to start an argument between you two regarding Varapamil. It's probable the dose I tried years ago simply wasn't strong enough; and, as you're aware, finding a Dr who has a clue is extremely difficult. I did mention Verapamil to the Dr yesterday but she wasn't open to hearing about my "Internet Med-School training" and said I should stick with the Propranolol as I seemed to be getting some relief.
Which, I guess, brings me now to wonder exactly what "Relief" is especially after the last few HAs I've had. This preventative (Propranolol) has prevented the HAs from being a suicidal 10 which, I find to be a miracle in itself when thinking what I've suffered with the last 25 years.
I figure I have another 2.5-3 weeks to go with this bout and after reading so much on this site, it's apparent I must find a Dr who knows about CH before the next bout starts.
I am grateful for all your help and advice! I'll keep you posted as to whether this new Propranolol schedule, as well as the Melatonin, is working.
Lisa
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Prense
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Re: Inderal/Propranolol dosage
« Reply #13 on: Jan 4th, 2004, 11:02pm » |
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on Jan 3rd, 2004, 11:23am, lisacollins10 wrote:| I figure I have another 2.5-3 weeks to go with this bout and after reading so much on this site, it's apparent I must find a Dr who knows about CH before the next bout starts. |
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Lisa,
If nothing else, find one that is willing to work with you. Without a doubt, if you were to read all that is available on this site and OUCH, you will know more about CH than the vast majority of docs out there.
Don't worry about the arguing...difference of opinion based on experiences. We all do it all the time... 
Stick around, let us know how you are doing.
Chris
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LSUnut
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Re: Inderal/Propranolol dosage
« Reply #14 on: Jan 5th, 2004, 1:59am » |
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I wasn't trying to knock Chris at all. I just noticed he gets a bit upset sometimes. I also worry about the info available on the internet without coming from trained professionals (every adverse affect from every drug is listed, even if it only occured once in a thousand times). If you were wondering (Chris) I'm a chemical biologist/medicinal chemist with many years of training in drug therapeutics. I know its frustrating sometimes because we've all felt like our doctors weren't taking us seriously or had no idea of the magnitude of pain produced by these HA's. For the most part, the problems lie in the drugs themselves. Because none of these drugs have been specifically approved for CH, in particular, many docs (especially PCP's) have a hard time rationalizing there distribution. Many of these drugs are dangerous, to the point of death vs. physical health. Many primary care physicians don't see CH's as a life-threatening illness, so you'll often have a hard time getting perscriptions for drugs like Verapamil, Depakote, Predisone, etc... These drugs are often viewed as "last-resort" options for those who are losing their quality of life. It's not even that they haven't read the literature concerning their benefits for CH, it's just that they don't want to be the responsible party(Verapamil has caused heart failure, Prednisone is known to cause kidney failure, and Depakote is known to cause acute liver failure). Your best bet is to keep track of what you've tried, document literature and successes for what you'd like to try, and get an appointment for a neurologist or flexible PCP who is willing to work with you. The truth is, often times, doctors hate to see people like us coming. Good luck, and how bout' my TIGERS???
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Prense
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Re: Inderal/Propranolol dosage
« Reply #15 on: Jan 5th, 2004, 8:16am » |
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on Jan 5th, 2004, 1:59am, LSUnut wrote:| Verapamil has caused heart failure |
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I didn't take it as a "knock" either...no worries. I didn't know this though. I was under the impression that verap was prescribed to people with cardiac issues of sorts.
This is written by docs...don't take my word for it.
http://neuroland.com/ha/cluster.htm
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