Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Hi New Here, Varapamil, what dosage are people on?
        
(Message started by: prcole18 on Jul 27^th, 2006, 1:47pm)

Title: Hi New Here, Varapamil, what dosage are people on?
Post by prcole18 on Jul 27^th, 2006, 1:47pm

Hi been suffering with CH for last 5-6 years here in the UK. Currently using imigran injection as abortive which are briiliant!

Ive decided im a chronic as I cant remember the last time I had a decent break from these things (certainly hasnt been 30 days in a row)!

Preventive wise, I have tried loads of things, I am currently on Prenisolone which have sometimes seemed to have kept them at bay, but at the minute Im going through a bad cluster of 3-4 Ch's every 24 hours, so the Prenisolone don't seem to be doing a lot!

Just come back from the doctors who has just subscribed me on Verapamil (2x120mg a day), so I just wondered what dosage other people are on with Verapamil?

I am going back to the doctor on Tuesday & he will possibly up the dose if they arn't working & said it was best to start me off on a medium dose of 2X120mg a day.

Any advice or info on preventives would be greatly appreciated.

Thanks

Paul

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by kenco on Jul 27^th, 2006, 2:50pm

hi paul- verapamil 160mg 4X daily. it takes a few weeks to build up a good level and controll a cluster

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by bfc13888 on Jul 27^th, 2006, 3:33pm

i was on verapmil 180x2 my last attach period 1 1/2 ago. It work great. This cycle started 3 weeks ago. The same dosage won't work now. I upped to 270x2. i am still having attaches every 2 days. I am bach to search for new meds

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by prcole18 on Jul 27^th, 2006, 3:49pm

Looks like my dosage may not be enough. Litterally just had a headache, tried the redbull method, after reading the redbull thread on here last night, didn't seem to work, waited as long as I could before giving myself the jab in the leg! (how long do you bloody leave it!)

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by Bob_Johnson on Jul 27^th, 2006, 4:47pm

: Headache. 2004 Nov;44(10):1013-8.

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.

Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by hm54 on Jul 27^th, 2006, 8:04pm

I've taken high doses of verapamil for a long time with generally good results and no apparent side effects except- even at normal doses, it causes gingivitis. The minimum dose that ever brought any noticeable relief was 480mg and that relief was minimal at best and unfortunately the dose has kept getting higher and higher to be effective. I'm up to 1200 prescribed, I pushed it to 1320 sustained release or 1200 immediate release (there is a difference in the effectiveness of it)in three divided doses per day. When that stopped working, I had to add topamax to the brew.

My gingivitis was passed off as normalfor several years. I now have severe periodontal disease. I suggest anyone using this stuff at high doses talk to their dentist and use a prescription mouthwash whether they need it or not to head it off. Very good dental hygiene isn't even close to good enough to stop it from biting you very suddenly

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by Jonny on Jul 27^th, 2006, 8:17pm

on 07/27/06 at 20:04:18, hm54 wrote:

even at normal doses, it causes gingivitis.

Lets make it clear that it causes that in YOU!

I have been reading everyday here for seven years and never heard anyone say that.

That said, I have been taking 480 Verap EVERYDAY for 15 years and that didnt happen to me.

Party on ;;D

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by chewy on Jul 28^th, 2006, 6:20am

240x2 day.

Constipation seems to be the biggest side effect complaint around here.

Quote:

it takes a few weeks

usually 10 days.

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by ShaneM on Jul 28^th, 2006, 12:39pm

Constipation is the main side effect for me. I battle it easily now though drinking about 4-6 oz of prune juice in the morning and using a mild stool softener. make sure to get plenty of fiber in your diet as well. The fiber tablets are okay and add about 3grams to your daily intake. Fruit is real good too.

Shane

Title: [url]Re: Hi New Here, Varapamil, what dosage are p
Post by hm54 on Jul 29^th, 2006, 2:15am

on 07/27/06 at 20:17:48, Jonny wrote:

Yes, let's make things clear. It didn't happen to you. I didn't mean to rumple feathers just post a friendly warning of a verified fact. Reread my post. My reccomendation for mouthwash clearly states high doses. My teeth were/are near perfect but I have severe gum problems that hit in a matter of two or three years and are a constant battle.

Apparently you missed this post and did no research before posting. http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=medsarchive2004;action=display;num=1103747052.

At 480, one can afford to be a bit nonchalant about it. I was. 30 years ago. At 480. When one breaks 1200 mg per day, one read's the pharmacology in depth and posts accurate information. A simple google on "verapamil gingivitis" gives you the link above and at least ten pages of hits. Or ask a neurologist.

Title: Re: [url]Hi New Here, Varapamil, what dosage are p
Post by Jonny on Jul 29^th, 2006, 10:02am

on 07/29/06 at 02:15:57, hm54 wrote:

At 480, one can afford to be a bit nonchalant about it.

on 07/27/06 at 20:04:18, hm54 wrote:

I've taken high doses of verapamil for a long time with generally good results and no apparent side effects except- even at normal doses, it causes gingivitis.

Which is it?

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by paul2006 on Jul 29^th, 2006, 9:57pm

Hi Paul,

Verapamil dose? 480 mg began to work for me [chronic] and Neurologist upped it to 960mg. Works better and I swear by it. Everyone IS different though. You may not need as much.

Don't know about all the gingivitis stuff mentioned above though, but I do get side effects which, no matter how 'bad' they may seem are far, far better than the HA's.

O2 & imigran are also in the arsenal ;)

Hope all works out for you.

Cheers
Paul

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by prcole18 on Jul 29^th, 2006, 10:19pm

Thanks for all your replies ao far.

Im currently getting 6 hits in 24 hours, been on Verap for 2 day's @ 2X 120mg.

I also started taking 500mg Magnesium 2 days ago.
Also was my last day today of pred, going to try to stay off this now as I permanantly seem to be taking it which what im told ain't a good thing.

Currently sat here 3am (UK Time) awoken by the beast which turned into just a shadow which is unusual, as usually at this time I would need an imgran jab, last hit before this was 22:30 (4 hours ago) where I did have a jab.

Im not too sure how long the Verap takes to kick in or the magnesium for that matter. The 6 hits im getting are virtually the same times every day, so im just hoping they get less intense which possibly they seem to be like this one, or fewer attacks.

Also im drinking lots of water.

Im going back to the docs on Tuesday & he said he may up the Verap already.

I'm hoping this coming week starts to impove as next Sunday i'm going away for a week & fear I might have to have 1 suitcase just for Imgran injections, could be interesing at customs!

Also, do you people permanantly take Verap even when the headaches have calmed down? Unlike the way you take Pred?

Title: FYI
Post by _Lee_ on Aug 1^st, 2006, 8:03pm

I have no medical studies to back this up, only personal experience. At a dose of 480-720 mg over 25 years all of a sudden my heart rate dropped to 40bpm, after every heart and pulmonary test known to man the doctors all agreed the the problem was verapamil. They knew if I quit taking it my CH would return and elected to put in a pacemaker. As my heart continues to degrade they have to make monthly adjustments to keep my heart running somewhat normal. Today I was told that they can't make anymore adjustments and that stopping verapamil would be the only thing they know of that would help the problem. The pacemaker was installed early April, 2006

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by sandie99 on Aug 2^nd, 2006, 5:47am

Back in my verapamil days I took 200mg twice a day. That dose sent the beast into remission for nearly a year. (After that, just Red Bull for me, thank you very much).

What comes to side effects: 100mg - nothing, 200mg - I fainted several times, 400mg - nothing.

Best wishes & good luck,
Sanna

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by bfc13888 on Aug 2^nd, 2006, 11:19am

After reading Bob Johnson's reply, I started taking verapamil 3 time a day. Since most of my attackes occur in the afternoon, my second dosage have been at 1 pm with 1st in the morning and 3rd at 10pm. I have been ch free for 4 days with only a really mild shadow on the scond day but with no pain. However, I am taking 180mgx3=540mg, is it too high? Can I cut it down a bit?
Thx Bob for the info. It made the difference for me. :D

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by prcole18 on Aug 2^nd, 2006, 4:08pm

on 08/02/06 at 11:19:35, bfc13888 wrote:

Im currently on 480mg a day. I know of people taking up yto 960mg a day. before cutting down I would go see the doctor.

If 540mg is what you've been told to take I would say that isn't too high if that is working for you, just going by people on higher doses.

I'm no doctor though, just my opinion.

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by prcole18 on Aug 4^th, 2006, 10:13am

Anyone have any idea how long Verapamil usually takes to kick in?

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by ccbiggsoo7 on Aug 16^th, 2006, 2:52pm

480 mg verapamil, 900 mg lithium for 9 years now. occasional neurontin thrown in when needed. good luck

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by chopmyheadoff on Aug 17^th, 2006, 2:49am

480 verapamil seems to be doing the trick for me (chronic) iv had a couple of break throughs but iv just killed them with imigran.

verap took about a week to kick in for me.
maybe even quicker if i think back ;)

pfw

not sure about all that gingivitis lark though :-/

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by big_guy on Aug 17^th, 2006, 6:40am

560mg Verapamil and 2400mg neurontin and prednisone taper have the Beast at bay for me. He is still around but I have the best of him now Only two imitrex jabs in the last week

hope you can get PF

Big Guy

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by prcole18 on Aug 17^th, 2006, 10:22am

Well, either the Verap may be kicking in or the gallons of redbull im drinking is working as a preventive.

Last night (12:30am) only had 1 kip 3 which redbull sorted. I would then normally get another at 4:30am, I still woke up at this time but no headache :D. I would then normally get one at around 8am when waking up again, but no, no headache :D :D.

Right now its 3pm & again I was due one about 2pm, but i'm still waiting!

Don't wanna speak to soon, infact, shit, I probably have!

I only took one Taurine tab yesterday as im being carfeull as i'm on Verapamil, I havent taken any Taurine tabs today, just drinking redbull as a preventive & im convinced this is helping keeping them at bay.

Just got back from tesco with cases of kick (same amount of Taurine as redbull but a bloody lot cheaper)!

Its now exactly 24 hours since I had an imgran jab which is the most ive been in over 2 weeks & that was only once in the last month.

It would be nice to know though weather its the Verap working, the redbull, the Melotonin last night, the headaches are coming to end or the predtaper. I still get them while on the pred taper though so I do not think its that
Saying that I dont care which it is working as long as the bloody things stay away.

pain free days to everyone.

Paul

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by paul2006 on Aug 21^st, 2006, 7:55pm

on 08/17/06 at 10:22:11, prcole18 wrote:

Just got back from tesco with cases of kick (same amount of Taurine as redbull but a bloody lot cheaper)!

hehehe... Kick tastes nicer than Red Bull as well...

Local Spar supermarket, Red Bull is £1.29 for 250ml ... Blue Bear is £0.89 for 250ml

Tescos, Kick is 3 litres for £2.50 or so... that's all I ever buy there!! They don't believe it is for 'medicinal' purposes. ;;D

Title: Re: Hi New Here, Varapamil, what dosage are people
Post by HeadhurtinMama on Aug 21^st, 2006, 8:17pm

I take 480 in the morning and 240 in the evening. It has been working up until lately. Lately, I have still been having 3-4 ch a day. [smiley=huh.gif] I will see what the neuro says on Friday, but I have also started on the sugar free Red Bulls. Seems to be helping.