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Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Best Time of Day to take Verapamil?
(Message started by: VinceFromOhio on Oct 21st, 2007, 9:21am)

Title: Best Time of Day to take Verapamil?
Post by VinceFromOhio on Oct 21st, 2007, 9:21am
What is the best time of day to take Verapamil if you're mainly interested in trying to prevent nighttime hits?

Also....if you're on a daily regimen of Verapamil, can you still take Imitrex during a hit?

Thanks in advance....
Vince

Title: Re: Best Time of Day to take Verapamil?
Post by aloneuk on Oct 21st, 2007, 9:25am
dunno about others but mine were taken 3times a day one in the morning one at lunch and one before bed.

and yes you can still use your trex while on verapamil,

some others will be along with much more info im sure, i just wanted to give you a quick answer

pf wishes

ike

love the pic by the way

Title: Re: Best Time of Day to take Verapamil?
Post by Kevin_M on Oct 21st, 2007, 9:28am
Different types of verapamil.  SR is sustained release for about 12 hours.  There is another type though.  

Like Ike, trex is fine, oxygen very good to have also if you need an abortive more often at times.

Title: Re: Best Time of Day to take Verapamil?
Post by Wayne on Oct 21st, 2007, 10:15am
I'm also on three doses a day, morning, evening and night. I do take the night time one quite late, like 8:30 or so. Its working so well though that it doesn't seem to matter now.

Good luck Vince.

PS - read your post on smoking and am seriously considering the challenge.

Title: Re: Best Time of Day to take Verapamil?
Post by billyjoe on Oct 21st, 2007, 11:02am
I take more at night than during the day and has helped me through the night.  It think it depends on when you get hit.  Personally, I'm pretty good during the day and only have problems in the evening and at night.

Title: Re: Best Time of Day to take Verapamil?
Post by Annette on Oct 21st, 2007, 11:16am

While my husband was in cycle, at the peak of it he was getting hit like clock work 4 times a day : 9 am, 3 pm, 8 pm and 4 am. We could have set the clock to the hits !

After some experimenting, he found that taking verapamil 3 times a day about 1 hr before the hits would reduce the intensity and sometimes prevented one from breaking through. The 4 am ones were reduced significantly when he took melatonin before going to bed.

He was on the immediate release one, not the slow release. The slow release one ( Verapamil SR ) is supposed to last 12 to 24 hrs so you can only take that daily or maximumly twice daily, you cant really take it 3 or more times per day.

Title: Re: Best Time of Day to take Verapamil?
Post by DennisM1045 on Oct 21st, 2007, 2:30pm
I take the ER type.  It's a once a day formulation.  I was taking it at night but switched to 9:00am as I'm always up and around by 9  ;;D  Half the time I was forgetting to take it or my bed time changed too much.  For me, it is only once a day pill and I had to find a time where I would be consistent with it.

One thing I have noticed ... I screw up a dose ... even by a few hours I get nailed within 36 hours of when I should have taken it.  So apparently it is doing something for me and consistency is the key.

-Dennis-

Title: Re: Best Time of Day to take Verapamil?
Post by VinceFromOhio on Oct 21st, 2007, 2:32pm

on 10/21/07 at 11:16:12, Annette wrote:
While my husband was in cycle, at the peak of it he was getting hit like clock work 4 times a day : 9 am, 3 pm, 8 pm and 4 am. We could have set the clock to the hits !

After some experimenting, he found that taking verapamil 3 times a day about 1 hr before the hits would reduce the intensity and sometimes prevented one from breaking through. The 4 am ones were reduced significantly when he took melatonin before going to bed.

He was on the immediate release one, not the slow release. The slow release one ( Verapamil SR ) is supposed to last 12 to 24 hrs so you can only take that daily or maximumly twice daily, you cant really take it 3 or more times per day.

If I switch my prescription to the immediate release, what dosage should each pill be to be able to take it 3 times daily?

Thanks in advance...
Vince

Title: Re: Best Time of Day to take Verapamil?
Post by Brewcrew on Oct 21st, 2007, 6:00pm
If it takes 7-10 days to build up to theraputic levels in the body, would it not stand to reason that it's not going to matter much what time it's taken?

Lithium is the same way - 7-10 days before it becomes really effective. I take 600mg in the morning and 300mg at night. When I was taking verapamil, I did it similarly - 240mg in the morning, 240mg in the evening.

Once you get up to that theraputic level, you're simply maintaining it. Not something to get too bent out of shape about.

Title: Re: Best Time of Day to take Verapamil?
Post by Annette on Oct 21st, 2007, 6:28pm

on 10/21/07 at 14:32:51, VinceFromOhio wrote:
If I switch my prescription to the immediate release, what dosage should each pill be to be able to take it 3 times daily?

Thanks in advance...
Vince



Vince, you will need to check that with your doctor. He will need to do the switching for you and decides on the dosage. Usually it means the total dosage is still the same, for eg if you take 240 mg a day now it would translate to 80 mg three times a day.

But you shouldnt change your meds without first checking with your doctor.

Daniel was originally on the slow release version but it wasnt working too well and he noticed that the hit closest to the time he took the tablet was always the least intense so we discussed that with the neuro and he told us there had been reports of people experiencing a more immediate effect with the normal release Verapamil. As an experiment he switched and played around with the timing of the dosage a bit until he was most happy with taking it 1 hour prior to the regular hits.

Interestingly some psychiatrists use Verapamil as an antianxiety and mood stableliser for other condition such as bipolar and they found that the immediate release version work well while the slow release one did not.

I dont know really whether the antianxiety effect of the immediate release Verapamil was the one helping Daniel more or whether it was just coincidental but it sure worked better that way for him. Last year was his first cycle and it was a very long one so it caused him a lot of fear and anxiety so taking care of that side of CH was very important for him. Maybe with others who have long term experience on how to deal with CH and do not suffer as much anxiety, it would not matter which type of Verapamil they use and when they take it.

This is definitely not hard and fast science but it was our experience. Hope it helps you in some ways.


Edited to add: if you want to avoid the night hits, you might like to try melatonin before going to bed, it works for many.

Title: Re: Best Time of Day to take Verapamil?
Post by Annette on Oct 21st, 2007, 6:41pm

on 10/21/07 at 18:00:52, Brewcrew wrote:
If it takes 7-10 days to build up to theraputic levels in the body, would it not stand to reason that it's not going to matter much what time it's taken?



The level of the meds inside of you is never a stable straight line. There will always be peaks and troughs. When they say it reaches its therapeutic level it simply means the average level is within the therapeutic levels. However, the peaks can be rather high or low depends on how the body metabolises the meds. Thats why you can get side effects even when you are within therapeutic level because the peaks can still be too high for you individually.

You can never maintain a perfectly leveled concentration of the med in your blood. The timing of you taking it even when you are on the same dose can affect those peaks and troughs depending on what else was going on within your body at that time. Certain food and drink can affect how the body metabolise the meds. Taking it with or without an empty stomach can also affect it. If you take the tablet and then go for a long run sweating profusely you could increase the concentration of the meds in the blood simply due to dehydration. Otherwise if you take your meds and go to sleep this would not happen.

Reaching therapeutic dose simply mean getting a dose high enough so that these outside influences wont affect the average level of the meds in your blood, but they still can affect how high the peaks are and how often the levels vary.

I am not sure if I have done a good job explaining this. Pharmacokinetic is rather complex and it wasnt a subject I liked too much in med school !  :P

Title: Re: Best Time of Day to take Verapamil?
Post by Miz_D on Oct 22nd, 2007, 7:10am
Thought I'd add to this post as I am just adjusting my verapamil as we speak. I have traditionally taken the er version of 120mg  3 x per day but am now moving to 120mg 2 x per day (morning and night). I chose 2 x per day as I was getting attacks within 2 hours of taking the verap so I added topomax 2 x per day (morning and night) and found that when taking the verap at those times, I wouldn't experience an attack. Hopefully this will work... :-/



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