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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
        
(Message started by: BILLY on Apr 7^th, 2003, 10:59pm)

Title: MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
Post by BILLY on Apr 7^th, 2003, 10:59pm

Is it a bad idea to dose Verapamil (immediate release) higher at bedtime (as I've read is done for Lithium for example) if sleep is when 90+% of your attacks happen (generally 90 min after onset) or should every dose be the same three times a day?

Interested in people's thoughts,

Title: Re: MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
Post by BILLY on Apr 7^th, 2003, 11:04pm

P.S. - Sorry about the Cap Lock in the Subject, please don't hold it against me:)

Title: Re: MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
Post by domm on Apr 8^th, 2003, 4:01pm

Billy - once I got the Vera at the right dosage in my system (that took about 7 days), I kept the dosage even throughout the day and night (one at breakfast and one after dinner). I didn't seem to have any ups or downs after I found the right dose. When I say "right dose", I mean the level where I was not getting any breakthrough.
Good luck finding what works for you.
domm

Title: Re: MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
Post by BILLY on Apr 8^th, 2003, 7:08pm

Thanks for sharing that domm, it is comforting. I have noted in your post & others that they only take verapamil 2x/day (with food am & pm)?

I thought immediate release verapamil (the version most recommended for CH) was supposed to be taken 3x/day? Do many CH'ers get by on Verapamil-IR on just 2x/day or are you taking a controlled release version?

I also noticed in some people's post that they take a higher dose at one time versus their other dose & that's why I wondered if one could get by with improved efficacy & tolerability if the doses were targeted more to when they most likely get attacks (sleep in my case may improve the efficacy & experience less side effects while sleeping than a steady non-targeting dose) as long as it wasn't otherwise detrimental?

Title: Re: MORE VERAPAMIL AT BEDTIME VS STEADY DOSES
Post by domm on Apr 8^th, 2003, 8:01pm

Billy - I don't think Vera has a traditional "half life" the way other drugs do (Imitrex ~ 4 hours, etc.). The fact that it takes _days_ to "build up" in your system and the fact that effective dosages range all over the map, tells me that this med is different. Ueli or Bob P are probably better informed / educated to answer this than me. I also think you have to experiment a bit to find what works best for you. Do so with your Doc's approval and watch your blood pressure.
I used the immediate release variety. Started at 120mg/day (with dinner). Then upped it to 180 to 240 mg/day (breakfast and dinner) and found complete relief. It cut my normal 16 week cycle at least in half. After I knew my cycle was over, I stepped back to 120 mg/day and switched to extended release for a few months. Now, I'm off it completely because of other unwanted side effects.
Eat lots of roughage, and good luck.
PFDANs
domm