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Cluster Headache Help and Support >> Medications,  Treatments,  Therapies >> verapamil problems
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Message started by tcrotty80 on Mar 4th, 2009 at 6:30pm

Title: verapamil problems
Post by tcrotty80 on Mar 4th, 2009 at 6:30pm
i have been on verapamil er 120mg 1 a day for six days now. yesterday i called my neuro because i was having tremors in my right hand. and now today i woke up with leg pain. it felt like growing pains just much more intense. as the day went on it started to move back and forth between my legs and stoped at my left where the pain got really bad and if i put any weight on it i would get shooting pain from my foot to my knee. so i called my neuro again and she said stop taking it. has this ever happend to anyone else?

Title: Re: verapamil problems
Post by Bob_Johnson on Mar 5th, 2009 at 11:07am
New one on me, especially since your dose is so low. But calling the doc is the correct move. IF it turns out NOT to be the Verap, suggest you print the following and share with your doc. This approach has become well accepted.
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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: verapamil problems
Post by howcoolrutoday on Mar 5th, 2009 at 3:49pm
Sounds like a side effect of another medication - anti-seizure class. Are you taking any other meds WITH Verapamil? Verapamil's most prominent side-effect is constipation - as such fiber-rich diet and plenty of fluids are recommended.

Title: Re: verapamil problems
Post by slhaas on Mar 5th, 2009 at 4:36pm
I've heard of low BP, constipation, a feeling of depression, fatigue, irritability, diziness, ED, etc., but never this.  Don't eat grapefruit while on verapmil, and be sure no other meds are interacting with it.  Every person can have unique side effects to any med, so good call on talking to the doctor.  Let us know if the symptoms continue even after you've stopped the verapamil.

Title: Re: verapamil problems
Post by tcrotty80 on Mar 5th, 2009 at 8:25pm
well i went in to see my doc today they gave me a full exam. everything is ok. turns out that there are no known interaction with zyban and verapamil. but my doc and my neuro think that the zyban had attacked my nerves due to reacting to verapamil. and created pain in my legs that was pain wise comparable to a k7. so i am now off the zyban and back on verapamil. quiting smoking will wait till this cycle is over with. to be honest that is fine with me. its about all i have to keep calm.

Title: Re: verapamil problems
Post by Guiseppi on Mar 6th, 2009 at 3:49am
Well that's good news.....like Bob said, don't be suprised if they ratchet that verapamil dose up a bit. Many go ito the 960 mg a day range to get relief.

Joe

Title: Re: verapamil problems
Post by Dennis on Mar 6th, 2009 at 4:39pm
I've been taking 960 mg/day verapamil for over 3 months.  Once it's taken for a few weeks, the side effects ease for most people, though when I took it with Topomax a few years ago I had some serious ankle swelling.  Gotta watch for those interactions.  I hope it works for you.

Dennis

Title: Re: verapamil problems
Post by mezza on Mar 11th, 2009 at 11:21pm
I tok 620 mg daily last cycle.  I had shaky hands and would get charley horses in my feet.   Never got the constipation ,  did get the fatigue though.  

Good move in calling your doc just to make sure things were okay.

Good luck to you

kelly

Title: Re: verapamil problems
Post by Garys_Girl on Mar 12th, 2009 at 12:18am
If your doc does begin to ramp you up on the verap, please just keep an eye on your blood pressure if your doc doesn't mention this.  Gary was on only 540mg of verapamil when he began to have serious problems with low blood pressure - to the point he had to taper back off the verapamil.  It is a drug designed to lower blood pressure, and if you don't have high blood pressure to begin with, apparently for some people it works (to almost dangerously low levels) anyway.  

Laurie

Title: Re: verapamil problems
Post by toader on Mar 12th, 2009 at 1:47am
Hated the stuff.  Nothing but bad things happened when I was on it.  Also had the same experience with low blood pressure.  My feet swelled up pretty big ... I made a great Hobbit! :)

Title: Re: verapamil problems
Post by Steambug on Mar 12th, 2009 at 8:08am
hope it helps you, I've had verapamil both for cardiac arrhythmias (I was on it for 5 years for that), and also for headaches, Im back on 240mg a day now (120mg twice a day), so far it is easing things a bit, but not nearly enough so Im going to ask my doc if I can up the dose in a week or so once my body is used to it again.

When I was last on verapamil I was about 30lbs more overweight than now and had high blood pressure before starting it, but now Ive lost weight my BP is naturally a bit low, so will have to keep an eye on it (mind you Im on high steroids this month so that bumps it up a bit too!)

the first 6 months I was on verapamil I got really swollen ankles, but I dont get that anymore

Title: Re: verapamil problems
Post by marie on Mar 13th, 2009 at 1:03pm
if yrpriscriped vapramil how long u supposed to take it 4? i was priscribed this took it for amth then stoppe as r never treat sum 1 for ch and wasnt sure how long u shud take it 4?? she sujested i took untill my cluster was over it alsted about 5 weeks?? with the 1st week the worst!!

Title: Re: verapamil problems
Post by Guiseppi on Mar 13th, 2009 at 1:24pm
As with most of our CH meds, you need to work real close with your doctor on this. Verapamil is a blood pressure drug that has had great success as a preventative medication for CH. Most episodics take it only during their cycle, then wean off of it when their cycle is done.

Whether it's verapamil, lithium, prednisone or any other prescribed medication, work closely with your doc when going on and off of them. Some of them can really mess you up if not started and stopped properly! Did the verapamil help yopur cycle? And what waas your daily prescribed doseage?

Joe

Title: Re: verapamil problems
Post by barry_sword on Mar 13th, 2009 at 2:35pm
I'm into my 5th month with Verapamil at 480mg daily and when this cycle started, I went on it full dose. Not good, trip to the ER for too low blood pressure. I backed off on the amount and gradually upped it until I reached the 480mg level. Much better.

I am tapering off very slowly to see where I am at with this cycle, so far so good as I am down to 240 mg daily, and no hits as of yet! ;)

I am coming off early this time as my cycles usually last about one full year, but I have a "gut feeling" this time.

Everybody is different when it comes to how and what meds work for each individual person, so always work with your doc on this.

My friend Jonny once told me never to increase or decrease my meds without my doc's approval.

 Barry :)


Title: Re: verapamil problems
Post by marie on Mar 14th, 2009 at 9:21am
dont mean to sound dumb but what a cycle?

Title: Re: verapamil problems
Post by Steambug on Mar 14th, 2009 at 2:08pm
I was trying to find some info on how verapamil works in CH. I understood that the drug had the action of being a vasodilator (I used to work in cardiology so had experience of it being given to arrhythmia patients - of which I ended up being one too!), so was curious as to its mechanism in CH, given that triptan vasoconstrict...



I just went up to 360mg yesterday, so far havent had an improvement, maybe too early, maybe not high enough dose yet?

Title: Re: verapamil problems
Post by tcrotty80 on Mar 16th, 2009 at 10:08am
well it was great when i started it i noted a decrease in ch within a day. then a week later i was in pain again but in my legs not my head. so i was ordered to stop takin my qtsmoking meds and all is well again ive only had 1 ch in 2 weeks and im able to drink beer so i may be out of my cycle. i really hope so. i have had no shadows and no ch fro 2 weeks.

Title: Re: verapamil problems
Post by Dennis on Mar 16th, 2009 at 3:34pm
A couple of entries ago on this thread, Marie asked what a cycle is...

The more common form of cluster headache is 'episodic,' as opposed to the less common 'chronic' form.  

The term episodic means that we have episodes of cluster attacks, followed by pain-free periods of remission.  Chronic suffers are not so fortunate.    

Those of us who are episodic often refer to an active episode of headaches as a 'cycle.'

Dennis

Title: Re: verapamil problems
Post by Steambug on Mar 17th, 2009 at 12:22am
oh I had forgotten the constipating joys of verapamil, it was pain from that that woke me up at 3am this morning rather than a hit for a change.

I *think* the verapamil might be starting to work... I didn't have my usual 8pm hit last night, 1st time in this cycle with no evening one (which is usually my 'big' one of the day, although I did have 2 in the daytime)..... fingers crossed.

Title: Re: verapamil problems
Post by marie on Mar 17th, 2009 at 9:56pm
saw my gp today and theyve put me back on the vapmaril but long term untill i can see a nuro at the very least there also trying with the nasal spray xx they said i can try the o2 erepy too so will see what happens xx

Title: Re: verapamil problems
Post by superhawk2300 on Mar 20th, 2009 at 9:23am
I second what Toader said. Hate the stuff and pretty much refuse to be on it.

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