Ok, so my neuro RX'd me Verapamil, Prednisone, and O2.  The O2 will be delivered today (YAYYYY!!!) and I only filled the Verapamil, as I learned that Prednisone has a nice little side effect called weight gain (and I know someone who gains 50 lbs everytime they go on!)
I was told 80mg of V-3x a day = a total of 240mg daily.  So yesterday I started it as directed - 80mg in the morning, 80mg at lunch, 80mg in the evening.  Well............I didnt make it to the evening dose.  I sincerely think that damn Verapamil caused me to have MORE episodes and that they were more painful than usual!!!  Is it possible????
I RARELY get ch during the daytime hours until after maybe 6pm.  Yesterday, I got a rager at about 4:15 (Yup, still at work.  I wont tell y'all how THAT went!).  Then I got another one at 12:20am that woke me.  I finally got to sleep around 2:30am, only to be woken up at 4:30am with YET ANOTHER!!!!  I'm crying and screaming (my apartment neighbors must adore me) and thinking - this cannot be happening!! 

So..............in my 16 years of suffering ch, I have NEVER experienced more than 2 in a 24 hour period.  I take the Verapamil and I have 3 in a 12 hour period.  What am I to conclude???  I'm not taking it today.  Forget it. 

Thoughts?  I'm beside myself!

Take the pred till the verap kicks in.  You won't gain that
much if your careful.  You will eat.  Then the O2 will help
too!If the Doc says try you should try, then if it doesn't work
try a new direction.  Most people try many things before they
find a solution that works for them.

Good luck and hang in there.

Verapamil doesn't reach therapeutic serum levels for 10-14 days after starting it. What you experienced is what's called a fluke. Keep taking it - it's got the highest preventative success rate of all the regular pharmaceuticals - although 240mg/day is on the low side. Most need between 480-920mg/day.

Beautiful Disaster wrote on Jul 21^st, 2010 at 2:55pm:

I take the Verapamil and I have 3 in a 12 hour period.    Thoughts?

Verapamil takes time to be effective, but worked to bring from many a day and night to none when at a fitting dose.  Gradually adding during a pred taper could work, but if not going to take it, you'll know if it had contributed to frequency when the pred taper ends. 

I wouldn't have much thoughts otherwise about it if you just started adding 160mg for one day, CH can change on its own. 



I see comments were posted while I replied that are good advice.

I might give it another try again tomorrow.  I got my O2 today, so I'm hopeful.  The only other issue I had that day that I can accurately attribute to the verapamil is being very shaky.  I wasnt dizzy or sleepy, but my hands would not stop shaking.  It was embarassing at work.  I certainly think I can deal with a side effect like that in order to off these headaches!!  Brew, I do, I do, I do hope it was just a fluke!!  But now it's got me scared!  Its still crazy to me after all these years that just the THOUGHT of a ch can evoke such a pure fear in me.

Thank you all for your advice!!!!

Maybe I wasn't being very clear - you have to be on it for a minimum of 10-14 days before you'll even find out if it works for you. And that's without any adjustments to find out if the level is right.

No, no...I got you.  I meant start it again tomorrow and keep it up.  My fault...it was probably me who wasnt clear.

Cool beans. Good luck, and you may want to consider that prednisone taper while the verapamil is building up in your blood. 10-14 days of prednisone is not going to cause 50 lbs. of weight gain.

The only side effect I ever got from prednisone was that I wanted to throttle the living shit out of whiners.

Come to think of it, that could be described as an effect, not a side effect. 8-)

Not a good one to just start and stop either.  You need to
build Verap slowly that's the problem!  Can't just start on 600
or 700 mg.  I'm on 600mg now but didn't start there took
weeks.  Also on Topomax another slow builder.

Peace and luck to you on finding your solution.

I'd be surprised if 240 did the trick, but good luck.  The lowest dosage I have found effective is 480.  Verapamil does have a few significant side effects, but much more tolerable than Prednisone or Topamax in my book.

All medications effect everyone differently, but you may -

1.  Get seriously constipated.  Drink a lot of water.
2.  Feel tired until your body adjusts.  Verap is a blood pressure medication that hits you pretty hard in the beginning, but levels out after a while.  Since some of us are on it for months and months, your body evens out after the initial period.

I'd try the Pred taper while starting Verap.  You'll feel very medicated for 2 weeks, but almost anything is better than CHs.  The main point is to give them a full attempt to work.  One or two days won't do anything.

Chronic

Chronic wrote on Jul 22^nd, 2010 at 10:36am:

I'd be surprised if 240 did the trick, but good luck.  The lowest dosage I have found effective is 480.  Verapamil does have a few significant side effects, but much more tolerable than Prednisone or Topamax in my book. All medications effect everyone differently, but you may - 1.  Get seriously constipated.  Drink a lot of water. 2.  Feel tired until your body adjusts.  Verap is a blood pressure medication that hits you pretty hard in the beginning, but levels out after a while.  Since some of us are on it for months and months, your body evens out after the initial period. I'd try the Pred taper while starting Verap.  You'll feel very medicated for 2 weeks, but almost anything is better than CHs.  The main point is to give them a full attempt to work.  One or two days won't do anything. Chronic

Amen.

Some conditions that lead to high blood pressure can be alleviated by Calcium channel blockers such as Verapamil.

But calling Verapamil a "blood pressure medication" is akin of calling a hammer a "thumbnail coloring device".


                 [smiley=smokin.gif]

As I mentioned can't take 600 at start.
I'm on 600 tired as heck can't sleep much tho, suckin O2
eatin Dope-o-max  100 mg just bumped to 125mg
Had Nerve bloc, got 36 hr HC free, some sleep and he's
back saying hello!

Oh!  Not as many tho!  :-)

Hey But the Prd tapper is over and the big real pain is gone
again.  Thank you someone or thing!

Peace all!

Hope your hanging in Beautiful Disaster

AlienSpaceGuy wrote on Jul 22^nd, 2010 at 11:42am:

Some conditions that lead to high blood pressure can be alleviated by Calcium channel blockers such as Verapamil. But calling Verapamil a "blood pressure medication" is akin of calling a hammer a "thumbnail coloring device".                  [smiley=smokin.gif]

I honestly don't want to take the bait on this one, but I guess my quick attempt to describe the main use for the drug was not acceptable to this individual.  Therefore -

Why is this medication prescribed?

Verapamil is used to treat high blood pressure and to control angina (chest pain). The immediate-release tablets are also used alone or with other medications to prevent and treat irregular heartbeats. Verapamil is in a class of medications called calcium-channel blockers. It works by relaxing the blood vessels so the heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart and slows electrical activity in the heart to control the heart rate.

Verapamil (brand names: Isoptin, Verelan, Verelan PM, Calan, Bosoptin, Covera-HS) is an L-type calcium channel blocker of the Phenylalkylamine class. It has been used in the treatment of hypertension, angina pectoris, cardiac arrhythmia, and most recently, cluster headaches.[1] It is also an effective preventive medication for migraine. Verapamil has also been used as a vasodilator during cryopreservation of blood vessels. It is a class 4 antiarrhythmic, more effective than digoxin in controlling ventricular rate, and was approved by the United States Food and Drug Administration in 1981, some years after it was introduced in most western countries.

In my experience (1st time I try Verapamil prophilax) it took 2 weeks for the dose (starting from 120mg/day and raising to 240mg/day after 10 days) to be effective.

However, forgetting to take it for a single day will cause immediate return to a normal number of attacks, even after 3 weeks since CH had disappeared. The attacks were very strong, apparently the drug stops functioning way faster than it starts!

It doesn't seem to stop the problem, but it seems to "interrupt" it for the time being. Am still on, wonder how long before I can stop...

...but if you've been taking it for three weeks and miss one dose, it won't take you three more weeks for it to become effective once again.

It seems as though the small dip in serum level is what is most likely responsible.

Brew wrote on Jul 27^th, 2010 at 12:20pm:

...but if you've been taking it for three weeks and miss one dose, it won't take you three more weeks for it to become effective once again.

Indeed! A dose the day after skipping brings the situation back to "normal".

I take 240mg Verap a day while out of cycle.  Every time if I go off of it I begin shadowing and my eye starts twitching so I have just resigned myself to staying on it.  While in cycle the Doc doubles that and I throw in an alternative method as well. 

Give the Verap a chance.  It helps many people. 

PF wishes,

Jeannie

most i ever gained from prednisone was 5lbs. don't sweat it. wish you the best.

Verapamil has been a miracle for me but I can't miss a single dose. I sure hope I don't have to be on it forever everyday.