Back after 2-3/4 years! (on behalf of my husband) At what point after starting Verapamil (80 mg, 3 times daily) would an episodic patient want to think about starting to taper UP? I've printed out and appreciate the instructions on how to do this, but am wondering when to think about bumping it up. This dosage worked last time, but of course it is different every single time. It's been only two weeks, and the Verapamil currently has my husband so tired from lowering his blood pressure...I don't want to ask for an increase unless necessary. Thanks in advance!

When your doctor tells you it's okay.

Might help to give the present dose 2-3 more weeks and see if the BP issue eases--body may adjust and react less strongly.

If not, then little option except to try another preventive.

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Thanks for the helpful advice Bob!

For what it's worth on my last cycle I ramped up - with close doc monitoring - to 940mg verapamil before it fully worked

IMO, it depends on the amount your trying to get to and how quickly you can tolerate it.  My doctor said that I could go to 2-2-2 as soon as possible.  I did 1-1-1 for a day then 1-1-2 the next, then 2-2-2 on the 3rd.

Sure I fall asleep FAST out after taking my nightly 2, but that's ok with me...!  I'm also not taking any other medications.  Just check with your doctor.

After reading through more of the archives, we decided to try adding a can of Red Bull an hour before the usual mid-day hit...that did the trick without upping the Verapamil. He hasn't had a full-blown cluster since then (had been having them first thing in the morning, mid-day, and right after falling asleep). We ran out of Red Bull last weekend, and he did have some strong shadows all day...got some more RB and he's good now. I was always skeptical about that whole Red Bull thing, but it appears that it made the Verapamil more effective. He is feeling less lethargic now too, but still not exactly energetic. Still, a huge improvement!

That's good news!