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Verapamil Dosing (Read 2941 times)
koctail
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Verapamil Dosing
Jul 24th, 2014 at 2:53pm
 
I currently take 480mg, one pill in the morning and one at night. I am doing D-3 regimen but still having CH break through. I am thinking of upping my dose to 600 mg and taking that extra 120 with my dose I take before bed. Sound like a wise move??
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Bob Johnson
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Re: Verapamil Dosing
Reply #1 - Jul 24th, 2014 at 4:27pm
 
With the increased dose you should have a routine EKG to keep an eye on your heart. I assume your doc is aware of this issue.

Timing of the dose is not important because is takes some time before a dose change becomes effective, i.e, it's a slow acting med.
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FYI.
J Headache Pain. 2011 Apr;12(2):173-6. Epub 2011 Jan 22.
Cardiac safety in cluster headache patients using the very high dose of verapamil (=720 mg/day).
Lanteri-Minet M, Silhol F, Piano V, Donnet A.
SourceDépartement d'Evaluation et traitement de la Douleur Médecine palliative, Pôle Neurosciences Cliniques du CHU de Nice, Hôpital Pasteur Avenue de la Voie Romaine, 06002 Nice Cedex, France. lanteri-minet.m@chu-nice.fr

Abstract
Use of high doses of verapamil in preventive treatment of cluster headache (CH) is limited by cardiac toxicity. We systematically assess the cardiac safety of the very high dose of verapamil (verapamil VHD) in CH patients. Our work was a study performed in two French headache centers (Marseilles-Nice) from 12/2005 to 12/2008. CH patients treated with verapamil VHD (=720 mg) were considered with a systematic electrocardiogram (EKG) monitoring. Among 200 CH patients, 29 (14.8%) used verapamil VHD (877±227 mg/day). Incidence of EKG changes was 38% (11/29). Seven (24%) patients presented bradycardia considered as nonserious adverse event (NSAE) and four (14%) patients presented arrhythmia (heart block) considered as serious adverse event (SAE). Patients with EKG changes (1,003±295 mg/day) were taking higher doses than those without EKG changes (800±143 mg/day), but doses were similar in patients with SAE (990±316 mg/day) and those with NSAE (1,011±309 mg/day). Around three-quarters (8/11) of patients presented a delayed-onset cardiac adverse event (delay =2 years). Our work confirms the need for systematic EKG monitoring in CH patients treated with verapamil. Such cardiac safety assessment must be continued even for patients using VHD without any adverse event for a long time.

PMID:21258839[PubMed]
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Bob Johnson
 
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koctail
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Re: Verapamil Dosing
Reply #2 - Jul 25th, 2014 at 6:07pm
 
Thanks Bob, for the info....I have been on Verapamil for proably 7 years at 480mg and my Dr has never said anytihng about an EKG. Probably would be wise huh...My Neuro did OK me to increase to 600 and if I stay on for a while I will ask him about EKG.
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blacklab
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Re: Verapamil Dosing
Reply #3 - Jul 25th, 2014 at 11:15pm
 
koctail Hi
            if your taking the d3 regime, with all the co factors ?  including calcium ?   The calcium can effect the verapamil, the trick is to take it 12 hours apart. so because your taking a morning dose and an evening dose of verapamil, I would drop the calcium from the vit d3 regime.
usually its best to take the regime at night with the fattiest meal of the day, but if it includes calcium, that would make your evening dose of verapamil  less effective !!!!
  are you taking every one of the co factors in the regime ?

cheers
col
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koctail
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Re: Verapamil Dosing
Reply #4 - Jul 28th, 2014 at 1:30pm
 
Hey blacklab....funny you bring that up. I have been doing the D-3 regimen for a couple years now but never did the calcium portion due to verapamil conflict, but I just noticed when going through all my meds that my kirkland multi vite that i would take every morning along with my verapamil had 200 mg of Calcium in it. I stopped taking the multi vites altogether. I bumped up to the 600 starting on Friday the 25th. Still having CH breakthrough but manageable and one this morning was quickly aborted with O2.

Odd thing is even at 480mg I would get swelling in ankles/feet. i have noticed little to no swelling even with bumping up to 600mg....maybe its too early to see it. Verapamil has really worked for me in the past so hoping temporarily bumping up to 600 and stopping calcium supplements will do the trick. I am also busting with RC seeds.
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blacklab
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Re: Verapamil Dosing
Reply #5 - Jul 30th, 2014 at 11:26pm
 
Hi koctail,
              ive just gone off verapamil, 3 months ago, so im stand alone on the regime,  going thru a cycle at the minute, which im trying to control with increasing the d3 portion.  Hey, I wouldn't stop taking the multi, just take it at night, taking it 12 hours apart and the calcium wont effect the verapamil. but the important co factors in the multi are a must for the d3 absorption,  its turning out that the k2, magnesium d3 and calcium all work so closely together, to get where we need to be.  things like vit a, boron etc etc are also in the multi. If you have to drop the multi, talk to batch about foods that can replace all those necessary elements you'de miss out on.....
good luck with it all
colin
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Bob Johnson
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Re: Verapamil Dosing
Reply #6 - Aug 3rd, 2014 at 1:47pm
 
The Disclaimer statement at the bottom of this page is more than a CYA protection for DJ; it's good sense.....
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Bob Johnson
 
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shoot
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Re: Verapamil Dosing
Reply #7 - Aug 5th, 2014 at 2:58am
 
I too would not drop the calcium from the D3 reg,the way I understand it the D3 will find calcium to react with even if it has to deplete it from your bones,I have read material both supporting and denying the claim that Ca will interfere with verapamil efficacy but Im sure if you space them out it shouldnt have any bearing. Ive also read several sources that claim the rapid release verap is more effective than the timed release for CH. I take both,the timed release when Im not very active and the rapid release during the day and evening when Im most active. I felt like the timed release was wearing off during the day but fine for late evening and while Im sleeping,think it may be metabolism. If you read the entire D3 reg as Batch presents it,he describes in detail the roles that the cofactors play and you will understand the importance of taking them all,your mileage may vary but I believe you void your warranty if you dont take the entire regime. The D3 reg is not presented as an ala carte,you need to eat everything on your plate.
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feisty
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Re: Verapamil Dosing
Reply #8 - Aug 5th, 2014 at 3:53pm
 
shoot wrote on Aug 5th, 2014 at 2:58am:
If you read the entire D3 reg as Batch presents it,he describes in detail the roles that the cofactors play and you will understand the importance of taking them all,your mileage may vary but I believe you void your warranty if you dont take the entire regime. The D3 reg is not presented as an ala carte,you need to eat everything on your plate
Having extensively researched D3 from a number of sources, I strongly agree with Shoot.
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Smiley wife of 48 year old husband who suffers from episodic CH ~ Batch's Anti-Inflammatory Regimen works!
 
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