Missed Verapamil

[HeadCase]

Anyone had any experience with a Cluster cycle irrupting after missing a dose of Verapamil? I am generally very careful to always take my verapamil and always around the same time each evening. Thursday night I missed a Dose and I’ve been in a perpetual state of CH shadows for days with Nocturnal Attacks every night now for 3 nights....it’s sucks. I’ve been almost headache free for several months other than an occasional headache that I’ve been able to abort with O2.

[jon019]

.....what's yur dosage?

....timing of doses....just the one?

...immediate release or extended?

 

[HeadCase]

47 minutes ago, jon019 said:

.....what's yur dosage?

....timing of doses....just the one?

...immediate release or extended?

 

Verapamil 240 xr once daily. I take it evenings.

[jon019]

...missing one dose and having breakthroughs sounds like you've found the bottom of the effective dose for you....called titration. is GOOD to know...

....240 is on the low end.....most reported effectiveness is 320-480 mg/dy in DIVIDED doses (through out day). for me, anything below 480 was useless and i went up over 1000 in high cycle. not recommending that high, just reporting experience and observation of these forums...

.....verap is a very dose dependent med for CH control...clusterheads can tolerate doses that are way above that needed for blood pressure control. scares docs who are unfamiliar. hoping yours is not reluctant to up your dosage...just one more notch (80 mg tabs) to start would seem prudent...

...depending on your cycle you may be able to ramp back down in between....

....there are those who feel stop/start results in ineffectiveness in the long run....this should be discussed with an experienced hedache physician. my cycles too close together to determine personally..... 

....since it can cause heart rhythym problems is always a good idea for a baseline ecg and any time dosage increased.

.....extended release is reported by many clusterheads to be less effective than immediate release...xr never worked for me but that could well have been that blood levels not high enough due to slow release. even if you and your doc decide not to increase dosage, you should try the immediate release verision...

.....if you know your cycle hit times you can time doses to several hrs before anticipated hit. it's definitely a crap shoot, but on occasion i'm sure it helped...not really possible with xr...

.....feel free to pm if you want to talk about off line...

best

jonathan

[dmlonghorn]

Yeah, I would get activity after missing a single dose of verap. I was taking 240mg 3x per day.

[Sog]

same here re attacks after missing a dose, my Dr told me if I forget/miss a dose, to take it between the next 2 doses. It certainly lessens the shadows/attacks that followed for me. I'd get around 5 days of attacks if I missed one dose but if I took it between doses it would be 2 days tops.

oddly, the same thing happened when I changed brands, same dose, same name, different brand name... 5+ days of attacks, it took me ages to figure that one out!

(I'm on 420mg SR/MR once a day, SR/MR in UK = slow or modified release)