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Can Verapamil consumption be stopped abruptly?

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Posted on Tue, 10 May 2016
Question: Verapamil.

Taking about 1/4 of a 40mg tab twice a day (roughly 10mg) to see if it helps with migraine prevention. Have been taking for about a month.

Not really working, so I am going to stop and try something else as it makes me sleepy and a little less energy.

Can I stop this cold turkey since I am only taking 10mg twice a day?
doctor
Answered by Dr. Ilir Sharka (29 minutes later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I would explain that this is a really low dose of verapamil.

You can stop it cold turkey or just reduce the dose to 1/4tb daily for 2 days and then stop it (in order to avoid possible tachycardia from the abrupt interruption of the drug, which can occur in sensitive persons).

From the other hand, you should know that the dose of verapamil used for migraine prophylaxis is much higher: 160-320 mg/day (divided three times daily).

So the dose of verapamil that you are taking is a really low dose, ineffective in the prevention of migraine headaches.

Before considering stopping it, I would recommend discussing with your attending physician on the possibility of increasing the dose gradually based on your tolerance.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (4 minutes later)
I would try higher dose but the low dose seems to made me more tired, is that normal ?
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Verapamil is not known to reduce the muscular performance. But sometimes in high doses it can do this effect.

Nevertheless this is a really low dose even for this adverse effect.

What are your heart rate and blood pressure values?

It can lead to low blood pressure and low heart rate, which can be perceived like tiredness. Even these effects occur in higher doses. That is why the dose is raised based on the individual tolerance.

If the further increase in the dose of verapamil, lead to increased tiredness, you should discuss with your doctor on the possibility of switching to another therapy.

Hope you will find this answer helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (10 minutes later)
My BP when calm is normally 120/70ish and about the same on low does verapamil. Resting HR around 55 with/ about the same without maybe slightly lower.

I was just a little concerned that the verapamil at that low of a dose was causing some tiredness. I also gained about 4 lbs in a month on that low dose of 10mg x 2 which is such a low dose. Kind of made me think something is wrong with my heart or something. probably just all in my head. I had a echo last spring and results were normal, I have attached it in this email. I can run 2 miles, do 100 pushups, etc. My concern was verampil at that low of a dose causing minor weight gain and mild tiredness pointed to a cardiovascular issue. but with the normal echo I am thinking I am fine and it's just all in my head. I am very very sensative to medications. I tried low dose beta blocker inderal, at just 10mg put my heart into the upper 40s! I also had a 48 Holter last spring, looked great! So I guess I should just try another medication and not think to much about the verapamil. echo report attached.
doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again,

I carefully reviewed your cardiac ultrasound and would confirm the fact that you have a normal cardiac structure and function.

So relax! You have nothing to worry about!

It is true that verapamil could cause fluid retention, leading to weight gain and leg swelling.

Betablockers from the other hand can lead to low physical performance and low heart rate (bradycardia).

Coming to this point, I would recommend discussing with your neurologist on other prevention therapies for migraine like topiramate or amytriptiline.

Topiramate is an antiepileptic drug, very helpful in reducing the severity and frequency of migraine attacks.

Amytriptiline is an antidepressant, as well effecting in migraine prevention.

These drugs should be started in low doses and increased slowly, to prevent from occurrence of adverse effects.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8469 Questions

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Can Verapamil consumption be stopped abruptly?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Thank you for asking on HCM! I would explain that this is a really low dose of verapamil. You can stop it cold turkey or just reduce the dose to 1/4tb daily for 2 days and then stop it (in order to avoid possible tachycardia from the abrupt interruption of the drug, which can occur in sensitive persons). From the other hand, you should know that the dose of verapamil used for migraine prophylaxis is much higher: 160-320 mg/day (divided three times daily). So the dose of verapamil that you are taking is a really low dose, ineffective in the prevention of migraine headaches. Before considering stopping it, I would recommend discussing with your attending physician on the possibility of increasing the dose gradually based on your tolerance. Hope you will find this answer helpful! Kind regards, Dr. Iliri