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Old 08-16-2007, 11:33 AM   #1
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Calcium channel blockers

Hello,

This might be of interest to those of us on calcium channel blockers.
The results of a new study, titled "High dose Verapamil for cluster headache may pose arrhythmia risk" were published on August 13th in the Neurology.

Higher than usual doses doses of Verapamil are used in the treatment of cluster headaches. This is why the doses in the study ranged from 20-1200mg/day, average doses in two groups of patients 512mg and 587mg daily.

These dosages resulted in alarming rates (20&#37 of arrhythmias and bradycardias. There were incidences of 1st and 2nd degree heart block, complete heart block and right bundle branch block. The PR interval on the ECGs normalized AFTER this drug was discontinued. This study highlighted the need for careful ECG monitoring of all patients on this therapy. Routine doses of this drug do not require ECG monitoring> (That does not mean they cannot be harmful!).

I have not gone into much detail because it really bothers me to think that I have been and will remain on one of these drugs. While it proves helpful in improving certain conditions, it also helps create others that may be potentially worse that the original ones. We must be aware of these facts. They could be or already are affecting our health.

When reading about its negative effect on the electrical conduction system in the heart (in this study), I was deeply disturbed. There are other unfavorable traits this medication has. In combination with diuretics, it increases the risk of heart disease. It's been rumored to increase the risk of breast cancer (not sure if these cancer allegations are true) and it can cause heart attacks. All people on this drug should monitor their heart rate. If it dips bellow 50 or becomes erratic, contact your doctor without delay. Do not stop taking it suddenly (as I did) as this can make you very ill and bring on an angina or MI, especially in CAD.

Flowergirl

Last edited by flowergirl2day; 08-16-2007 at 02:16 PM.

 
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Old 08-16-2007, 10:42 PM   #2
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Re: Calcium channel blockers

Thank you very much for posting this information!

While I will probably never have this issue with Verapamil (it is one of the meds I take, but my BP is still rarely under 100 and spikes to 180 just for the heck of it at times) but it is good info to know.

I am reminded of a Editorial Cartoon I saw once... it showed a Dr standing in front of a Man saying "The good news is our new wonder drug has stopped your wife's PMS... the bad news is as a side effect she has grown a penis"
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Old 08-17-2007, 05:37 AM   #3
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Re: Calcium channel blockers

Quote:
Originally Posted by penybobeny View Post
....I am reminded of a Editorial Cartoon I saw once... it showed a Dr standing in front of a Man saying "The good news is our new wonder drug has stopped your wife's PMS... the bad news is as a side effect she has grown a penis"
That sums it up so very well!!

Bethsheba

 
Old 08-17-2007, 07:05 AM   #4
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Re: Calcium channel blockers

Flowergirl,

The thought of all that verapamil is indeed frightening. BUT if it used to abort a cluster headache then ANY risk is worth taking. They don;t call these headaches "suicide headaches" for nothing. I had one (blessedly rare) attack me while I was in New York and getting home was so awful that I actually entertained the idea of throwing myself into the path of an oncoming subway to stop the pain. It gives new meaning to the term CRUCIFYING pain.
If I had to take a SHOVELFUL of verapamil to stop that murderous headache I would have willingly done so.

The headache is unique in that the pain is so bad that the only thing that seems to help a teeny bit is pacing or RUNNING back and forth (unlike migraine where dark quiet rest is sought.) A cluster headache is one of the true horrors of life.

I've never taken verapamil...my doctor once said he'd like me to go on a channel blocker. I said "FINE, I'll try verapamil or diltiazem but NOT Norvasc" which I found to be a truly hateful drug.
He never brought up the subject of channel blockers again nor did he write a Rx so I know pretty assuredly what HIS guiding motive was. Sorry Pfizer!

Last edited by Lenin; 08-17-2007 at 07:11 AM.

 
Old 08-17-2007, 08:09 AM   #5
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Re: Calcium channel blockers

Luckily, I have not had to deal with a cluster headache. The ones I did have, especially my recent six week constant headache, were bad enough. I've never heard anyone describe a cluster headache. They sound prety bad. I always say to myself that things could be worse! (as in being six feet under) That makes everything somewhat more bearable.

As for the calcium channel blockers, reading the article gave me goose bumps and was the reason for this post. I'd recently experienced some of the things described, including a change in the heart rhythm and chest pain. My recent ECG showed the PR interval out of whack. I tended to blame the HCTZ and the edema for these irregularities. Now I am not so sure. I read (just yesterday, on a Canadian pharmaceutical website) that patients should not be given higher than the maximum recommended dose of this medication, due to the unpredictability of adverse affects at higher doses. I think it's affecting me at this "normal" dose. Too bad the doctors won't listen when we start about the side-effects. My doctor insisted on my re-starting the CCBs, despite the edema it had caused, and wants me back on a max dose. Discontinuing the CCBs will be my number one issue to discuss with the specialist next month. He'd put me on Norvasc originally, so the chances are he'll nix the idea. I am hoping to convince him to re-start the beta blockers and drop the CCBs. If successful, I don't know what the BB's will do to my breathing. By the way, one of the side effects of CCBs I dug up is respiratory problems in some people. Sorry for venting, I feel better now.

Flowergirl

 
Old 08-17-2007, 10:55 AM   #6
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Re: Calcium channel blockers

Quote:
Originally Posted by flowergirl2day View Post
...I'd recently experienced some of the things described, including a change in the heart rhythm and chest pain. My recent ECG showed the PR interval out of whack. I tended to blame the HCTZ and the edema for these irregularities. Now I am not so sure....
Well, the change in heart rhythm could be due to a low potassium so I wouldn't rule out the hct which can deplete potassium levels. I just wanted to add that after being on Norvasc/amlodipine (a calcium channel blocker) for about 3 months, I started to experience little pains in my chest that I never had before. The pains didn't last long (a second or two) but I immediately suspected the bp med. Haven't experienced the pains since discoing the med.

Quote:
I read (just yesterday, on a Canadian pharmaceutical website) that patients should not be given higher than the maximum recommended dose of this medication, due to the unpredictability of adverse affects at higher doses....
I think it's safe to say that this applies for all meds.

Quote:
My doctor insisted on my re-starting the CCBs, despite the edema it had caused, and wants me back on a max dose.
I've read that edema is a very serious side effect...but don't know exactly why.

Quote:
He'd put me on Norvasc originally, so the chances are he'll nix the idea...
Did you get headaches with the Norvasc? I forget what you had said.

Quote:
By the way, one of the side effects of CCBs I dug up is respiratory problems in some people. Sorry for venting, I feel better now. Flowergirl
Well, "some people" means just that--not everyone gets those side effects. But if we are informed about side effects BEFORE we get them, life can be easier...and perhaps not as scary. For what it's worth, FG, I didn't have respiratory problems with a ccb...but I definitely did with hct---looking back, that's when I got my first inhaler! Or should I say my "last" inhaler.

Bethsheba

 
Old 08-17-2007, 12:14 PM   #7
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Re: Calcium channel blockers

I guess I should not complain...things could be worse!

You are so lucky, Beth, to be off the meds! I wonder what life would be like without them for me....It's only been 9 months since I started taking mine. I can hardly remember what being med-free is like. It's been one long struggle with the side effects, or so it seems. After a while they seem to merge, making it impossible to tell what's causing what. I am on Nexium now and don't even know why. The pharmacist commented about how sad it was to have to treat the side effects of meds with yet another med. I thought I was on it for another reason. I'll have to ask. The calcium channel blockers scare me. Dealing with nausea, fatigue, shortness of breath and such is one thing; it's quite another to have heart rhythm disturbances and abnormal ECG readings. Some side effects are easy to tolerate. Others are not. We do not appreciate the simple things in life until they are no longer there for us.

I ended up taking my meds last night before going to bed anyway. My blood pressure was high. I guess it's either bite the bullet (and swallow the meds), or take your chances.. I am not going to be flushing the meds down the toilet yet. (don't blame me for thinking about it! ). I don't know what my potassium and other electrolyte levels are. Or the liver enzymes. Have not had the enzymes tested since early April. My doctor told me I should not worry about things like that. (He sure doesn't.) Beth, my long ugly headache coincided with the abrupt withdrawal from alpha/beta blockers (Labetalol). That's the one I was referring to in my post.

Flowergirl

 
Old 08-17-2007, 02:46 PM   #8
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Re: Calcium channel blockers

I would have an apt name for any doctor who kept prescribing CCB's after periperal edema: "EX-DOCTOR."


You women are relatively lucky to be spared a major scourge: cluster headaches are almost universally the bane of men! (And nobody say "Well, it's good they get SOMETHING! ")

Last edited by Lenin; 08-17-2007 at 02:50 PM.

 
Old 08-17-2007, 03:43 PM   #9
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Re: Calcium channel blockers

You have me counting my blessings and feeling lucky!
Things could be worse, I suppose!


I noticed that women have a much better pain tolerance while you guys complain about the slightest ache. We are tougher by nature and certainly no crybabies. It's good to know that the cluster headaches are a "guy thing".


P.S Lenin, I will read up on cluster headaches. They sound downright terrible. I hope to never get one of those and also that you won't have any repeats!


Flowergirl

Last edited by flowergirl2day; 08-18-2007 at 10:22 AM. Reason: adding PS

 
Old 08-17-2007, 05:49 PM   #10
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Re: Calcium channel blockers

Quote:
Originally Posted by flowergirl2day View Post
I guess I should not complain...things could be worse!
You're not a complainer, Flowergirl! You've been through an awful lot with not so much as wimper...you have earned the right to feel what you feel, and then to move on! It may become a problem if one gets "stuck" in one stage, but since you've been on these boards you've been moving, reading, studying, listening, supporting others, laughing, and keeping an open mind. That's ALOT when you're also dealing with side effects that can immobilize your mind, your body, and your spirit! So be gentle with yourself, be kind to yourself, and pamper yourself because you're working hard and because you deserve it!

Quote:
You are so lucky, Beth, to be off the meds!
Yes, right now I'm lucky...but my luck will run out if I don't diet and exercise...I've been given a second chance and I don't want to blow it as I may not be given another.

Quote:
I wonder what life would be like without them for me....It's only been 9 months since I started taking mine. I can hardly remember what being med-free is like. It's been one long struggle with the side effects, or so it seems. After a while they seem to merge, making it impossible to tell what's causing what.
Yes, it must be overwhelming at times...but I think when they find the cause of your conditoon, things will improve radically for you...it just takes time, work, and guts...and work!

Quote:
I am on Nexium now and don't even know why. The pharmacist commented about how sad it was to have to treat the side effects of meds with yet another med.
Your pharmacist is right...it is a HUGE problem in medicine. I think he must be a very good pharmacist to be aware of that problem and to say it openly. Unfortunately, your situation may be different from most, and as a result you may not have as many options as some people do...at least right now.

Quote:
...The calcium channel blockers scare me. Dealing with nausea, fatigue, shortness of breath and such is one thing; it's quite another to have heart rhythm disturbances and abnormal ECG readings. Some side effects are easy to tolerate. Others are not. We do not appreciate the simple things in life until they are no longer there for us.
Yes, I would be scared too as any drug scares me. But we both know that sometimes we have to take drugs until we have better choices. You are at some advantage, though, because you are AWARE of some of the side effects. We both know that all drugs have side effects, some you can live with, some you cannot. But if you are AWARE of the side effects, YOU can DO something about it. I was not aware that hydrochlorothiazide could make me sleep for 12-20 hours a day...because I didn't know it was the hct, I couldn't do anything about it. If I knew that was a possible side effect, I might be able to have an "action plan" ready if I experienced the side effects. You, too, can have an "action plan" beforehand--find out what the side effects might be, find out what to do when you get those side effects, find out if you can go "cold turkey" or if you need to wean yourself off of the med...and this may not make you feel any better, but the side effects I expereinced on Norvasc/amlodipine, were minimal compared to the diuretic, ACE inhibitor, beta blocker, and other meds I've taken. Yes, the sleep problem was disturbing, but high blood pressure might be worse than having to wake up nights (at least I could DO something at midnight, grin).

Quote:
...I am not going to be flushing the meds down the toilet yet. (don't blame me for thinking about it! ).
When the time comes to flush, tell me, and I'll flush at my end, too! But that time will be when they've id your cause, treated it, and are med free!!!!

Quote:
...I don't know what my potassium and other electrolyte levels are. Or the liver enzymes. Have not had the enzymes tested since early April. My doctor told me I should not worry about things like that. (He sure doesn't.) Beth, my long ugly headache coincided with the abrupt withdrawal from alpha/beta blockers (Labetalol). That's the one I was referring to in my post.

Flowergirl
Well, I'm not sure I agree with your doctor that you should not have to worry about things like that...I think you SHOULD be concerned with things like that...but perhaps it's not necessary to test for things like that as long as you feel ok...but again, do be aware of the symptoms of low potassium and electrolyte imbalances. That way you can do something before things get out of control.

Thank you for the reminder of the alpha/beta blocker withdrawal...I was so very worried about you at that time. I'm glad you're not experiencing that now.

I hope you're able to vent and to let out some steam at home...you're going through an unbelievable time right now and the more you can surround your self with people who can listen, will make it easier to do what you need to do to take care of yourself.

In the meantime, give yourself a BIG hug for me!!

Bethsheba

 
Old 08-17-2007, 10:34 PM   #11
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Re: Calcium channel blockers

Thank you for the cyber hug!

Also, many thanks for your incredible post. I was really touched. I am lucky to have such supportive and understanding friends here. These boards are invaluable. We learn so much from others like us. And it's always wonderful to hear of success stories.

I will try to talk to my doctor about my concerns. He avoids discussing certain things and does not give straightforward answers. I think it's wrong to pretend a problem does not exist. It doesn't matter that he means well. There's been a change in his attitude and he now seems eager to get things controlled and/or keep at present levels. His interest may be self-serving but it's good to see regardless.
Beth, I must have frequent kidney function checks and should have the electrolytes done often, too. Also, anyone on medication has to get their liver tested often, because so many drugs are metabolized by the liver. People with reduced/impaired kidney or liver function may run into big problems when metabolizing drugs. The clearance rates just can't keep up with the medication intake and the drugs can quickly build up in the system. The more drugs a person with reduced kidney/liver clearance takes, the better a chance of this happening. My doctor graduated at the top of his class and is not stupid. He knows I need the tests. He knows that I know, too. He just pretends it's no big deal. He told me more than once that he's just trying to make me feel better...or witholding information because he does not want me to worry. I need a complete blood & urine workup before I see the specialist next month. My doctor would not dare to send me there without the labs. When I said in the previous post that he does not worry, I was just parroting his words. I wouldn't worry about this, I wouldn't worry about that...He had me listen to one aria last week before taking my blood pressure. The opera singer was VERY BAD. She sounded wounded. We were in agreement on that. In spite of the horrible song, my blood pressure was good.

To get back on track: you are so right in stressing the importance of being familiar with any potential side effects of the drugs we are prescribed. Everyone should research a new drug thoroughly BEFORE taking the first pill.
The calcium channel blockers are just one of many medications with side effects. Often, after the drugs are released into the public use, new information about adverse reactions to the drugs, unknown at the time of approval for public use, comes to light. That is why it is so important to keep up with ongoing research and keep seeking information. This may be time-consuming, but it is out there for the taking.

Quote:
I hope you're able to vent and to let out some steam at home
Not really. Hubby has enough problems of his own. My girlfriend is right up to date on everything.

Flowergirl

 
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