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Varapamil Tapering Confusion
« on: Feb 16th, 2003, 2:18am »
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Dear Friends,
 
The more advice I get the more confused I am becoming!
 
I live in Kenya, and the nuerologists here don't have the requisite experience with CH (none in fact), thus I am dependent on the literature I can access over the internet and advice from this message board.
 
This is my situation.  I have been headhache free for 8 days and my intuition is that the CH cycle is over.  I took 80 mg of prednisone for 9 days then stepped down to zero mg over the course of 7 days and today is my first day of no steroids. (16 days of steroids!  Never again!)
 
I have been taking 720 mg of verapamil per day for the last 8 days (during the first week of prednisone treatment I was only using 360 verapamil and headaches returned so I upped the dose).  I came to this number just by an educated guess of reading the literature and this message board.  Tablets are 80 mg, thus, I take three for breakfast, lunch and dinner.
 
So my question is after 8 days of 720 verapamil, how do I go about stepping down to 0 mg verapamil?  I have not been able to discern either from the literature or the message board any consistent "rules of thumb".  The advice has ranged from: "stay at 720 for another week or two and then step down to zero over a 2 week period after that" to advice that said "drop by 80 mg a day per day over a 8-9 day period to zero".
 
Sorry for the long post.  All wisdom welcomed!
 
In Gratitude,
 
Mark in Nairobi
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Re: Varapamil Tapering Confusion
« Reply #1 on: Feb 16th, 2003, 11:07am »
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Hi Mark.  You have a very good question, I wondered that as well the first time I was on verapamil.  Part of the reason you are getting such a wide variety of advice is because there isn't really one way to taper off of verapamil.  Alot depends on your situation and what you can tolerate.  The main concern is that you may not want to taper too quickly.  If you rapidly taper down to zero and then realize that your cycle is not over, then you will be suffering until you can get the verapamil level back up to where you need it.  Also, if you taper too quickly you may experience some physical side effects.  When I tapered off of verapamil I felt a little dizzy at times until my body adjusted.  So basically, you may have to start tapering slowly and see how your body reacts.  You may have to do a little experimenting, just be prepared to listen to your body.
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