So What Is A Migraine Exactly
Its a common misconception that migraine is just a headache. The reality is migraine is a neurological disease that affects about 12% of people in the U.S.most of whom are people assigned female at birth. Indeed, people with vaginas are approximately three times more likely than those without to have migraine, most likely because of the hormone estrogen.1
Youll know you have a migraine because it typically comes with debilitating symptoms, and not just head pain. Though severe head pain, often on one side of the head, is a major symptom. It may feel like a throbbing, pulsing, or stabbing sensation that gets worse with physical activity. You may also experience nausea, vomiting, and sensitivity to light, sounds, and smells.
Another defining feature, that some, but not all, people with migraine experience is aura. This involves visual disturbances before the attack begins, such as flashes of light, sparklers, squiggly lines, blurred vision, or even vision loss that usually resolves within an hour.2
What Are The Possible Side Effects Of Taking Verapamil
Verapamil has some side effects. For most people, these are mild and go away with regular use.
But some people can experience serious side effects with verapamil. If you experience a serious or life threatening reaction to verapamil, call 911 or get to an emergency medical center immediately.
This is not a complete list of all the possible side effects and interactions of verapamil. Your doctor or pharmacist can provide more information about all the side effects and interactions of verapamil.
Only Day 5 Of Verapamil For Vestibular Migraines And I Have Side Effects
I was given verapamil to take in increasing dosages starting at 40 mg for the first week and then increading dosages over the 2nd and 3rd weeks. Now it’s only day 5 of the first week and the side effects of extreme fatigue and acid reflux have steadily increased. the other day I took my 40 mg dose and fell asleep as I was sitting on the couch about 30 minutes later. Today I thought I was going to pass out as I was taking a walk and the acid reflux is so bad today it feels like someone is grabbing ahold of my throat and strangling me. My throat also burns. Has anyone else had these kinds of reactions on such a low dose? I’m afraid to even take 40 mg tomorrow, much less increase the dose with a second 40 mg the following day 7.
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Before Taking This Medicine
You should not use verapamil if you are allergic to it, or if you have a serious heart condition such as:
“sick sinus syndrome” or “AV block”
very low blood pressure or
if your heart cannot pump blood properly.
You may not be able to use verapamil if you have:
severe congestive heart failure
certain heart rhythm disorders
a heart condition that causes you to have very rapid heartbeats or
if you are receiving an intravenous beta-blocker .
To make sure verapamil is safe for you, tell your doctor if you have ever had:
congestive heart failure
liver disease or
a nerve-muscle disorder such as myasthenia gravis or muscular dystrophy.
It is not known whether verapamil will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breastfeed while using this medicine.
Verapamil oral is not approved for use by anyone younger than 18 years old.
Who Can And Cannot Take Verapamil
Most adults can take verapamil. It can also be given to children aged 1 year and over.
Verapamil is not suitable for some people. To make sure verapamil is safe for you, tell your doctor if you:
- have ever had an allergic reaction to verapamil or any other medicine
- have liver problems
- have any other heart problems, including heart failure, or a very slow or irregular heart rate
- have a heart condition called Wolff-Parkinson-White syndrome
- are trying to get pregnant, are already pregnant or breastfeeding
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Which Migraine Medications Are Safe To Use During Pregnancy
Migraine headaches may become less frequent during pregnancy. However, in rare cases, migraines may appear for the first time during pregnancy or become worse. Non-drug therapies are considered to be safer during pregnancy, they should be tried first. Non-drug therapies such as relaxation, sleep, massage, ice packs, and lifestyle changes are considered first-line options during pregnancy.
If drug treatment is required, acetaminophen is usually the treatment of choice. When used appropriately, acetaminophen treatment does not affect the pregnancy or the unborn baby.
Nonsteroidal anti-inflammatory drugs are considered second-line options and thought to be safest in the second trimester. They should not be used near the time of birth. Opioids are third-line options. Prolonged use of opioids may cause addiction and dependence in mothers and children.
Triptans are reserved for moderate-to-severe symptoms in women who have failed to adequately respond to other treatments. Sumatriptan is the oldest and most studied triptan in pregnancy. A pregnancy registry for sumatriptan did not find an increased risk of birth defects or miscarriage in 600 patients who were treated with sumatriptan during pregnancy.
Ergotamines should not be used during pregnancy as they may potentially induce hypertonic uterine contractions and vasospasms/vasoconstrictions which can cause harm to the unborn baby.
Cautions With Other Medicines
Some medicines can affect the way verapamil works.
Taking verapamil with other medicines that lower your blood pressure can sometimes lower it too much. This may make you feel dizzy or faint. If this happens to you, tell your doctor, as they may need to change your dose.
Tell your doctor if you are taking any of these medicines before starting verapamil:
- antibiotics, such as clarithromycin, erythromycin or rifampicin
- antifungal medicines, such as itraconazole or ketoconazole
- ivabradine, a medicine for angina and heart failure
- darunavir or ritonavir, medicines that treat HIV or hepatitis C
- epilepsy medicines like carbamazepine or phenytoin
- medicines that suppress your immune system, such as cyclosporin or tacrolimus
- more than 20mg a day of simvastatin
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Isometheptene Dichloralphenazone And Acetaminophen
This combination drug has sympathomimetic properties. Isometheptene, in particular, dilates cranial and cerebral arterioles, causing a reduction in the stimuli that lead to vascular headaches. Dichloralphenazone has sedative and analgesic properties. Acetaminophen inhibits the synthesis of prostaglandins in the central nervous system and blocks pain impulses generated in the periphery.
How To Take Verapamil
Swallow your tablets whole with a drink of water. Do not chew or crush them, as it’s important that they go into your stomach before they dissolve.
You can take verapamil at any time of day. It may help you to remember if it’s the same time each day.
If you’re taking verapamil as a liquid, it will come with a plastic syringe or spoon to help you take the right amount. If you do not get one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give you the right amount.
You can take verapamil with or without food.
It’s important not to eat grapefruit or drink grapefruit juice while you’re taking this medicine. Grapefruit can increase the amount of verapamil in your body and make side effects worse.
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Which Medications Are Used For Preventing Migraines
Preventative therapy should be considered for patients who suffer from recurrent migraines that cause significant disability, frequent migraines that require treatment more than twice a week, or migraines that do not respond or respond poorly to symptomatic treatments. Currently there are no drugs that specifically target and prevent migraines. Certain blood pressure medications as well as some antidepressants, anti-seizure drugs, and herbals have been shown to have beneficial effects in preventing migraine headaches. It’s important to understand that prophylactic medicines may not produce any significant benefits right away and maximal effects may not be seen for weeks to up to 6 months.
Although a number of medications have been used for the prevention of migraines, the medications that have been shown to be effective in controlled clinical trials, and are therefore recommended by the American Headache Society and the American Academy of Neurology migraine prevention guidelines include:
The side effects associated with the herbals used for migraines include burping and gastrointestinal issues.
CGRP antagonists have fewer side effects than many other migraine medications and may include:
- Pain at the injection site
How And When To Take Verapamil
Take verapamil exactly as your doctor has told you and follow the instructions that come with your medicine. If you’re not sure, ask a pharmacist or your doctor.
Verapamil comes as standard tablets, slow-release tablets, and a liquid .
Slow-release tablets release the medicine gradually into your body. This means you do not need to take them as often.
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What If I Forget To Take It
If you forget to take your medicine, take it as soon as you remember unless it’s nearly time for your next dose. In this case, leave out the missed dose and take the next one at the usual time.
Do not take 2 doses at the same time to make up for a missed dose. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
Report Problems With Your Medications To The Fda
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
For more information, visit the Duke Health Pain Disorders Center
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A Review Published In Headache Indicates That Existing Research Supports The Use Of Verapamil Dr Katherine Hamilton Weighs In
Verapamil is the drug of choice for cluster headache prevention for three decades running. Despite this, its mode of action and therapeutic target are still unknown. This lack of understanding was the basis for a recent review published in Headache®, where Rigmor Jensen, MD, of the Danish Headache Center and colleagues evaluated existing literature dealing with the effect of verapamil and other calcium channel blockers in cluster headache treatment and investigated its possible effect mechanisms.
Katherine Hamilton, MD, of the University of Pennsylvania, reviewed this article for the American Headache Society. Dr. Hamilton says verapamil is one of the most commonly used medications for cluster headache. She highlights, however, that there are not a lot of studies dealing with verapamils use in this manner. But Dr. Hamilton says much of the research that does exist appears to indicate that it is effective for cluster headache treatment.
There is definitely evidence to support the use of verapamil in cluster headache prevention, she says. There are limitations on the studies that exist, but we have to go on what evidence we have.
What Are The Warnings And Precautions With Migraine Medications
In 2006, the FDA warned about combining triptan drugs with selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors . Taking the drugs together could cause an overload of serotonin in the body, causing what is known as the “serotonin syndrome.â Symptoms of this life-threatening condition include a rapid increase in blood pressure, fast heart rate, and increased body temperature.
The use of topiramate can result in decreased sweating and increased body temperature. This may be especially concerning during hot weather. Wearing light clothes and drinking plenty of fluids while using topiramate during warmer months is very important. A physician should be consulted if body temperature rises.
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Butalbital Aspirin And Caffeine
This combination drug is effective for mild to moderately severe migraine headache. The barbiturate component has a generalized depressant effect on the CNS. Caffeine is used to increase GI absorption. However, butalbital and narcotics are associated with rebound headaches. Increasing the use of combination preparations may fail to provide pain relief and may worsen headache symptoms.
Other Things To Know About Verapamil
Before starting treatment with Verapamil, patients should talk to their doctor about all their medical conditions. Some people should not take Verapamil, including those withsevere heart abnormalities, low blood pressure, poor heart function, certain heart rhythm problems, certain types of blockages in the heart called second or third degree atrioventricular block, rapid heart rate or any allergic reaction to Verapamil.
Patients should talk to their doctor about all their medications , supplements, and herbal remedies they are taking. Some medications should not be taken with Verapamil, including CYP3A4 inhibitors. Other medications taken in combination with Verapamil may require close monitoring by a doctor, including simvastatin, lovastatin, beta blockers, and digoxin.
Grapefruit juice can significantly increase the levels of Verapamil in the body.
Drinking alcohol while taking Verapamil can increase the blood alcohol concentrations and prolong the effect of alcohol in the body.
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Identifying And Managing Triggers
Migraine triggers are specific to individuals. A headache diary is a helpful tool to aid patients in identifying particular triggers, monitoring the number of headache days, and documenting therapeutic response. Common triggers include delayed or missed meals, menstruation, stress, weather changes, alcohol, and certain odors. Common dietary triggers include chocolate, soft cheeses, red wine, and artificial sweeteners and additives such as monosodium glutamate.5,6 Caffeine can be helpful in relieving headache pain, but acute withdrawal from daily consumption can be a trigger . After triggers are identified, a physician can recommend ways to manage these triggers, such as avoiding certain foods, establishing regular mealtimes, managing stress, and evaluating and treating underlying sleep disorders or psychiatric conditions.
Should You Try Lifestyle Changes And Home Remedies For Migraine Relief
In addition to taking OTC and prescription meds, there are lots of things you can do to manage migraine episodes on your own. At the first sign of an attack, lay down in a dark, quiet room and put a cool cloth or ice pack on your head . You can also try out a few lifestyle adjustments to avoid migraine triggers and help keep attacks at bay, per the Mayo Clinic:
- Develop a sleep routine: Try waking up and going to bed at the same time every day . An erratic sleep schedule can trigger a migraine.
- Eat at regular times: Fasting can increase your risk of migraine. Thats why its a good idea to eat meals at the same time every day if you can, and have a snack or two throughout the day to keep your blood sugar steady.
- Stay hydrated: Drinking lots of water can help stave off migraine.
- Get a workout in: Exercise is a great stress-reliever and can help prevent a migraine . Just be sure to warm up slowly.
- Keep calm: Relaxation techniques like meditation and biofeedback can help reduce stressand possibly the number of migraine attacks you get each month.
- Keep a migraine diary: It can be helpful to write down when your migraine started, what may have triggered it, how long it lasted, and what you did for relief . This can help you and your doctor track your progress and adjust treatment as needed.
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Articles On Migraine & Headache Prevention
Anticonvulsants. These are medicines that prevent or reduce seizures. Your doctor may recommend topiramate or valproic acid to prevent headaches. Anti-seizure drugs could make you sleepy. You may also find it harder to focus.
Beta-blockers. These relax your blood vessels. Theyâre often prescribed to control blood pressure. For migraines, your doctor may suggest atenolol , metoprolol , nadolol , propranolol , or timolol. Side effects include feeling depressed and having problems during sex.
Botulinum toxin . A doctor can inject small amounts around your face and scalp every 3 months to keep migraines from happening. This treatment is approved only for people who have headaches at least 15 days a month. The more often you have migraines, the better Botox seems to help.
Calcium-channel blockers. These include diltiazem and verapamil . They ease the narrowing of your blood vessels and are also given to treat heart disease. Side effects can include constipation and low blood pressure.