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Verapamil ER treats high blood pressure or controls angina. The list of conditions treated is short partly due to the fact that this drug is an extended release formula. In tablets that don’t have a slow release, verapamil may have additional approved applications. For example, it might address certain types of arrythmias like supraventricular tachycardia, and atrial fibrillation or flutter. Some controversial applications of extended or non-extended release types of this medication have also been suggested; examples of off-label uses include treating migraines and cluster headaches, and the manic phases of bipolar disorder.
The group of medicines to which verapamil ER belongs is called the calcium channel blockers (CCBs). These medications reduce the amount of calcium that flows into heart cells. The action of CCBs provides greater and more efficient contractility of the heart and dilates or opens blood vessels to lessen resistance.
As a blood pressure medication, verapamil ER is useful due to the way it influences heart and blood vessel function. It can also reduce episodes of angina, but it is not fast acting like nitroglycerin. Patients may still need to keep nitroglycerin or another medication on hand for breakthrough angina pain.
Some pharmaceutical companies occasionally combine verapamil with other CCBs. This may increase its effectiveness in lowering blood pressure. These combination drugs are not advisable for everyone and may increase patients' risk of developing hypotension.
Each calcium channel blocker works differently, and many of them are used to treat certain arrhythmias. Verapamil ER isn’t always a first choice, but non-extended release tablets containing the drug could be used in this way. Often, arrhythmia control may require a more frequent application of medicine than ER formulas provide.
CCBs don’t treat all arrythmias. Heart rhythm dysfunctions like atrioventricular block or sick sinus syndrome can contraindicate the use of verapamil ER. Also, it’s important to note that all CCBs occasionally induce irregular heart rhythms and must be used carefully.
At present, the wisdom of using verapamil ER for conditions like cluster headaches or bipolar disorder has not been proven. Other calcium channel blockers have shown some limited effectiveness in treating these conditions. Unfortunately, all of them increase the risk of very dangerous side effects, including potentially life-threatening arrhythmias. It’s not clear that CCBs are ever a good choice for treatment of these conditions, unless no other options have worked effectively. More study is needed to determine if these off-label treatments justify their risks.
@dfoster85 - You and your husband have my sympathies. I had a bout with cluster headaches a couple of years ago. My wife said she had never seen me like that before. I was crying and banging my head on the wall.
The urgent care doc had just given me the nasal medicine, but then I saw a neurologist who put me on verapamil. From the first dose, I never had another cluster headache. (He also gave me a really good 24-hour NSAID that works well on headaches.)
I have weaned off it now, but while I was on verapamil, side effects were not a problem for me. If your husband has any trouble with it, the doctor may
be able to try another calcium channel blocker or adjust the dosage.
The headaches really do make you useless, so you might need to take charge for your husband and get him to a headache specialist to get him some real medicine. Hope he feels better!
Has anyone tried Verapamil for cluster headaches? My husband has recently become quite debilitated by these; they call them "suicide headaches" because they hurt so bad that killing yourself seems like a reasonable option. (They strike mostly men, but women who've had them say they're worse than childbirth.)
His doctor prescribed a headache medicine in a nasal spray, but it's very expensive and doesn't keep him from getting the headaches in the first place. We're not keen on the idea of prednisone, the other main option for controlling the headaches (he was on it once for something else and couldn't sleep a wink), but he's also concerned about the side effects of verapamil. Anyone have any advice?
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