Verapamil?

[Bonnie58]

Hi, need to pick your clever brains.

I am 62, have tachy brady syndrome. Had cardioversion for Af in March last year and returned to NSR until had brady in 30s in Sept and had dual chamber pacemaker fitted beg of Oct. Annoyingly AF returned beg Feb. Increased Bisoprolol helped slightly but couldn't tolerate the side effects. Gp advised by cardiology to switch from Bisoprolol to Verapamil. Started yesterday with Verapamil extended release 120mgs once daily.

I know it is early days but AF is worse controlled, Verapamil doesn't kick in until midday. Does it take a while to get used to Verapamil, Gp not reviewing dose for 2 wks.

Many thanks,

Elaine.

[Hidden]

bnf.nice.org.uk/drug/verapa...

Is this Half-Securon SR?

In hypertension, the dose seems to be given twice daily after 240mgs daily

One for your GP, perhaps. Are you in paroxysmal still?

[Bonnie58 in reply to Hidden]

Thank you for replying Badger.

Yes Half Securon SR. Am mostly in Af, rates vary depending on time of day and whether am sedentary or pottering about the house.

Just wondered if anyone has had a similar experience with Verapamil..

[Hidden]

Did your cardiologist specify the slow release form of verapamil?

medsafe.govt.nz/Profs/Datas...

[Bonnie58 in reply to Hidden]

I don't know, sorry.

[Hidden in reply to Bonnie58]

Section 5.2 in the paper gives details of half life: also peak levels after each dose, between four and five hours. I think! I suppose that might explain why at this very early stage, verapamil doesn’t seem to be kicking in straight away. Maybe there is still some bisoprolol in your system. Biso and verapamil can interact to cause bradycardia but your pacemaker will deal with that. I don’t know whether the combination can cause fast rhythms.

If your GP practice employs a Clinical Pharmacist, she will be very well placed to advise you. You could also ask if the slow release preparation is best suited to treating atrial fibrillation. It does not seem to be mentioned as being used normally for supraventricular dysrrhythmias, of which AFib is one.

I have not had Verapamil myself.

medsafe.govt.nz/Profs/Datas...

[Bonnie58 in reply to Hidden]

Many thanks, I suspect I will need to consult with Gp sooner rather than later.

[Truckerclark]

I’m on slow release verapamil and it takes a while to get used to it ,I’ve git single pacemaker fitted ,but I’m on 340 mg. I take in the morning ,,,but it did take a while to get best amount to help ,,,I’m sure yiur cardiologist will up yiur dose to help you ,

[Bonnie58 in reply to Truckerclark]

Thanks for your reply, that is reassuring, is it usual to wait 2wks before increasing dose if needed?

[Truckerclark in reply to Bonnie58]

Yes ,it takes time to start working properly so they normally give you few weeks to check see how you are with each change ,,, I was put on slow release as normal one made me so tired all the time ,that you’ll get used to , have a nap when you need it at first ,

[Bonnie58 in reply to Truckerclark]

Naps are good 😁

[Spinners]

Hello Bonnie.

I changed from bisoprolol to verapamil last year. I take a 120 mg slow release twice daily. I was very careful to eliminate the bisoprol from my system and then started with one dose in the evening for a few days until my body was used to it, then increased to both. Wouldn't go back now as it has completely removed the bisoprolol brain fog which made me feel like a zombie sometimes. I do suffer from swollen ankles now and a sluggish digestive system, but it is worth it for the lack of total apathy I felt with the bisoprolol. I also don't have to worry about my BP or pulse any longer.

Hope you have a similar good result. It does take a while before everything settles down, so do not give up too soon.

By the way. I have permanent Afib, but live with it quite happily.

[Bonnie58 in reply to Spinners]

Thank you Spinners for your encouraging reply. I realise now it will take time to adjust to the med switch. I suppose I am disappointed that the AF has returned and I have to learn to live with it.

I was on the point of recommencing my work, I work for myself as a gardener, I was getting used to the new pacemaker, so this seems like yet another setback. Am still hopeful that in time the Verapamil will control AF sufficiently for me to resume most of my activities. Thanks again. Elaine.

[Jaws66]

I have permanent AF, now on 3x80 Verapamil daily. I was previously on Atenolol, a beta blocker, but it had big side effects, so switched. It does take a while to change meds, so I'm not surprised you've been given a fortnight. I have no idea what sort of release my Verapamil is, but I now take 2 first thing in the morning, and one about 4pm. Apart from constipation and diuretic effects which I can live with, I don't have major side effects. It did take a few weeks to get used to it, and for the first few years I took one tablet every 8hrs, but my cardiologist said it didn't really matter as long as I take them. I've tried once or twice taking all three first thing in the morning, but felt sluggish jogging at lunchtime.

Medication changes aren't instantaneous, and it takes a while to get used to your body getting used to them. Speak to your GP about your dose/concerns, as everyone reacts differently.

[Bonnie58 in reply to Jaws66]

Many thanks it helps knowing others have had a similar experience. I am probably also getting the beta blockers out of my system. Patience is a virtue!

[Jaws66 in reply to Bonnie58]

It is indeed, and beta blockers are quite powerful. When you see your GP, grill them about when to take tablets etc. I try to have a list of qns when I go, to be prepared. Also, your dose is just a starting point, so may need tuning.

[Bonnie58 in reply to Jaws66]

Indeed, I am starting to feel the beta blocker fog lifting. They really dragged me down.