Hoping for advice on change of meds.

[Ilovedogs12]

Hello,

I have been taking Diltiazem (Adizem XL 240mg) daily at noon and it is slow release over 24 hours.

Now I have to stop taking it and start Ranolazine 375mg modified release, twice daily.

So do I take the last Diltiazem and then take the first Ranolazine 24 hours later at noon the next day?

Would that mean I will take it at noon and midnight, which is impractical for me as I am always in bed by 10, or can I adjust the times somehow?

I rang the surgery to ask but didn't get a straight answer, so I'm hoping someone here will have had a similar experience and be able to help. Thanks.

[BenHall1]

I can't help as I don't use either of those drugs. Perhaps you could have a chat with the Pharmacist who received your prescription from your surgery. Pharmacists generally have a better understanding of how drugs work and interact.

[Ilovedogs12 in reply to BenHall1]

Thanks Ben.

I collect my medication from the surgery, it's all done in-house. And it was the pharmacist at the surgery who gave me the unclear answer - maybe I didn't put my question to her well enough?

I rang again this morning but she was on another call and I was told she will ring me back. I'm still waiting but it is Monday morning so I'm making allowances. Big heavy sigh!

[BenHall1 in reply to Ilovedogs12]

Sorry to read that. My next bit of guess work is .... do you have the NHS App ? May be there is something on it 😀 Another thought is .... is there a pharmacy advice section on the NHS website, sometimes they list phone numbers. Good luck.

[Ilovedogs12 in reply to BenHall1]

Thanks, nothing on the NHS app. But CarerEdi has suggested calling the cardiac nurse - I don't have one but I have a phone number for my cardiologist's secretary so if I don't get a proper response from the surgery pharmacist I'll give her a call.

[BenHall1 in reply to Ilovedogs12]

Oh dear 😥 must admit I tried talking to our surgery pharmacist the other day .. a 4 week wait 😱😱😱😱

[Ilovedogs12 in reply to BenHall1]

😟😢😟

[CarerEdi]

Hi llovedogs12! So my mum is on Angitil SR (Diltiazem slow release 90mg) but swapped over from verapamil (calcium channel blocker). When we were on the verapamil, which was 2 daily, she used to feel unwell as she was not taking it every 12 hours (e.g. 10am, 10pm). Opposite to you she was a late riser so sometimes taking at 11am and then second dose at 9pm. You could tell when she had gone too many hours without as she'd be tired during the day. For the Angitil, she takes it every morning, around 10am. I wonder if you could take the Ranolazine at 10am and 10pm, or even 9am and 9pm if that suits you better? However I have no medical training so this is only speculation. For things like this, we found the cardiac nurse very helpful - have you got access to a cardiac community nurse? You can ask your GP to refer you, if she hasn't already. Otherwise I'd try to call the hospital cardiology contact number if you have one, from your last cardiology appointment to confirm the best times and how to transition to the new drug. We found when it came to very detailed questions like swapping meds and side effects, the GPs didn't quite have the in-depth knowledge. Whereas the cardiology nurse has a lot of patients on the books who've been through the same thing, as well as more complex cardiology cases. In my mums case, she was put on the Angitil as the other meds triggered severe Raynaud's. It was the cardiology nurse who we were able to call when things were bad or dosage was insufficient. I really think someone with cardiology expertise will be better to talk to rather than a regular pharmacist or GP (no offense to either).

[Ilovedogs12 in reply to CarerEdi]

Thanks, great suggestion.

I don't have a cardiac nurse but I have a phone number for my cardiologist's secretary so I'll give her a call.

You've been very helpful 😊

[Tapanac in reply to Ilovedogs12]

Admin Tracy or Holly on this forumare very knowledgeable so try getting hold of them and they might be able to help

I have changed the times of my pills although not the same as yours, and I find 8.30am and 8.30pm works for me

All the best

[Ilovedogs12 in reply to Tapanac]

They would be good times for me too. I've eventually got hold of the pharmacist at the surgery this morning and she's given me the information I needed.Thanks for the suggestion though, it's good to bear in mind that they're around.

[Tapanac in reply to Ilovedogs12]

👍

[Parya]

Hello I have found that anything like this for med timings or interactions with anything my local high Street pharmacist is instantly available on the phone or in person I had to swap times with a few of my meds recently and I took them to the shop and he went through which ones could safely be moved they are highly trained after all people tend to forget what a valuable resource they are .

[Twosumsmum]

I am on both , you can take straight away , why are you not going to be on both

[Ilovedogs12 in reply to Twosumsmum]

I am on both, but it wasn't clear to me. When I originally spoke to the pharmacist she said she was getting the Ranolazine in for me. She said I should carry on with the Diltiazem until it came, then start the Ranolazine twice a day.I misunderstood her, I thought she meant continue with the Diltiazem until I had the Ranolazine, then stop it and begin the Ranolazine. So when I was asking her about timings she misunderstood me and it was all a mix up.

So it's a good job I have spoken to her this morning and sorted it out.

Do you find any benefit from taking both?

[Twosumsmum in reply to Ilovedogs12]

Absolutely helps

[Ilovedogs12 in reply to Twosumsmum]

That's good to hear, hopefully I'll be the same 🤞

[Twosumsmum in reply to Ilovedogs12]

I am on 375mg Ranexa twice a day , I did do up to 500mg but the lower dose suited me best , I keep the higher dose for when I am having a bad patch . I see by your photo you are young , does your chest pain come with your menstrual cycle? Mine did all my life and cold temperatures and stress was more immediate. I also have nicorandil ( depending on where in the world you live if it’s available) I am in Uk

[Ilovedogs12 in reply to Twosumsmum]

I'm on the same dose, 375mg twice a day.

I'm afraid that isn't a photo of me, I didn't put one on here and I don't know where that one came from.

I just assumed we were all given one at random 😁.

I'm 67, and my problem started almost two years ago when I had covid immediately followed by a terrible bad cough with staphylococcal aureus. Apart from my heart issues I have been left with problems with my right lung, which is all very frustrating because I have always been very healthy until then.

But I'm always hoping to eventually make a full recovery, I don't know whether I can or not but I look after myself and hope for the best.

[ozziebob]

You said you don't have a cardiac nurse, but the BHF have a free service to talk to a cardiac nurse, weekdays 9am-5pm (excl bank holidays). Just in case the need arises.

[Ilovedogs12 in reply to ozziebob]

That's a brilliant piece of information Bob! It's good to know someone knowledgeable is available, thank you so much for sharing this ❤️

[JOY2THEWORLD49 in reply to ozziebob]

Hi Bob

I see BHF are offering their services in NZ too.

cheri JOY. 76 (NZ)

[JOY2THEWORLD49]

Hi

Diltiazem I take 120mg CD changed from 180.

Diltiazem is very dramatic in the Heart Rate. Not so much in BP control.

What is wrong with your alarm if you wish to be exact?

I have not heard of the substitute or are you taking Diltiazem with an anticoagulant? I would never take these together.

My Diltiazem 120mg CD is taken up immediately and works showing within 2 hours and wears off afternoon.. especially to allow my normal 47avg at night.

I have a super chemist lady. She is also into natural pharmacuticals.

cheri JOY 76 (NZ)

[Ilovedogs12 in reply to JOY2THEWORLD49]

Hi Joy,I had my alarm set for the Diltiazem. In fact I have a pre-alarm alarm. It goes off 15 minutes before I need to take the tablet to give me notice in case I'm in the middle of something and will need to break off. Then the actual alarm goes off 15 minutes later and I take my tablet.

I've now set my alarm for the Ranexa and it has just gone off - 9pm here in UK.

I'm taking it at 9am and 9pm, and I take the Diltiazem at 12 noon.

[JOY2THEWORLD49 in reply to Ilovedogs12]

Hi,

What is RANEXA? I've never heard of it.

Reducing pills daily is great.

125mg Synthroid for ca thyroidectomy 5-7am

1 x Diltiazem 120mg CD 8am

Twice PRADAXA 110 10am & 10pm. Chose not to have big dose once day.

Taking AMOZIL-CLAV for UTI 7 days worth 3 x 8hrly day. Last day!

My 5 days B12

Oh well keeps me alive I guess

133/79. 80s

cheri JOY

[Ilovedogs12 in reply to JOY2THEWORLD49]

It's Ranolazine Joy, a brand name. I don't know what kind of medication it is, but I had a 24 hour ECG and it was still showing a large number of bigeminy and trigeminy beats so my cardiologist added it to my diltiazem to try to get it under control. It says on the leaflet that it's usually used for angina which I don't have, but every medication I have been given seems to be used for other things so there's nothing new there.

I took the first lot yesterday and I have to say I have noticed a huge improvement, my heart has been calm overnight and I have just taken a reading on my Kardia and it was NSR and a lovely neat regular pattern. 56 beats per minute, BP 107/67.

Mind you, it's usually this way with every change of medication for the first few days and then it kicks off again. Hopefully this time... 🤞😁

[JOY2THEWORLD49 in reply to Ilovedogs12]

Hi

Medical tells me it is an anti-angina med. It does not bring down to control BP or H/Rate .. so what does it do???

I don't have symptoms unless my H/Rate is over 100. Then sweating, fatigue is there. AF persistent.

Your BP remains low. 120-130 over 80 would be better Day avg. for your H/Rate.

Diltiazem will bring down your H/Rate dramatically within 2 hours.

I have 1 dose 120mg CD early morning at 8am so that it runs down in afternoon to allow my 47mg avg Night take over.

Low is difficult to control. Your ECG looks nothing like mine. A have a sharp narrow spike in each sub picture but it looks regular inside irregular.

Your specialist will advcate what is best for you.

Try not to get anxious.

Cheri JOY