stopping diltiazem and ranolazine - British Heart Fou...

British Heart Foundation

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stopping diltiazem and ranolazine

14 Replies

hello

Seen cardiologist and long and short of it told me to stop Taking diltiazem amd ranolazine (was taking for 5 and 6 months respectively) and to go back on amlodipine 5mg once day (used to be on this 10mg a day). My last doses were Thursday morning before saw cardiologist.

any one else told to go “cold turkey” and stop, have you had any side effects regards stopping / going out your system?

thanks

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14 Replies
DD13 profile image
DD13

Hi i was on 180mgs of Dilitzem. I was told you have to be weaned off them by lowering the dose until zero. You can't just stop them.

Regards Dee.

in reply to DD13

ooh that’s interesting. I will need to contact pharmacist to re check. Cardiologist just said to stop and pharmacist when picked up prescription for amlodipine said nothing on this unless they were making massive assumptions. Cardiologist wants me to call back next week to see if any improvement in chest pain as she’s going to try and get me into a test in four weeks time. BUt I will ask at least pharmacist.

DD13 profile image
DD13 in reply to

When the nurse from cardiologist dept, told me i could stop taking the Dilitzem, i said i would stop it the next day, save getting a new prescription. He told me no, i must not do that, as i couldn't just stop taking them. I would be ill and may end up in hospital. Had to get the nurse to speak to the chemist to give me that prescription as the gp surgery told chemist to not full fill it. Luckily i got it. Then got prescription to wean me off, once nurse got in contact with gp. The gp apologised, but assumed that as i had got such a high dose, there wasn't anything lower.

Regards Dee.

Milkfairy profile image
MilkfairyHeart Star

Hello,

Has the Cardiologist given you a diagnosis?

I agree with Dee you can't just stop taking Diltiazem especially if you live with vasospastic angina.

Ranolazine has mixed reviews it seems to help those living with microvascular angina rather than vasospastic angina.

in reply to Milkfairy

so I am still keeping an open mind…..

Cardiologist focused on the myocardial bridge being the source of my angina and is pursuing this line of treatment and potentially surgery. Facebook group members for this condition have commented my bridge whilst short is quite deep. (28mm long and 0.5 to 0.79 cm at its worst area in LAD, also showed me how proximal to that LAD has remodelled and thickened).

Cardiologist has ruled out vasospams as adenosine nuclear scan was negative.

This cardiologist is the first to give me clear answers and explained and showed why they feel the MB is the problem. She showed me on my angiogram views where my LAD completely disappears into my heart muscle. It was fascinating to see and a relegation someone acknowledges a MB can be symptomatic not benign.

However research tells me an MB can cause vasospams / microvascular dysfunction and some people who have been unroofed continue to experience these issues. The artery may have been dug put but it’s still the same damaged physiologically artery. So it’s not the end of the line got MVD etc 😊

Neither drug has brought any relief from angina and I get angina on any exertion. I think truth be known I jumped at the chance to stop them

But will check with pharmacist as soon as opens.

Thanks for the words of caution.

Milkfairy profile image
MilkfairyHeart Star in reply to

Talking to a Pharmacist would be a good idea.

I suggest keeping a log of your symptoms and then gradually reduce one medication at a time, keeping a note of any change of your symptoms as you go along.

Diltiazem lowers your BP so recording your BP would be important and whether it goes up as you stop taking the Diltiazem.

There are lots of things that can increase my symptoms. The change in the weather especially if there is a big drop in the temperature.

Emotional and mental stress are also triggers. My poor blood vessels are very trigger happy at the moment with the sadness of the Queen dying.

Good luck with the change in medication routine.

in reply to Milkfairy

I feel we’ve lost a very great and strong woman. ❤️

Thank you I am quite relieved to being off them to be totally honest but let’s see what the chest pain does. Not sure it will miraculously disappear as I have an anatomical issue!!!! That’s my logic!

Will contact Pharmacist, and yes should record symptoms and will monitor BP. 😊

Milkfairy profile image
MilkfairyHeart Star

Ps

"Cardiologist has ruled out vasospams as adenosine nuclear scan was negative."

The only way to test for coronary vasospasms is by an angiogram with acetylcholine.

You can have vasospasms in your small and large coronary arteries.

in reply to Milkfairy

good reminder, cardiologist did mention acetylcholine was ‘off label’ or something like that and that the “people in charge” highly unlikely to say can use. Also very reluctant for a test where shove a wire through the buried bit and also this is why they cut my angiogram short I knew they stopped abruptly as I heard other cardiologist murmur as if given up! (said would have to have a very good answer when a coroner asks why they good idea to put a wire through stuck bit🥺). Going for dobutamine stress test instead. The IVUS would have been more definitive apparently though.

Milkfairy profile image
MilkfairyHeart Star in reply to

Maybe time for a second opinion?

St Thomas's Hospital is the place to go if you have Microvascular and vasospastic angina to get a proper diagnosis.

The team are very experienced in carrying out the appropriate testing. They have been given permission to use acetylcholine routinely.

My local trust is going to start the this functional testing soon too.

My experience is that Cardiologists who don't truly understand NOCAD or dismiss it as a nuisance of a condition do not choose to learn the skills and overcome the barriers to carrying out the testing we need as a group of patients.

in reply to Milkfairy

thanks am still keeping an open mind and as studies show even if a MB is “fixed” the damage it has done will still be there which is as you’ve mentioned. I know CABG is the answer to help address the anatomical issue, but yes the impact of a buried artery I need to keep at them to purse.

Milkfairy profile image
MilkfairyHeart Star in reply to

Myocardial bridges are they the innocent bystander or the culprit?

in reply to Milkfairy

interesting one! Probably bed fellows!

in reply to Milkfairy

pharmacist said to refer back to doctor (which means go back to cardiologist who told me to stop and start the amlodipine next morning) but to monitor BP. Guess too late now, been 48 hours since stopped. At present no worse (no better mind!) 😊

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