Dilitizem dosing query

[LynneAll]

Hi Guys.I have been diagnosed with microvascular angina and have been experimenting with beta blockers,long acting nitrates and now dilitizem.My cardiologist has started me on 60mg twice a day of immediate release dilitizem,but all the literature says start at 30mg 4 times a day,assumedly because the immediate release version has a half life of 3 to5 hours and thus won't last 12 hours.Most commentary on dosing is about the extended release versions.Any thoughts?

[Milkfairy Heart Star]

Hello LynneAll,

Welcome to the forum.

How has your microvascular angina been diagnosed?

Sometimes people are given a presumed diagnosis without testing.

I was originally incorrectly presumed to have microvascular dysfunction, however after a specialised angiogram my diagnosis of coronary vasospasms was confirmed.

I have lived with vasospastic angina, another type of ischaemia/ angina non obstructive coronary arteries, INOCA/ANOCA, for 11 years.

Many of the medications we are prescribed as patients living with MVA or VSA have not been specifically tested on us as a group of patients.

The dosing and timing of medications may have to be altered.

Diltiazem slow release is the corner stone of treatment of coronary vasospasms.

I was originally prescribed immediate release Diltiazem which I took 4 times aday.

This didn't help with my night time chest pain, so was switched to slow release tablets. The dose has been slowly increased over the years.

I now take 240mgs of Diltiazem slow release at 8am and 8pm.

I suggest you keep a diary of your symptoms and see how well you respond to the Diltiazem and contact your Cardiologist if there is no improvement in your symptoms.

It can take a while to find the best combination of medication that will work best for you as an individual.

There is growing evidence that nitrates may not be as affective for people living with microvascular angina.

The BHF has this information about microvascular angina.

bhf.org.uk/informationsuppo...

You may find this website helpful too. It was created by 4 patients with over 50 years of combined experience of living with microvascular and vasospastic angina. They are supported by 30 world leading expert Cardiologists.

internationalheartspasmsall...

[Milkfairy Heart Star in reply to Milkfairy]

academic.oup.com/eurheartj/...

Recommended treatment for microvascular and vasospastic angina