Treatment with verapamil (Veraloc retard)

The medication 

Verapamil was originally developed to treat high blood pressure and other heart conditions, but it can also reduce the frequency and intensity of cluster headache attacks. 

Effect

The exact mechanism of action is unknown, but verapamil is believed to have a regulating effect on the nerves in the hypothalamus, which controls body temperature, metabolism, and hormones, among other things.

Side effects 

Constipation, dizziness, fatigue, nausea, swollen legs and arms, slow heart rate, low blood pressure, chest tightness, erectile dysfunction, skin itching, rashes, and hair loss.

Precautions 

Should not be used during pregnancy.

Some types of medication increase the effect of verapamil, including antibiotics, simvastatin, and others. Other types of medication may be less effective if you take verapamil at the same time. Therefore, always talk to your doctor about any other medication you are taking before starting verapamil.

Before starting treatment 

Before you start taking verapamil, you must have blood tests and an ECG performed. 

Furthermore, your ECG must be monitored regularly while you are being treated with verapamil.

What dosage should you take

You usually start with 100 mg twice daily. 

However, if you have previously been treated with verapamil without any issues, you can usually start directly on 200 mg twice daily.

The dose can subsequently be increased by 100 mg, alternating between morning and evening, until you achieve the desired effect or experience bothersome side effects, up to a maximum of 800 mg per day.

IMPORTANT! If you need to take more than 400 mg of verapamil per day, a new ECG must be taken and approved by a doctor for every 200 mg increase in the daily dose.