Is verapamil effective in preventing migraine?

Verapamil belongs to a group of medicines called calcium channel blockers. These drugs are mainly used to manage high blood pressure.

They work by relaxing the blood vessels, allowing blood to flow more freely to the heart. It helps lower blood pressure.

In the past, verapamil was also prescribed to treat cluster headaches and prevent migraines. However, it is not approved by the Food and Drug Administration (FDA) for these conditions, so it was considered an off-label treatment for them.

“Off-label” means that a drug is used for another reason or dose than it has been approved. It is common practice.

Preventive migraine medications are different from reliever treatment medications. Preventive migraine medications help reduce the overall number of monthly attacks, their duration and the severity of migraine attacks.

Doctors previously believed that increased pressure in the blood vessels could cause migraine attacks, and this is one of the reasons verapamil was prescribed.

There is little evidence that verapamil is effective in preventing migraine. This is why it is not the first option that doctors choose.

The Canadian Headache Society migraine preventive treatment guidelines offer a weak recommendation for verapamil. The American family physicians The guidelines also indicate that verapamil has little evidence of effectiveness in preventing migraine.

Verapamil is used to treat cluster headaches. A 2019 review to study of verapamil for cluster headache has been shown to be effective for this type of headache attack. A dose of verapamil of 360 milligrams (mg) per day has helped half of those with chronic cluster headaches. And those with episodic cluster headaches had one less attack per day with verapamil.

Read this article for more information on migraine.

Verapamil is available in several branded and generic dosage forms and strengths. Brand names include Calan, Calan SR, Verelan and Verelan PM.

It comes in immediate-release, extended-release and delayed-release capsules and tablets.

The dosage of verapamil depends on:

• the reason for its use
• other health problems you may have
• other medicines you are taking
• your age

Your doctor will start prescribing the lower dose for you to provide the maximum benefit with the least risk.

You can take extended-release verapamil with or without food. Do not split, crush or chew the extended-release capsules. You can split the extended-release tablets, but do not crush or chew them.

Read this article for tips on swallowing pills.

For use in preventing migraine, doses may vary. Doses can range from 120 mg to 480 mg. Your doctor will prescribe the lowest effective dose to prevent migraine and increase the dose gradually as needed until you get relief.

It may take several weeks for this to work, so be patient with your treatment plan. Ask your doctor how long it may take for verapamil to start working.

In clinic studies of use of verapamil for cluster headaches, the dose used was 360 mg per day.

Verapamil contains Side effects. For most people, these are lightweight and go away with regular use.

But some people can experience serious side effects from verapamil. If you experience a severe or life-threatening reaction to verapamil, call 911 or go to an emergency medical center immediately.

This is not a complete list of all side effects and possible interactions of verapamil. Your doctor or pharmacist can provide more information about all the side effects and interactions of verapamil.

Common side effects

People may experience more common side effects from verapamil, including:

• constipation
• cough
• headache
• Low blood pressure
• drowsiness

Serious side effects

Some people may experience serious side effects when taking verapamil. These side effects include:

• difficulty in breathing
• dizziness or lightheadedness
• fainting
• changes in heart rate, palpitations or chest pain
• itchy skin
• swelling of the legs or ankles

Drugs interactions

Verapamil can interact with other medicines that you take. These interactions can include:

Verapamil can also interact with foods, vitamins, and other over-the-counter products. Tell your doctor about all of your medications and over-the-counter products that you are taking.

Do not take verapamil with grapefruit juice. It can slow down the elimination of verapamil from your body, causing the drug to build up. This can increase the risk of serious side effects.

Yes, you can overdose on verapamil. Taking too much verapamil can cause serious and even fatal reactions.

Serious symptoms of an overdose include:

• very low blood pressure
• heart rhythm problems
• kidney problems
• convulsions
• slow heartbeat

Take the exact dose of verapamil prescribed by your doctor. Do not increase your dose of verapamil yourself.

Call Poison Control at 1-800-222-1222 if you think you have taken too much verapamil. For a life-threatening medical emergency, call 911 or go to an emergency medical center immediately.

Today, there are many options for both preventing the onset of migraine and treating acute symptoms.

Verapamil does not have strong evidence of effectiveness in preventing migraine. A review of studies showed that verapamil did not reduce migraine episodes compared to placebo.

The American Family Physician recommends other drugs as first choice options for migraine prevention with good evidence of effectiveness.

Read this for a detailed explanation of the medications used to treat migraine.

Verapamil does not have strong evidence of effectiveness for use in preventing migraine. There are other drugs that are better, so this is usually not the first option considered.

Your doctor may discuss verapamil if other treatments haven’t worked or if you also have high blood pressure with migraine.

Find out what triggers your migraine attacks (environmental, eating, behavioral) and develop steps to avoid them.

Here are some examples of migraine triggers:

• stress
• sleep problems
• perfumes
• certain foods
• hormonal changes
• weather changes

Ask your doctor about other medications and lifestyle support options for migraine, such as cognitive behavioral therapy, yoga, biofeedback, relaxation training, and acupressure that may help relieve your pain. symptoms.