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Probably for a pharmacist; I am taking Verapamil 120mgSR.

Sent to Health Experts August 12 09:23 PM

Probably for a pharmacist; I am taking Verapamil 120mgSR. I am constipated and want to take Correctal Brand Bisacodyl 5mg stimulant laxative. It it safe to take the two together?

Edited by Customer (name blocked for privacy) on August 12 2006 at 10:43 PM

 

Optional Information:
Female , Age: 49

Already Tried:
fluids and fiber

Customer (name blocked for privacy)
Status:  Closed   Value: $30
Answer
August 13 4:42 AM (7 hours and 18 minutes and 39 seconds later)
         
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There would be no problem with taking Correctal with the Verapamil. I would continue to drink plenty of fluid, and fiber (you could use one of the various fiber supplements available)

I was wondering how you were doing with the Verapamil - for the migraines. Have you started to notice any improvement?

Edited by FamilyPhysician on August 13 2006 at 4:46 AM

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 12:44 PM (8 hours and 2 minutes and 7 seconds later)
         
Reply to Family Physician's Post: It has been 2 1/2 weeks now on the verapamil. I think it is helping some. The headaches I have last about 3 hours now instead of the 6 hours that they used to they are alaways in the evenings and I can ride them out without Maxalt. I also started taking Magnesium Oxide 500mg and Co-enzyme q10 100 a day. I hope these help. I hope to not have to go on the really strong stuff like Topamax or Amitriptyline I see a neurologist this week. The thing that concerns me now is not so much the headaches that I always get on the same day probably because of the climara, but my head continues to feel "not normal" and if I do any kind of strenous exercise where my heart really gets pumping it brings on a migarine with throbbing and I have to take Maxalt and go to bed for it to subside.
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Answer
August 13 12:50 PM (6 minutes and 41 seconds later)
         
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I'd continue to use the Verapamil, although as you found out some people have problems with the constipation. In my experience, the constipation does tend to get better as time goes on.

I'm glad to hear that the headaches are getting better. Hopefully they will continue to improve. The usual goal of migraine prevention is to reduce the fequency to a more managable level, where they are easily treated, and don't interfere with daily life.

Good luck with the neurologist next week

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 1:05 PM (14 minutes and 47 seconds later)
         
Relist: I still need help.
Are you aware of any other HRT patch that gives a smoother release of estrogen? I read about SQ estrogen pellets on the web, they are made by a compounding pharmacy and inserted by a physician. Also are you aware of tamoxifen(anti-estrogen drug) being used as a preventative to suppress estrogen withdrawal headaches?
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Answer
August 13 1:38 PM (32 minutes and 24 seconds later)
         
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The use of tamoxifen for migraine prevention of migraine is not supported by the evidence. There was one mention of it in Lancet in 1986, however in 1996 a review (in German with an English Abstract) reported that Tamoxifen was outdated
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12799861&query_hl=1&itool=pubmed_docsum

You could talk with you doctor about trying a different estrogen product. Are you on the Estrogen for hot flashes or for osteoporosis prevention?

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 1:47 PM (9 minutes and 22 seconds later)
         
Reply to Family Physician's Post: I started on a climara patch because of the menopausal migraines. Before my Hysterectomy I had Lupron for 6 months and tolerated the menopausal symptoms quite well (hot flashes don't hurt like migraines) I had no migraines during the 6 months of lupron, they only occured post-surgery. I wouldn't mind gooing off HRT but it has only been 11months and I think the migariens would be worse.
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Info Request
August 13 1:59 PM (11 minutes and 53 seconds later)
         
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Have your migraine gotten better or worse after starting the Climara? Also what dose of Climara are you using?

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 3:44 PM (1 hour and 45 minutes and 14 seconds later)
         
Reply to Family Physician's Post: I got better with the climara, to the point of no headaches. We decided to increase the dose because my head felt "tight" on some days. The increase caused worsening headaches so after 1 ekk on a .037 climara patch I went back to th .025 climara patch. two weeks after going back I began having migraines. That was 2 months ago. We did an MRI which was normal. I made an appt with a neurologist. I also started the Verapamil 2 1/2 weeks ago. Before my hysterctomy 1 year ago I never had migraines with my periods.
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Answer
August 13 6:28 PM (2 hours and 44 minutes and 1 second later)
         
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OK...I wasn't sure of the exact timing/sequence of the Climara and the headaches.

See what the neurologist says, but since your having problems (constipation) with the Verapamil, I don't think they would want to increase that. Also, as I remember, your blood pressure runs low, so that would also probably be problematic at a higher dose. They may want to try low dose Topamax.

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 10:55 PM (4 hours and 26 minutes and 43 seconds later)
         
Relist: I still need help.
OK, IF the neurologist starts me on a low dose of topamax, can I continue taking verapamil with it? Constipation doesn't bother me and I think it is helping a little. From what I read Verapamil has low efficacy but I can tell it is helpin a little. I'm going back to work next week after having the summer off and I am worried about the cognitive effects with Topamax. From what I read they seem to be dose related. Have you had persons taking Topamax that have had to quit work because it impairs them so much? Would I have to be on it the rest of my life? What have been your experiences with patients on it? If I took Topamax and Verapamil together would that allow me to take less topamax? I will ask all this to the neurologist but All of this is scary to me so it helps me to get another opinion. Thanks
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Answer
August 13 11:03 PM (8 minutes and 41 seconds later)
         
REPLIEDCheck Mark
I think I probably have 4 or 5 patients on Topamax. They all are doing well. I started with a low dose, and gradually increased it. Several of them did have some complaints of feeling weird at higher doses, although they reduced their doses, and have done well.

As you said, the side effects (and effectiveness) seem to be dose related. I have been very impressed with the effectiveness - and NONE of my patients have actually needed to stop the medicine.

YES, you can indeed continue the Verapamil, and if it is helping, there is no reason to stop it, you can just add the Topamax. This would probably reduce the dose that would be required with the Topamax.

As always, if you get too many side effects, you could always stop the Topamax

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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August 13 11:20 PM (16 minutes and 11 seconds later)
         
Reply to Family Physician's Post: Thank you, you are helping me not feel so scared. One last fear and I think I'm done with the questions. The cognitive related side effects with the topamax, they are not permanent right? They are reversed once the drug is stopped? Also, do people ever get off these meds or does the body ever build a tolerance and require higher and higher doses? I don't want to get overly panicky but I want to make good long term choices. Isn't it better to be on Verapamil long term than Topamax? What about liver damage? Also I have mild asthma, will Topamax interact with albuterol or singular?
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Answer
August 13 11:39 PM (19 minutes and 41 seconds later)
         
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NO...they are dose related and temporary. If the medicine is stopped they clear.

I don't know of any interaction between Topamax and albuterol

This is not a drug that people seem to build up a tolerance to, and need higher and higher doses.

I do not worry about people being on Topamax long term.

If it makes you feel better, I put my one god-daughter's mother on Topamax

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4121 Health Accepts
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