Posted by Scott L. Schofield on January 20, 2000, at 14:58:03
In reply to Re: Ca++ blockers; Parnate , posted by Annie on January 20, 2000, at 12:15:45
> > Anybody used Ca++ blockers (especially, but not only, with MAOIs)? How are they? I've only taken Procardia a couple times.
> Elizabeth, I take Covera HS(Verapamil Hydrochloride) with Parnate. It is a calcium channel blocker like Procardia, but it has a 4-5 hour delay in drug delivery (vs 30 minutes)and is extended-release. I haven't had any problems with the combination and my BP has stayed relatively constant on the Parnate. Since I had a spontaneous hypertensive crises the last time I trialed Parnate, this has alleviated a lot of my fear. I have hypertension, so if your BP is normal, the combination with Parnate could cause a more profound hypotension. It also intensifies the action of Lithium so if you are still taking it, you may have to adjust it to avoid possible toxicity.
Hi Annie.
I am curious. Did this hypertensive episode with Parnate occur early on in treatment? From the stuff I read a few years ago, I got the impression that the chances of this happening were slim once one got past the first few days or weeks. Unfortunately, I read that Elizabeth can have this occur well into treatment any time the dosage exceeds 30 mg (?) or so.It really sucks being in one of those "slim-chance" positions. I was initially told that I was lucky to have this illness - that the great majority (85% or so) got well with the drugs that were available at the time. Once the SSRIs and other psychotropics came along, the chances of being refractory to treatment had been reduced to 5%. Guess what?
I wonder if taking an antihypertensive during a Parnate "break-in" period might be effective in preventing a rise in blood-pressure, after which it can be discontinued. Parnate did cause me quite a bit of dizziness early on. You may be right in your thoughts regarding some sort of cumulative hypotensive effects when combining the two. That would be undesirable.
I used to carry a capsule of Procardia (nifedipine) with me just in case I was lured into participating in a pepperoni-eating contest ("pepperoni-effect"). Thankfully, I never had to use it. The first time I was prescribed an MAO-inhibitor (Parnate), I was told by the doctor that the best way to treat a hypertensive crisis was to use a drug named Regitine (phentolamine), a nonselective alpha-adrenoceptor antagonist that is used as an antihypertensive. I think it works by dialating peripheral blood vessels. It is now used quite a bit for surgery. It was once available in both oral and injectable forms. I'm not sure why, but the manufacture discontinued the oral form quite a few years ago.
An oral preperation of phentolamine is currently being investigated as a treatment for ED (erectile dysfunction - impotence). Many studies have shown it to be effective. I'm sure there will be more studies to make sure that things hold-up. If it is approved for ED, I'm hoping my doctor will allow me to carry some around for hypertensive and other emergencies.
- ScottIt's snowing here.
poster:Scott L. Schofield
thread:19261
URL: http://www.dr-bob.org/babble/20000112/msgs/19275.html