Can Calcium Channel Blockers Cause Tachycardia?

[Tzipora]

I posted recently about starting Verapamil and someone did say it and other CCBs can make POTS worse. Is this true? Can anyone point me to any links or studies on it?

I'm supposed to switch to taking the Verapmil twice a day tomorrow and I kind of do want to at least try it. The very first day I took Verapamil was terrible and it lowered my blood pressure quite a bit. But now I actually seem to be running higher than my norm (which puts me more t a "normal" blood pressure since I tend to run low) And now I've heard that POTS patients can end up getting increased blood pressure from CCBs or BBs. But my bigger thing is I'm either running more tachy or just noticing it more and having more palpitations. I can just roll over in bed and feel my heart racing. Tonight I was running tachy and having palpitations and all out shaking for a half hour. I went out to the store about an hour after taking the Verapamil and that's what caused the shaking and all. Now I tend to have a lot of problems shopping or anything but have never been to the point where I was shaking like this and I guess was extra palpitation-y. Because by the time I sat down and tried to calm down I was about 120bpm but felt as if my heart was way faster (When I was first diagnosed with sinus tachycardia I'd be 130 and not even know it or feel different...) So I don't know really. I don't feel too good though. In general I feel like I was adjusting better to the Verapamil until tonight and going to the store but for sure I'm at least as tachy as before so I guess I'm willing to try upping the dose as I'm supposed to because I figure I'll either know for sure if it makes me more tachy or maybe, just maybe it'll make me less tachy as it's supposed to?

I guess I'm questioning too- how long to try a med before you give up on it because of side effects? I'm having to lay down so much more since taking the Verapamil and I'm not even sure if it's a blood pressure thing, a tachy thing, or just general fatigue from the medication. I was supposed to take 20MG at night for 4 days, then 20MG twice a day for 4 days, then go to 20MG 3x a day for 4 days and call my neurologist to discuss how it was working. Maybe I should be calling sooner? It's my first POTS med so far so I suppose there's got to be other options so maybe I shouldn't be suffering with this? I just don't want to give up on it too soon if the side effects will decrease over time and it might work.

Sorry to ramble. I'm just so very unsure of what to think of the Verapamil nor do I know if the Verapamil is really making me any worse or if it's just that it's not really doing anything.

[peregrine]

1

I'm currently on diltiazem (Cardizem), another calcium channel blocker, prescribed to help with the atrial tachycardia since I refused ablation. In my experience it has (mostly) slowed down my heart rate; things that used to trigger it to, say, 200bpm now trigger it to 140bpm. But that's all it did; no improvement in the dysautonomia, and I think (subjectively, don't have enough data) that it actually has made it worse. (I say dysauto because I haven't gotten a diagnosis yet, but it looks like POTS according to me and the cardiologist)

[E246]

Hi,

When i first took diltizem i dont think it made the pots better but it helped with the chest pain. Then i had a few funny episode with it stopped for a while Tried it last week when i had tachy from it but i was in a bad phrase and really felt unwell but it did seem to make it worse. Of all the drugs it is probably one of the safer.

It's all trial and error - good luck.

[Elegiamore]

Yes - please look at the cardizem post before yours today - they are practically the same meds and both cause pooling, edema and tachycardia in many/most POTS patients.

WORST med to start you on. My advice - ANOTHER DOCTOR QUICKLY. READ the section on this website on what drugs to take and not take ("What to do" and "What not to do."). Then you will see why, if I were you, I would run from the calan. High bp with POTS needs to start with clonidine or beta blockers. ALL BETA BLOCKERS are not equal. Lopressor, FYI, does NOT lower bp from high adrenaline, for instance. Some don't lower heart rate at all. Others lower heart rate and bp. I take Kerlone, a 20 year old beta blocker that has strong anti-tachycardia results. Nothing else works as well on me.

Calcium blockers open blood vessels which can lead to pooling and POTs symptoms. If you have low blood volume (hypovolemia) you need to avoid these meds, and diuretics also. Like the plague.

You just need to educate yourself, fully and quickly, before more inappropriate meds are forced on you. Good luck with education comes better health.

[E246]

There's nothing like a bad spell to try and get to grips with this. i am in England and it has been quite difficult to get to see anyone who knows very much. I went for a second opinion in London but there is a year long waiting list. And it seems to have upset the Prof i was seeing here.

The problem i have is that beta blockers knock my HR down into 40-50's This can feel very uncomfortable when it is chemically induced.

Have just started Florinef - 1/4 of 1mg tab has had an amazing effect but is raising my bp at times too much. But it is the first time i have walked out of the house for a month. I do not think this is a med that is normally of for hyper pots. So you do have to find what suits you individually.

it has taken time for me to understand the complexities of this but am getting there.

Tzipora look at the post sent to me from Mighty mouse asking for info to take to the doctor - it has a link to NDFR site about dysautonomia and that has helped me identify what my problem is and then you can start working out what will work.

[Tzipora]

Thanks.

I'm just not really sure where else to turn... If I had the money and ability to travel I'd get myself to Mayo Clinic for sure. I might be headed in that direction anyway because of my GI issues too...

I ended up in the ER as a result of the Verapamil. Called up my neurologist because I actually was in the bradycardic zone which has NEVER happened to me before and I felt very strange. And I had a blood pressure of 85/50. So I was told to stop taking the Verapamil, obviously and given fluids and had an EKG and all. The neurologist said he'd call me back if they figured out anything else to try me on but I haven't gotten a call back! He told me anything else they put me on would probably lower my blood pressure too. Ugh.

ANd now that I'm not on the Verapamil (took the last dose last Friday before ending up in the ER) both my blood pressure and heart rate are all over the place seemingly worse than ever. I have no clue if the Verapamil made things worse or what. And I've been generally hypotensive, more than ever or I get some odd readings. My regular home health nurse (who comes out weekly to draw labs and change the dressing on my pICC line) was off yesterday so a different nurse came out and my blood pressure was 100/50 and she asked if I normally run low. ANd yeah, I do but usually my norm is somewhere closer to 90/60ish give or take a few points and I've never really seen the bottom number so low like that with a normal top number.

So I really don't know. One thing I do know is that I have an amazing GI doctor who is really doing all he can to help me overall and I'm thinking about asking him if he knows of anyone in that medical system who works with POTS patients. The neurologist I have been seeing is at the University of Michigan but I'm very unhappy with their neurology department there. So I don't know. I'm kind of in limbo. I have an appointment with my primary care doctor later today too so maybe I'll talk to her.

[peregrine]

Just got told to stop taking the diltiazem today; I've gained 20 pounds in the last 2.5 months since being put on it. My primary care doc (who diagnosed the edema, which was a little tricky since with compression stockings it wasn't in my calves except in the front of my shins) has had me call the cardiologist who put me on it to ask for another option (probably a beta blocker, although the cardio was a little nervous about those due to mood issues). I'm just glad to be off of it, especially given the edema! Plus the fact that it did ~nothing, besides lower my high heart rates, which (if they're compensating for something else) isn't the best idea.