Hi,

I think that Verpamil and Gabapentin interact with each other in ways that might not be helpful . . . in some weird way that I do not understand and am not smart enough to figure out.
I have been having chest and back pain since last night/ Sunday.

I believe that raising the Gabepenitn the past few days from 500 to 550 mgs (5 and 1/2 one hundred mgs capsules) might be causing chest and back pain.


Both drugs seem to be involved with calcium.

. . . so confused.

M

Mari

I am not sure what to say, It might be just because you have a problem
each time you go up.

I take both at the same time. Verapamil 340mg I believe. and 600mg
of Gabapentin.

I then take 600mg of Gabapentin at night.

The only suggestion I would have is you might split the gabapentin into
twice a day.

Donna

Donna,

I forgot that you take both.
I think are right. When I increased the dose, I got this.
Maybe splitting them to a.m. and p.m. will work.

Mari

I totally agree with Donna about splitting the gabapentin. it is usually given in divided doses (typically 3 or even 4 per day!) and is usually more tolerable and more effective that way. some folks can take it undivided and still get benefit.

Gabapentin does not have metabolic interactions with verapamil, nor with calcium. This med is pretty well free of drug-drug, food-drug and herb-drug interactions.

Gabapentin does its bit in the body and then exits through the kidneys as unchanged drug. it does not undergo metabolic change. Neither does it affect the rate of absorption or metabolism of other drugs.

it may "interact" in the sense of having magnified effects in combination therapy with other drugs that have similar effects. for instance, taking it with another drug that causes CNS depression will produce increased CNS depression.

so yeah, try splitting it.

hope that works out for you!!!

~ waves ~

It is possible that chest and back pain may also be stress related and not related to the gabapentin increase.

~ waves ~

Mari

I will also state, that as Waves says, Many doctors want you to take
gabapentin 3 to 4 times a day. My pain doctor prefers 3 times a day
at least. But I can't remember the 3rd time a day. So when I went
to my primary and explained I wasn't getting the 3rd dose in and was
not sure what to do. He changed my dosage to twice a day, and
increased the dosage.

I had also asked that he start prescribing the medication. Because
it was the only thing at this point I was seeing my pain doctor for.

It is working for me at this mg, and 2 times a day.

Donna

Hi,

I am not experiencing stress this week so I do not understand about the chest and back pain except that I was raising the dose. This week I was taking 550 mgs.

Wikipedia says that Gabapentin may be involved in the calcium channels.
Some patients on the Internet mention not taking calcium with the Gabapentin.


I barely am keeping my job . . . . .sleep deprivation is REALLY difficult . . . . . . . . I am concerned that an a.m. dose of Gabapenin might not mix well with work and next to no sleep the night before.

M

Mari - I don't have any experience or insight to offer, just wanted to say that I care.

When I saw this thread I thought oh no, not again. I hope you can get some sleep soon. And I hope the people at work will be extra kind while all this is going on. Hey, I can wish!

interesting. i had not thought about the eventuality of its pharmacokinetics being calcium-channel mediated or affecting voltage-gated receptor ligands. eeks. i was thinking all in terms of drug metabolism. one track mind.

i found this article :

Pharmacological disruption of calcium channel trafficking by the α2δ ligand gabapentin
i did check wiki which i don't fully trust - i wanted to see the refs. lol it pointed to the exact same article, lol.

unfortunately it is a good bit over my head. my best interpretation of the results presented, is that chronic gabapentin administration does inhibit calcium channel efficiency by a few different mechanisms. to me that would suggest an overlap with verapamil pharmacokinetics which would in turn imply an enhanced overall effect. it could mean potentiation of verapamil, even though i did not find documented interaction of these two drugs.

high doses of verapamil can cause a heart block, and as it is unclear to what degree it's effect may be enhanced by the GB. I'd definitely back off on something tonight. I'd probably even skip tonight's GBP dose.

Many people are rx'd both drugs together - and in high doses - for migraine or cluster headache prevention... seems strange if there were a safety / interaction issue.

If you are still having pain, I'd suggest the ER for an EKG and advice. perhaps bring the article above if you think it might help make a case. And you should definitely discuss with your pdoc this episode of sx as well as this potential interaction stuff.

This article might be handy too (citation is from the summary but the link includes the full text):
A comparison of Ca2+ channel blocking mode between gabapentin and verapamil: implication for protection against hypoxic injury...
hope you feel better soon"
~ waves ~

I am sorry to hear that you are having pain....and of course I am very sorry that you are sleep deprived most of the time.
(((((HUGS)))))
bizi