Medication help

[amyvk]

I have been diagnosed with coronary spasms, and have been prescribed Isosorbide mononitrate 60mg daily. I understand that this is a form of nitroglycerine, so I expected a headache. This is day three of treatment.  The first two days were tolerable, though the headache was pretty bad. Today is intolerable. I tried to return to work for the first time in two weeks and returned home by 11am. Along with horrible headache pain,  I am having some periods of time when I am having palpatations. and now some aching /  tingling in both hands. I called the Dr. earlier to discuss the headache and he advised me to cut down to 30MG for afew days, but that I must get up to the 60MG dosage. (They gave nitro to me during heart cath and found how much it took to stop spasm)

Are there treatments for spasm that work as well as nitro if I continue to feel so awful on this medicaiton? I cannot imagine how I am going to keep my job if this continues for any period of time. Is there a good place to get reputable info. on spasm?  I cannot find much. What should I expect in the future if spasm is an issue for me?

[Jack54]

I forgot to mention that I was on Isosorbide mononitrate for 2 years at 30 mg/day. I stopped it to try medicine for ED...

I am trying to start back but the headaches and other aches are a killer. I decided to wait until after surgery. Believe it or not, at 30 mg/day the headaches went away after about a month. There is a good headache medicine called Topamax that is for migraines.

Also some doctors don't like CCBs due to side effects like swelling ankles......

[Jack54]

Calcium Channel Blockers (CCBs) are prescribed for ca spasms.
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Coronary artery spasm is recognized as a cause of ischemic heart disease, producing a syndrome of the variant form of angina that occurs at rest. Spasm also may play a role in other types of rest angina (unstable angina) and exertional angina.

Calcium is essential for the basic tonus of vascular smooth muscle. The accentuated contraction that occurs in coronary artery spasm is the result of an increase in intracellular calcium ions

Current therapy is aimed at blocking the slow calcium currents that are responsible for electrical activation and contraction of smooth muscle cells. A marked coronary vasodilatation is produced with calcium channel blockers, thus demonstrating effective therapy for coronary artery spasm.

A similar effect is achieved by nitrates, and these agents will continue to have a role in the therapy of spasm. Calcium channel blockers produce beneficial effects on myocardial oxygen supply and demand and, therefore, are also useful in the prevention of classic exertional angina caused by fixed obstruction. Verapamil and diltiazem possess electrophysiologic effects and have, in addition, proved useful in the treatment of supraventricular dysrhythmias.

[bzmed]

There are also skin patches that worked better for me (no headache) vs the pills

[Cihindy]

Maybe he could prescribe you a sustained released nitro medication. There are several. That might help. Then you get a small dose released throughtout the day.

[marysano57]

i know its been more then 10yrs since you asked but when I was prescribed 90mg and could not function AT ALL  during the day my cardio immed told me to take it at night!  It worked like a charm and as its a mononitrate it stays in your system 7-9 hours.  By the time you wake up you may see a little fuzzy but after a week or two of taking it the headaches will ony return if you increase dosage (ive been on it 20yrs now, its a life saver!)  Good luck to you!