Diltiazem and/or propanolol

Has anyone tried either of these meds for their EM? I don’t have really high BP but Have had some crazy swings from 118/70 to 160/86 because of the stress of working full time and fighting this chronic condition. I get very emotionally upset about it all. I found a very nice cardiologist who is willing to try these with me. I took the diltiazem for three days now. Just one 30 mg pill. I felt it helped on Thursday and yesterday but today I did too much running around doing laundry and shopping
and I got the feet very upset. Anyway whatever info or advice you have is welcomed!

Hi Jordy

I have not tried diltiazem before but other calcium channel blockers + blood pressure meds. I find some success currently with amlodipine (a CCB). The amlodipine pills come in increments of 2.5 mg, but I actually find that 0.6 mg at night to be about what I can tolerate (I actually get the baby liquid suspension now instead of quartering the pills). Too much, and it seems like it fuels the burning. I’ve found it’s better to start out real low and really slowly titrate up, if needed.

When I tried to start with a full 2.5 mg pill of amlodipine, like you I found it initially very helpful, but the next day or 2 were so bad that I stopped.

The timing of when I take the drug can also make a difference in how effective (or hurtful) it is.

All these vasoactive meds can lower bp, but I’ve found for myself that eventually my body tolerates it and I am ok. At least this is just my experience (with trialling clonidine, propranolol, amlodipine, nadolol). My doc told me once that she has successfully ramped up people like me (petite females with normalish bp) up to the max dose of propranolol, but it takes a lot of patience + time to do so.

Another factor in this could be increased heart rate which a body can do to compensate for too low bp. Short-acting nifedipine is known for this and I don’t think it should happen with diltiazem but my docs have warned me to watch out for this with my amlodipine.

I’ve found that propranolol helps me personally with emotion-induced flares and take 5 mg as needed.

I think it’s awesome that you are determined to work full-time on top of fighting the pain.

Best wishes

Ive been taking metoprolol slow release, another beta blocker, for 6 weeks. I have bp spikes like you. It changed the range of the spikes. My bp is now low and spikes to normal. I started at 12.5 mg and now at 25. It helped flares from day 1. But had a flare last night. My body seems to adjust to dose over time. Not sure if it will continue to work over time but has been life changing in short term.

Hi I did try propranolol only took 1 tablet
And my body burned so badly I had to put cold packs on me it took days to settle down
So did not work for me . It’s hard to understand how it works because it’s a vasodilator
Glad you are having luck we are all different
Take care

Propranonol does not cause peripheral vasodialation.

Since β2 adrenergic receptors can cause vascular smooth muscle dilation, beta blockers may cause some vasoconstriction. However, this effect tends to be small because the activity of β2 receptors is overshadowed by the more dominant vasoconstricting α1 receptors.

β-Receptor antagonism