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Combinations: how do you take ’em?

Hi, for those of you taking 2 medications or more in the morning, do you throw both tabs back together or do you space them out a little? Thanks x

Ho. Ho. In gallops Helen. I was ahead of you there. Soon as I read the neuro told you to intro the Propranolol I immediately wondered how you’d have to time it. The answer with combos I think you’ll find is it depends on the Combo. Propranolol I found is easy to take and kind but - only guessing here if course - it seems to me there are more restrictions in what you can/cannot take with it than any other drug pretty near. And also on the timings of such events. By which I mean the other drugs you can safely take with it can only be taken at very precise spacing with the Propranolol. I imagine it’s in the PIL but I know I’m on short release PP 3 times daily and if I want to take an indigestion remedy I have a very brief window of opportunity which, if memory serves, is about one and a half hours after a dose.

Two other points to consider. Do study the very long list of all other drugs you are not supposed to take with PP. This includes NSAIDs, antihistamines, all hay fever and cold relief meds (Bye, bye Lemsip) to name but a few. Yes. It’s a pain. From experience (no names, no pack drill) taking small amounts won’t kill you but they can stop the PP from working. And they do. When at the height of MAV I inadvertently threw myself at the ground and smashed my shoulder. A&E gave me one Cocodamol for the pain which hadn’t actually kicked in as yet and within 30 minutes I was four times as dizzy as before. I managed six weeks ‘healing one broken shoulder by immobilisation’ and never took more than maybe five doses of painkillers total. The pain was far easier to take than the increased dizziness for somebody who was already rotating 24/7 for almost two years.

The other very important thing to remember is peaks n troughs with Propranolol. I was initially told to always take them before food. This meant I was taking three doses between perhaps 8.00am and 6.00pm. I believe they stay in the system about 5/6 hours. Eventually, a year or so down the line I decided to space them as evenly as possible throughout the 24 hours and what an improvement. I’d say that gave me as much more improvement as I achieved when the neuro increased my daily intake by another 33%! Helen

Hiya Helen, thanks a mill for the detailed steer, appreciate it as always. So on day 1 I took Venf with brekkie at 8am and took the pp at 1pm with lunch and not a bother…

The next day I took it with Venf at 8am with brekkie and after about hour and a half I felt a little off, today is the same… So tomorrow I’ll take it at lunch but I’m gonna have to experiment and research best way as I’ve gotta go up to 20mg after month on 10mg. Tbh this is why I wanted extended release via beta prograne but I don’t want the 80mg first off and neither does neuro.

Meds always throw up dilemmas for sure… No quick fix… I know the lunchtime pp OK and no issues so maybe 'll be taking the 20mg with lunch next month. Right off to Google now…
Thanks a mill xx

You’ll need to space the PP evenly over the 24 hours too. Dr Hain only uses XR. My GP wouldn’t allow me to change once titrated up to XR, thought it would cause me problems. (As it turns out XR only comes capsules form here and I can’t take any capsules of anything) Interestingly I noted that Grampian PIL I posted recently only uses immediate release. I know it’s supposedly a good combo (Hain) but can’t help wondering why they gave it to you. To stop those headaches maybe. Helen

OK so double dose then at lunch on 20mg…thank. Yep it’s to try put manners on the headaches and head pressure, the Venf helped hugely with the nerve pain around eye and temple, up in head on right hand side but didn’t nail the pounding headaches and pressure enough. I’ll give it a go, if it’s not helping with 150mg Venf after 3 months, I’ll go down 137.5mg because I suspect the 150mg Venf is different in how it manages the pain eg I woke with some slight nerve pain around right eye this morning… This was all gone before the 150mg dosage.

Guessed as much. Be interesting to see if it works. As i’ve said before It killed my vestibular attacks stone dead completely for three years from Day One. I started straight in at 10mg three times daily. Never had another full on vestibular attack for three years and three months. I was getting to think they’d gone for good until January of this year. That attack was no more than 50% the intensity of pre-med ones but lasted eight days same as before meds. PP took a lot longer to reduce head pressure though and it’s a recurring symptom even now, always indicative of trouble pending too. Sure you’ve right about the 150mg Venf. I was told with Adding In to drop back on the first drug once sure you could cope with Drug No 2 as a matter of course. Don’t know if that applies to you. Helen