Diltiazem

I've never heard of this medication. When I was first diagnosed with HCM, and it wasn't obstructive yet (it is now), cardiologist put me on metoprolol. They started me at 50mg daily and went up to 100mg daily. When I first started the 100mg daily, I was exhausted at all times. I needed that dosage so they told me to try taking it 25mg in the morning and 75mg at night. This helped with the fatigue. I would never make any adjustments without cardiologist approval. And if I had your symptoms, I would get in to see a cardiologist asap, or potentially go the emergency room. Good luck!

Hi @mmicahk . Boy does THAT sound familiar! A decade or so ago - well before I was diagnosed with oHCM, I was put on Metoprolol. Don't remember the dosage. Within a very short time I was literally falling asleep at my desk, dozing off while driving... No matter how much sleep I got, I would last about 6 hours and then be completely unable to stay awake. Even had to go on reduced hours at work. I was moved from Metoprolol to Diltiazem within a couple months and that problem went away immediately. Fast forward about 8'ish years and I was finally diagnosed with obstructive HCM (after about 16 years of fruitless investigations), and put on the brand-new Camzyos. Still on Diltiazem along with the Camzyos with zero negative effects. As I've posted here previously (ad nauseum, sorry folks), especially in the discussion below, I had symptoms exactly like what you describe, and within less than 2 weeks ALL of the symptoms were 100% gone. Now I'm back to being the poster-child for lazy with no excuse for lack of activity. Pre-Camzyos I could barely walk to the end of the block but this summer, at age 61, we're looking at a 3 week train & backpack-hiking trip around parts of Europe. Some folks here have not fared as well with Camzyos but it's been life changing (excuse the hyperbole) for me. It may be worthwhile for you to visit camzyos.com to learn about this relatively new medication. Good luck chasing this all down. Take the time to scroll through the many discussions here at Mayo Clinic Connect about HCM, Camzyos, and related topics. This place is a wealth of information and the people here are wonderful about sharing their experiences.
https://connect.mayoclinic.org/discussion/camzyos-mavacamten-prescription/?commentsorder=newest&signin=true&pg=1#chv4-comment-stream-header

Good day from Canada. I am on Candesartan and Diltiazen (a channel blocker) for high blood pressure. When I was prescribed Camzyos in 2024 they stayed the same. My recent ultrasound results have been great and when I asked if I still needed Diltiazen the cardiologist said no ‘you can discontinue it’. I did 10 days ago and my blood pressure has skyrocketed. I’m going back on Diltiazen since I think it made the difference. I’m never sure about the connection between BP and HCM. Be well

Susanml, How are your symptoms taking Diltiazen (Cardizem) and Candesartan? My doc is wanting to put me on a BP med since taking me off Metoprolol my BP has gone up too high 170s and 180s. I see Boats4life is on Cardizem, too, and no side effects. Side effects are what I'm worried about. I'm on 5mg Camzyos since Monday. I'm getting some symptoms of SOB, light headed woozy feelings, and they seem to go away in the evening. But I'm wondering if my BP is contributing- the Metoprolol kept me in the 145/150 area which isn't the greatest but not as worrisome as BP now. There were moments where I could feel Camzyos was giving me a positive effect, but as it builds up in my system, I feel like symptoms are getting worse and can't differentiate between Camzyos or high BP.

I am thinking about chatting with cardiologist about switching from Metroprol xl to cardizem. Feel like Metroprol makes me fatigued. On Camzyos 5 mg. and numbers all back to normal.Any thoughts
/suggestions?

I haven't heard from very many (any) other people who had my experience on Metoprolol, but was certainly the case for me. Never hurts to ask, right? Two things to note: (i) when I was on Metoprolol, it was way before Camzyos was even a twinkle in my eye. I'm on Diltiazem & Camzyos now with no side effects. Your mileage may vary. (ii) I'm not a doctor, so my advice is worth exactly what you paid for it! Good luck dealing with the fatigue.

I was on Cardizem way before Camzyos. BP controlled.
I went into afib 4/2023 and they changed me to Metroprol
Pacemaker May 2023.
Camzyos Sept. 2023.
Was able to cut Metroprol xl to 1/2 dose. on 25mg daily now.
maybe fatigue is my heart conditions (mitral valve stenosis and regurgitation and HOCM)

@peggynurse did you ever have afib before or was that a new symptom?

I just had a sinus surgery and am waiting to recover from that to experiment with my cardiologist on stopping metoprolol. He said if the fatigue goes away we’ll try Cardizem. Metoprolol is the only cardiac med I’m on currently.

that was my first and only a fib. I was actually in the hospital for 3 days with the a fib. they were going to do a conversion to a normal sinus rhythm in the morning, but in the middle of the night, I self converted, which was great except I flatlined for nine seconds. Then I had the pacemaker put in a couple weeks later, all is good with that now.
on Camzyos, Metropole XL, and Eliquis now.

The fact that you can be away for 3 weeks is something HOCM and Camzyos have prevented me from doing. Getting the echocardiogram for the Accredo Pharmacy to agree to deliver the next 30 pills each month so that I don't run out of my daily Camzyos pills has prevented me from being away for that long. How do you coordinate this?