Isoptin RR: unusually long delivery times

For the preventive treatment of cluster headaches, many patients rely on a constant dose of extended-release verapamil. This formulation releases the active ingredient verapamil slowly and continuously over 12 hours. Although numerous extended-release verapamil preparations are available, many patients have found that only Isoptin RR provides reliable relief, and that switching to a different medication leads to a recurrence of attacks. In recent weeks, we have received numerous concerned reports from affected individuals that Isoptin RR is unavailable and that pharmacies are quoting unusually long delivery times of 10 weeks or more.

Verapamil is not all the same

Cluster headache patients are frequently confronted with the situation where their prescribed medication is substituted at the pharmacy. One problem is that instead of a sustained-release verapamil preparation, an immediate-release version is dispensed. This drastically reduces its effectiveness. In particular, it usually provides no protection at night. Cluster headache attacks occur most frequently from 2-3 a.m. onwards. With immediate-release preparations having an effect lasting four hours, if taken the night before, little to no relief can be expected after midnight. Those affected are then left unprotected. Gaps in protection can also occur during the day, allowing attacks to happen.

Patients concerned

In our experience, different extended-release verapamil preparations have incomparable release rates and durations. Therefore, it is impossible to predict in individual cases whether a previously successful regimen will remain effective after switching to a different extended-release verapamil preparation. Given the severity of cluster headache attacks, many patients are currently concerned because the supply delays mean that a continuous supply of Isoptin RR is not guaranteed. These supply difficulties occurred without prior notice, and stockpiling was not possible.

Reason: Change of production locations

According to recent consultation with the manufacturer, it has been confirmed that the production of Isoptin RR 240 mg has been transferred from Abbott to Mylan Healthcare. This involved a change of production sites, which is the cause of the delivery delays. Isoptin RR will, however, be available again on the market, likely from mid-August 2015.

Alternative: Isoptin KHK will be available again from June 20, 2015

The preparation Isoptin KHK also contains identical sustained-release verapamil in a dosage of 120 mg. It will be available again from June 20, 2015. Affected patients are therefore advised to use two 120 mg Isoptin KHK capsules instead of the 240 mg sustained-release verapamil dose of Isoptin RR. Isoptin RR and Isoptin KHK have the same pharmacological properties; no difference in effect is expected from switching between them.