Dealing with DHE

Hello everyone.

I have a few suggestions for those having DHE IV treatment.

This is of course just based on my own experience but it might just help - especially for those new to the drug. 

First, a bit about my background. Suffered chronic CH for 13 years, average 2-3 a day. Been through all the meds. O2 helps but rebounds are now more of a problem. Have regular GON + SON. Waiting for ONS. Have a lot of other health problems so any CH relief is a big deal, as it is for all of us.

DHE gives me that much needed relief. Usually I get around 2-3 weeks good relief. By week 5 or so I am back to base.

BUT - DHE IV is a powerful drug. Over the years I have had it the treatment regime has improved a lot. The anti-nausea drip before each dose now helps a lot as do the domperidone tablets - INSIST ON TWO tabs. You will be written up for 2 but sometimes the nurses just bring one (or none). If the nausea is still bad ask for cyclizine - it will help.

The main thing is - take it slow. The anti-nausea drip and flush before each DHE take maybe 30 minutes. The post-DHE flush can take 15-30 minutes. The DHE itself is pushed through at a rate that you can deal with. The pump is usually set at 50 to start with. This will take 2 hours to go through so you are looking at up to 3 hours total. 

3 doses a day - in QS they are at 7am, 3pm, and 11pm. You are stuck to that drip for a long time. The temptation is to push up the rate so that you get it all done with quicker. Making the rate 100 for example will cut the time by half, to an hour.

My own experience is that this is a bad idea. Some people might not have a problem but I used to try to increase the rate each time but I was finding that nausea was worse. More seriously, I find that when the rate goes up, blood pressure goes down and pulse rate plummets. DHE is a vascular constrictor. My heart rate has gone as low as 39 a minute and was regularly in the low 40's - at this level you will feel very poorly. In fact I have had to stay in more than 5 days to recover.

Also, take it easy as the drug is hitting your body hard. Have a week's rest!

Now when I go in I tell myself I am in charge. I keep the rate at 50, move around but rest a lot too. I seem to handle it much better now.

Treat DHE with respect and you should be OK. I know a lot of people don't get any benefit at all and it's not for everyone. But if you do get the IV version remember it can have dangerous side effects.