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[bananafeet]

If I were currently telm 80 and metoprolol 50

Would I add ciln as a third med or replace one or the other?

I chose telmisartan myself not my GP. Heart specialist put me on metoprolol for rate control.

Just wanna chose the best medication that's all. If clin has a better profile I'll use it.

 

[malfeasance]

What's your BP?
That's the main question lol

What's your current BP?

That is a difficult question. Now, in the evening, I just checked it, and it was 135/87



It is not always, though. Here are a couple of months of tracking, BP, pulse rate, date, time, notes:

118/72 71 04 Sep 2025 8:13 a.m. after only one cup of coffee

122/75 70 immediately after because I was shocked it was so low

148/86 83 07 Sep 2025 3:00 p.m. Realized I forgot to take my blood pressure meds due to chest pressure and head pressure, so took them after

111/73 71 08 Sep 2025 8:05 a.m.

147/87 96 18 Sep 2025 8:58 a.m. No blood pressure meds, 2 cups coffee

114/72 74 15 Oct 2025 8:36 a.m. 1.5 cups coffee, doing cardio for a few days



So notice a low of 111/73 and a high of 135/87 (right now). I did not include the two days I forgot to take my BP meds in the "high" category.

Also, I quit going to the gym 5 days ago due to work being busy (I know that should not matter, but my blood pressure is lower when doing regular cardio and hitting the gym and it can literally go up a few days after stopping and go down after a couple of days of doing it) and I also think it is higher in the afternoon and evening than in the morning after cardio and taking my BP meds and sitting down with my cup of coffee to get on my computer and start working, and, oh, I will take my blood pressure right here in the a.m.

I think the afternoon/evening rise might be due to the short acting nature of metoprolol, which my doctor has prescribed once a day (and objected to it being used twice a day, but I occasionally -rarely- take it in the evening if I feel things getting higher, that pounding in the chest feeling)

 

[Ghoul]

That is a difficult question. Now, in the evening, I just checked it, and it was 135/87



It is not always, though. Here are a couple of months of tracking, BP, pulse rate, date, time, notes:

118/72 71 04 Sep 2025 8:13 a.m. after only one cup of coffee

122/75 70 immediately after because I was shocked it was so low

148/86 83 07 Sep 2025 3:00 p.m. Realized I forgot to take my blood pressure meds due to chest pressure and head pressure, so took them after

111/73 71 08 Sep 2025 8:05 a.m.

147/87 96 18 Sep 2025 8:58 a.m. No blood pressure meds, 2 cups coffee

114/72 74 15 Oct 2025 8:36 a.m. 1.5 cups coffee, doing cardio for a few days



So notice a low of 111/73 and a high of 135/87 (right now). I did not include the two days I forgot to take my BP meds in the "high" category.

Also, I quit going to the gym 5 days ago due to work being busy (I know that should not matter, but my blood pressure is lower when doing regular cardio and hitting the gym and it can literally go up a few days after stopping and go down after a couple of days of doing it) and I also think it is higher in the afternoon and evening than in the morning after cardio and taking my BP meds and sitting down with my cup of coffee to get on my computer and start working, and, oh, I will take my blood pressure right here in the a.m.

I think the afternoon/evening rise might be due to the short acting nature of metoprolol, which my doctor has prescribed once a day (and objected to it being used twice a day, but I occasionally -rarely- take it in the evening if I feel things getting higher, that pounding in the chest feeling)

You can add 10, even 20 mg Ciln without issue. It will only help you, there's no risk of hypotension in your situation.

If the pricing makes sense (ie 20mg is much cheaper than 2x10mg), you may want to consider getting 20mg tabs, and splitting them to start, then if all goes well titrating to 20mg, because I suspect you'll end up at 20mg.

 

[Wizbang]

Ciln has been a game changer for me, the blunting of stress related BP increase is something I've never been able to accomplish.

 

[malfeasance]

Ciln has been a game changer for me, the blunting of stress related BP increase is something I've never been able to accomplish.

What else do you take with it?

 

[Wizbang]

What else do you take with it?

Currently I am taking Telmisartan 20, Cilnidipine 5mg (though i'd like to get it up to 10 eventually for now it works) and I also classify Rhodiola (300mg) in my stress/heart stack.

With just Telm and Rhodiola I would have sometimes large swings in BP from very well controlled (just below 120/80) to significant elevation, the addition of cilnidipine has kept me from going above 130/80 at any point in the day, even during the stress of dealing with the passing of a loved one recently and having to manage their estate and all that comes with that I was cool as a cucumber bp wise.

 

[AlexDavis43]

I think the afternoon/evening rise might be due to the short acting nature of metoprolol, which my doctor has prescribed once a day (and objected to it being used twice a day, but I occasionally -rarely- take it in the evening if I feel things getting higher, that pounding in the chest feeling)

I remember reading something about the circadian dip in blood pressure in the evening being an important component to the overall benefits of managing hypertension, so dosing one of your BP meds later in the day might be worth considering

(maybe one of the ChatGPT nerds can double check me on this)

 

[Ghoul]

Ciln has been a game changer for me, the blunting of stress related BP increase is something I've never been able to accomplish.

It's Zen in pill, without zonking you out. It's like just before you're about to explode, it's the buddy that puts their hand on your shoulder to get you to chill out.

I've never had anything have such a subtly profound impact.

Since AAS users are carrying around heightened baseline (biologically induced ) psychological stress, it's like this BP med was designed for us. It's especially effective at reducing LVH that so many in the community have.

Cilnidipine lowered psychological stress-induced increase in blood pressure in a hypertensive man: a case report - BioPsychoSocial Medicine

Background In some hypertensive patients, psychological stress makes blood pressure difficult to control and causes physical symptoms such as headache or dizziness. We report the case of a hypertensive man whose psychological stress-induced increase in blood pressure was attenuated by...

bpsmedicine.biomedcentral.com

(QOL = Quality of Life)

 

[Wizbang]

It's Zen in pill, without zonking you out. It's like just before you're about to explode, it's the buddy that puts their hand on your shoulder to get you to chill out.

I've never had anything have such a subtly profound impact.

Cilnidipine lowered psychological stress-induced increase in blood pressure in a hypertensive man: a case report - BioPsychoSocial Medicine

Background In some hypertensive patients, psychological stress makes blood pressure difficult to control and causes physical symptoms such as headache or dizziness. We report the case of a hypertensive man whose psychological stress-induced increase in blood pressure was attenuated by...

bpsmedicine.biomedcentral.com

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View attachment 355790

I'll be honest it is because of you @Ghoul that i began looking into Cilnidipine, I respond pretty well to meds, 5 mg of ciln has leveled out my stress that i used to have tight traps, headaches, heart pounding in my throat and with such a small dose its been like a huge sigh of relief. Thank you again for being such an advocate for it.

 

[Ghoul]

I remember reading something about the circadian dip in blood pressure in the evening being an important component to the overall benefits of managing hypertension, so dosing one of your BP meds later in the day might be worth considering

(maybe one of the ChatGPT nerds can double check me on this)

You're correct in that there's an early "morning surge" in BP that's when a lot of heart attacks and strokes occur.

Both Telm and Ciln taken in the morning still provide significant protection during the surge the next morning.

But the protection is a little better when they're taken at night.

The thing is, adherence to actually taking it every single day is where the vast majority of protection comes from, and those who take them in the morning are typically much better at compliance than those who take them in the evening.

So knowing myself, I take all meds in the morning, despite the advantage of taking Telm and Ciln at night.

If night dosing works for you and is something you can do consistently, you'll benefit from a little more protection.

(on another note, statins also work a little better when taken at night, but again, compliance is the priority, so take it when you know you won't forget)

 

[Wizbang]

I too also take my BP/Stress meds in the AM, pitavastatin right before bed.

 

[nudemember]

It's the best in its class, calcium channel blockers. For blood pressure control, an ACE/ARB class med is almost always used first, and then a med from another class is added to improve BP control via a different mechanism.

Think of your circulatory system as different sized pipes, from very large arteries to microscopic capillaries. They're different organs, essentially.

ACE / ARBs like Telm primarily relax small arteries,Tension in those arteries is a major source of high blood pressure.

Calcium channel blockers primarily relax large conduit arteries, further reducing blood pressure.

Also, normally when BP drops adrenaline is reflexively released to increase heart rate and constrict blood vessels to try and force blood pressure back up. Ciln blocks the release of adrenaline blunting this effect. This is also why Ciln is uniquely effective at stopping blood pressure from rising during anger, frustration or psychological stress.

Even though you are more or less in normal BP range, Ciln is one of the gentlest BP meds, and doesn't typically lower BP to the point of going too low. It sits there and jumps into action when BP rises, stopping it from going up too much.

It also provides many organ specific protective effects, for the kidney, heart, brain.

So you could add 10mg, just be on the lookout initially for low bp sides in case you're an atypical responder. Check your BP daily for the first couple of weeks, and after that it should be fine. You could start with half (5mg) tabs to be extra cautious, but it's a very safe addition (unlike other "hard" bp lowering drugs).

out of curiosity, what would you consider a "hard" bp lowering drug? I'm considering switching to ciln/telm combo while cycling. I'm currently prescribed losartan, and amlodipine by my PCP for high bp prior to any PED usage.

 

[Nixonnow99]

I'll be honest it is because of you @Ghoul that i began looking into Cilnidipine, I respond pretty well to meds, 5 mg of ciln has leveled out my stress that i used to have tight traps, headaches, heart pounding in my throat and with such a small dose its been like a huge sigh of relief. Thank you again for being such an advocate for it.

Did you notice this effect immediately? After your first dose I mean.

 

[Wizbang]

out of curiosity, what would you consider a "hard" bp lowering drug? I'm considering switching to ciln/telm combo while cycling. I'm currently prescribed losartan, and amlodipine by my PCP for high bp prior to any PED usage.

I was put on my metoprolol xl 50mg I believe it was after my MI, it was as if my heart was barely pumping, I was exhausted and standing up caused me to nearly faint but let me tell you my numbers were as low as can be...

 

[Nixonnow99]

out of curiosity, what would you consider a "hard" bp lowering drug? I'm considering switching to ciln/telm combo while cycling. I'm currently prescribed losartan, and amlodipine by my PCP for high bp prior to any PED usage.

Losartan doesn't have a half life that lasts the full 24 hours between doses. Which in turn makes a person even more susceptible to the morning "widowmaker spikes". I switched to telm for this very reason.

And amlodipine has a much higher chance of edema in the extremities. Cilnidipine does not.

 

[Wizbang]

Did you notice this effect immediately? After your first dose I mean.

No, it wasn't until several days into cilnidipine that the effects became known, the first few days I wondered if I was on too low of a dose and then suddenly one day we will say about 5 days in I noticed things weren't bothering me the way they normally did, I felt way more chill and things that would have typically stressed me out just did not.

 

[Ghoul]

I too also take my BP/Stress meds in the AM, pitavastatin right before bed.

I

out of curiosity, what would you consider a "hard" bp lowering drug? I'm considering switching to ciln/telm combo while cycling. I'm currently prescribed losartan, and amlodipine by my PCP for high bp prior to any PED usage.

Telm is superior to Losartan in every way but cost, unless you have uric acid issues or liver problems. It's generally prescribed by default because it's one of the cheapest ARB class meds.

Amlodipine is usually fine, but Ciln is again, superior in every regard but cost. It's also not available in the US ( a long story I covered here, and a disgrace imo). The biggest problem I have with it is that it not only has temporary edema as a common side effect, it makes you more likely to develop edema by damaging tissues over many years of use! A terrible quality for a long term maintenance med.

If you tell me your current doses I can give you equivalents. (Ciln is easy. x2 amlodipine dose), and current BP (you might be able to tweak it into a better range).

As far as "hard" BP medications that lower BP by a fixed amount regardless of current levels vs "soft" or only lowers "relative to current BP" meds, so they're adaptive, lowering less when not needed and more when it is needed, I got a little lazy and had AI generate this chart ranking the top 20 by their risk of causing low blood pressure:

 

[David87]

A little feedback for pct24x7 also are they associated with pct zone ? ordered 10/1 , got tracking 10/4 ,received package the 20th.

 

[Zebedee]

are they associated with pct zone ?

No.

 

[nudemember]

Losartan doesn't have a half life that lasts the full 24 hours between doses. Which in turn makes a person even more susceptible to the morning "widowmaker spikes". I switched to telm for this very reason.

And amlodipine has a much higher chance of edema in the extremities. Cilnidipine does not.

I

Telm is superior to Losartan in every way but cost, unless you have uric acid issues or liver problems. It's generally prescribed by default because it's one of the cheapest ARB class meds.

Amlodipine is usually fine, but Ciln is again, superior in every regard but cost. It's also not available in the US ( a long story I covered here, and a disgrace imo). The biggest problem I have with it is that it not only has temporary edema as a common side effect, it makes you more likely to develop edema by damaging tissues over many years of use! A terrible quality for a long term maintenance med.

If you tell me your current doses I can give you equivalents. (Ciln is easy. x2 amlodipine dose), and current BP (you might be able to tweak it into a better range).

As far as "hard" BP medications that lower BP by a fixed amount regardless of current levels vs "soft" or only lowers "relative to current BP" meds, so they're adaptive, lowering less when not needed and more when it is needed, I got a little lazy and had AI generate this chart ranking the top 20 by their risk of causing low blood pressure:

View attachment 355823

I mentioned the half life being an issue with my PCP and she said it generally doesn't matter much. go figure. my bp was more elevated in the evening compared to the morning before she upped my dosage. I always take my meds/supps in the evening before bed.

I'm on 50mg losartan, and 10mg amlodipine. I'd like to get prescribed the telm but not sure how to go about it since she shot me down when i brought it up. as for ciln, there's a brand pct247 sells that's quite cheap, 20mg x 10 tabs for .5$. is that brand generally good quality in comparison to the counter part they sell?