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[Nixonnow99]

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?

I'm sure Ghoul will know more on the RX side of things. But I do know that you can get a legit script for Telmisartan from TelyRX. A 90-day supply costs just under $50. There are no doctor consults. It is automatically approved.

And yes, PCT24/7 has all pharma-grade meds.

Side note: 40mg Telmisartan would be equivalent to 50mg Losartan.

 

[nudemember]

I'm sure Ghoul will know more on the RX side of things. But I do know that you can get a legit script for Telmisartan from TelyRX. A 90-day supply costs just under $50. There are no doctor consults. It is automatically approved.

And yes, PCT24/7 has all pharma-grade meds.

Side note: 40mg Telmisartan would be equivalent to 50mg Losartan.

any idea if insurance would cover the script through them?

 

[Superchicken]

any idea if insurance would cover the script through them?

Telyrx sends through their own pharmacy so no insurance. Sesame and Push Health will send to pharmacy and you can use insurance. Sesame requires a face to face appointment and push doesn’t.

 

[dcfreak]

First TD from this source and definitely pleased. Another pack in route.

 

[bubba618]

I'm sure Ghoul will know more on the RX side of things. But I do know that you can get a legit script for Telmisartan from TelyRX. A 90-day supply costs just under $50. There are no doctor consults. It is automatically approved.

And yes, PCT24/7 has all pharma-grade meds.

Side note: 40mg Telmisartan would be equivalent to 50mg Losartan.

Mark Cuban's Drug Company (pharmacy) provides 40mg telmisartan in 3 bottles with a 30-day supply per bottle for $10.24 plus their processing and shipping costs which combined is under $20. Your physician should be able to go into their electronic systems and find it easily.

 

[bigdaddyandfriends]

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?

Losartan itself has a very short half life, but it's usefully extended by an active metabolite. Still its window of effect is significantly shorter than azilsartan or telmisartan. Of those two, telmisartan has the longer half life but azilsaran has a longer binding to AT1R. I've used both and there is little actual difference in practice. Being a cheap generic, I do not see why any doctor would prefer Losartan over telmisartan; azilsartan is still brand name (Edarbi) in USA maybe for another year or so. I suppose you could request telmisartan prescription for its added benefits via PPARγ/⍺ activation? Not that your PCP probably has any idea what that is...

If I were you, I'd just escape your PCP and buy Cilnep-T from PCT24x7 and use that. You'll get the superior ARB and cilnidipine is superior to amlodipine in every possible way (and getting a TelyRx prescription for that is not possible since it is not a formulary drug in USA). If your potassium runs on the higher side with an ARB or you want a little extra BP control, get the Telmiheal Trio which is a 3-in-1 combo pill that has telmisartan 40mg, cilnidipine 10mg, and chlorthalidone 6.25mg.

If you go with Cilnep-T, you can still get a TelyRx prescription for Indapamide or chlorthalidone as an add-on if needed/wanted; they're similar but indapamide is more potent and available in lower dosages 2.5mg versus 25mg for chlorthalidone.

I've been using either (Cilnep-T + Telmiheal Trio one ea per day), or (2) Cilnep-T + one 2.5mg indapamide per day) and the combo of ARB, CCB, and thiazide-like diuretic keep my BP perfect - even on 500mg anabolics and 7.5iu GH. Generally it stays in the 110-65 - 120/75 range.

The low cost Cilnidipine 10 or 20mg is made by the same company as the Telmiheal Trio (Healing Pharma)... so far I've been very satisfied with their medications. Have several others from them too including quetiapine (one quarter tab = 6.25mg for sleep) and they all work great and are nicely pressed and the blister packs are air tight.

I was diagnosed with diastolic HTN when natural and prescribed Edarbi by a cardiologist - it was $50/mo via manufacturer program as my insurance did not cover it. And I now see why because telmisartan is basically just as good (potentially better in some ways) and already a cheap generic.

 

[nudemember]

Losartan itself has a very short half life, but it's usefully extended by an active metabolite. Still its window of effect is significantly shorter than azilsartan or telmisartan. Of those two, telmisartan has the longer half life but azilsaran has a longer binding to AT1R. I've used both and there is little actual difference in practice. Being a cheap generic, I do not see why any doctor would prefer Losartan over telmisartan; azilsartan is still brand name (Edarbi) in USA maybe for another year or so. I suppose you could request telmisartan prescription for its added benefits via PPARγ/⍺ activation? Not that your PCP probably has any idea what that is...

If I were you, I'd just escape your PCP and buy Cilnep-T from PCT24x7 and use that. You'll get the superior ARB and cilnidipine is superior to amlodipine in every possible way (and getting a TelyRx prescription for that is not possible since it is not a formulary drug in USA). If your potassium runs on the higher side with an ARB or you want a little extra BP control, get the Telmiheal Trio which is a 3-in-1 combo pill that has telmisartan 40mg, cilnidipine 10mg, and chlorthalidone 6.25mg.

If you go with Cilnep-T, you can still get a TelyRx prescription for Indapamide or chlorthalidone as an add-on if needed/wanted; they're similar but indapamide is more potent and available in lower dosages 2.5mg versus 25mg for chlorthalidone.

I've been using either (Cilnep-T + Telmiheal Trio one ea per day), or (2) Cilnep-T + one 2.5mg indapamide per day) and the combo of ARB, CCB, and thiazide-like diuretic keep my BP perfect - even on 500mg anabolics and 7.5iu GH. Generally it stays in the 110-65 - 120/75 range.

The low cost Cilnidipine 10 or 20mg is made by the same company as the Telmiheal Trio (Healing Pharma)... so far I've been very satisfied with their medications. Have several others from them too including quetiapine (one quarter tab = 6.25mg for sleep) and they all work great and are nicely pressed and the blister packs are air tight.

I was diagnosed with diastolic HTN when natural and prescribed Edarbi by a cardiologist - it was $50/mo via manufacturer program as my insurance did not cover it. And I now see why because telmisartan is basically just as good (potentially better in some ways) and already a cheap generic.

thanks for all the useful info!

My BP on the losartan and amlodipine stayed around 130/80 to 140/90 for months, logging it everyday day twice a day before i finally got her to up my dose, which was when i brought up telm. i think she justified just upping the dose by stating my evening BP was elevated due to being ready for another dose. I didn't care to argue with her i just accepted the free meds and moved on. I would ditch her all together but she's done very well in managing my bipolar disorder.

i'm very interest in giving the cilnep-t a try. you think a straight swap from my current dosing to the cilnep-t would work? Would it be worth getting some 10mg ciln as well in case i needed to up the dosage for better bp control?

 

[Ghoul]

thanks for all the useful info!

My BP on the losartan and amlodipine stayed around 130/80 to 140/90 for months, logging it everyday day twice a day before i finally got her to up my dose, which was when i brought up telm. i think she justified just upping the dose by stating my evening BP was elevated due to being ready for another dose. I didn't care to argue with her i just accepted the free meds and moved on. I would ditch her all together but she's done very well in managing my bipolar disorder.

i'm very interest in giving the cilnep-t a try. you think a straight swap from my current dosing to the cilnep-t would work? Would it be worth getting some 10mg ciln as well in case i needed to up the dosage for better bp control?

You've got room for about 1,000 tabs per box. Shipping represents a good chunk of the cost so if you've got "room" it's always good to fill it up.

 

[explodingHeart]

You've got room for about 1,000 tabs per box. Shipping represents a good chunk of the cost so if you've got "room" it's always good to fill it up.

Chatgpt (sorry) says Ciln can still bloat you. But going by "feelz", it seems telmi + ciln = slightly to moderate less bloat than only Telmi. Is there any proof for either one?

 

[bigdaddyandfriends]

everything is potentially a side effect for any drug

Never heard of bloating from telmi - like other ARBs it should have a very mild diuretic effect on its own.

Edema in the peripheral subcutaneous tissues is a known side effect of CCBs, and the older ones up to 3rd gen available in USA are major offenders. Cilnidipine (a 4th gen CCB) is much less likely to cause this. I’ve been using 20mg/day and have had zero edema/bloating. My leg veins in fact look like a road map although I attribute mostly to GH.

 

[Ghoul]

Chatgpt (sorry) says Ciln can still bloat you. But going by "feelz", it seems telmi + ciln = slightly to moderate less bloat than only Telmi. Is there any proof for either one?

Edema isn't impossible with Ciln, but it's very, very rare. Much rarer than other CCBs. Ciln is what patients are switched to (where available) when Amlodipine gives them Edema.

This is mostly because there are a minuscule number of people who don't respond to the "N" calcium channel blocking of Ciln due to genetics, only "L". When this happens, Ciln is basically identical to Amlodipine (which is "L" blocking only), and unsurprisingly, some of them develop Amlodipine's edema side effects.

Combined with Telm, the risk of edema is lowered even further since Telm helps remove excess sodium and water.

(PS, when asking any AI about meds, enable the deeper thinking mode. With the free version of ChatGPT click icon at the bottom of the window that looks like an equal sign, , and choose "Deep Research". )

 

[bigdaddyandfriends]

thanks for all the useful info!

My BP on the losartan and amlodipine stayed around 130/80 to 140/90 for months, logging it everyday day twice a day before i finally got her to up my dose, which was when i brought up telm. i think she justified just upping the dose by stating my evening BP was elevated due to being ready for another dose. I didn't care to argue with her i just accepted the free meds and moved on. I would ditch her all together but she's done very well in managing my bipolar disorder.

i'm very interest in giving the cilnep-t a try. you think a straight swap from my current dosing to the cilnep-t would work? Would it be worth getting some 10mg ciln as well in case i needed to up the dosage for better bp control

50mg losartan ~ 40mg of telmisartan

Cilnidipine can take at 10-20mg depending on how your BP.

Cilnep-T you could take once per day, no problem. Or you can take two a day to get the most efficacious dosages ie 80mg telmi + 20mg cilnidipine. Beyond that there are diminishing returns and better adding a third drug ie diuretic.

I don’t really recommend beta blockers any more except in patients that need them for heart failure. An exception is propranolol for its CNS effects. Otherwise ivabradine is better at reducing RHR with fewer side effects.

 

[bigdaddyandfriends]

Edema isn't impossible with Ciln, but it's very, very rare. Much rarer than other CCBs. Ciln is what patients are switched to (where available) when Amlodipine gives them Edema.

This is mostly because there are a minuscule number of people who don't respond to the "N" calcium channel blocking of Ciln due to genetics, only "L". When this happens, Ciln is basically identical to Amlodipine (which is "L" blocking only), and unsurprisingly, some of them develop Amlodipine's edema side effects.

Combined with Telm, the risk of edema is lowered even further since Telm helps remove excess sodium and water.

(PS, when asking any AI about meds, enable the deeper thinking mode. With the free version of ChatGPT click icon at the bottom of the window that looks like an equal sign, , and choose "Deep Research". )

And the free version of ChatGPT likes to lie. It told me 7α-methylestradiol is a selective ERβ agonist, which is flat out false. Οne could wish! It provided a completely useless reference that didn’t even mention this specific synthetic estrogen. Ran the same query on my wife’s paid version and got different results.

Interesting I did find a selective ERβ agonist, believe it or not it’s a soy isoflavone (genistein) and cheap on Amazon.

 

[Ghoul]

And the free version of ChatGPT likes to lie. It told me 7α-methylestradiol is a selective ERβ agonist, which is flat out false. Οne could wish! It provided a completely useless reference that didn’t even mention this specific synthetic estrogen. Ran the same query on my wife’s paid version and got different results.

Interesting I did find a selective ERβ agonist, believe it or not it’s a soy isoflavone (genistein) and cheap on Amazon.

Correct. "Deep research" significantly reduces the chances of that (though not entirely). The paid version will also throw up BS, though much less often.

I use a paid platform that runs the inquiry through 5, 10, sometime 15 models or more, then compares, and works out factual discrepancies between them. It's very time consuming but the only method to ensure accuracy.

Most of the time I'll take a fast answer from an AI but always follow up by requesting links to and reading original sources before I believe anything it says.

 

[Photon]

I don’t really recommend beta blockers any more except in patients that need them for heart failure. An exception is propranolol for its CNS effects. Otherwise ivabradine is better at reducing RHR with fewer side effects.

Even if it's nebivolol?
I mean, even IVA is prescribed for h.f.

Why not IVA for both h.f and non h.f patients?

 

[newguy2]

Correct. "Deep research" significantly reduces the chances of that (though not entirely). The paid version will also throw up BS, though much less often.

I use a paid platform that runs the inquiry through 5, 10, sometime 15 models or more, then compares, and works out factual discrepancies between them. It's very time consuming but the only method to ensure accuracy.

Most of the time I'll take a fast answer from an AI but always follow up by requesting links to and reading original sources before I believe anything it says.

Care to share the platform?

 

[Ghoul]

Care to share the platform?

Custom API on You.com but the Research agent you get access to with a standard $20 pro subscription does something similar. It blends output from 40+ of the largest LLMs. All the models from OpenAI, Google, Anthropic. Grok, Meta etc

 

[newguy2]

Custom API on You.com but the Research agent you get access to with a standard $20 pro subscription does something similar. It blends output from 40+ of the largest LLMs. All the models from OpenAI, Google, Anthropic. Grok, Meta etc

Thanks bro.

 

[explodingHeart]

Custom API on You.com but the Research agent you get access to with a standard $20 pro subscription does something similar. It blends output from 40+ of the largest LLMs. All the models from OpenAI, Google, Anthropic. Grok, Meta etc

What's crazy is I've still never heard of Ciln anywhere outside of this board. Even with all of the easy AI searching that reads medical journals and summarizes in one click.

Where did you first hear about it?

Of course if I type it into any search there's a ton of research on it. It's like it's a forbidden drug in America!

 

[malfeasance]

I don’t really recommend beta blockers any more except in patients that need them for heart failure. An exception is propranolol for its CNS effects. Otherwise ivabradine is better at reducing RHR with fewer side effects.

Are you a doctor?