Blood Pressure

[BamaCrazy]

I'm having a hard time getting my BP down. I've been taking 80mg Telmi for a couple weeks now and it's not going down. Wanna say my BP monitor been avg close to 145/79.

Before I got into AAS it was fine (120/70) and I was a lot heavier then than I am now. I got some amlodipine coming to go with the Telmisartan. Anything else I should try?

Read up above at that study I posted and look for that thread where Ghoul discusses the Quattro study. Low doses of 2-3 classes of BP medication out perform increasing your dose of a single BP medication. Amplodipine can cause edema so a lot of us are switching to Cilnidipine. Telmisartan, Cilnidipine, Nebivolol and a diuretic at low doses are the way to go. Maybe not all 4 at once. But adding one at a time and evaluating progress before adding another is safe.

 

[Uncle Bub]

Is this pharma or ugl telm?

Have you seen zero noticeable drop in BP, or a little of you know?

Ugl from HYB I think is where I got it. I've seen zero drop since taking it.

 

[Uncle Bub]

Read up above at that study I posted and look for that thread where Ghoul discusses the Quattro study. Low doses of 2-3 classes of BP medication out perform increasing your dose of a single BP medication. Amplodipine can cause edema so a lot of us are switching to Cilnidipine. Telmisartan, Cilnidipine, Nebivolol and a diuretic at low doses are the way to go. Maybe not all 4 at once. But adding one at a time and evaluating progress before adding another is safe.

I've seen you guys mention cilnidipine lately. Does PCT 247 offer that? Might have to add that and nebivolol.

 

[Sampei]

I've seen you guys mention cilnidipine lately. Does PCT 247 offer that? Might have to add that and nebivolol.

Yes he has it if you want I can give you another source that has even better prices, PM me if you need it.

 

[aljowa]

I've seen you guys mention cilnidipine lately. Does PCT 247 offer that? Might have to add that and nebivolol.

They do, but it's not on their product list. Just ask them directly via email and they'll give you the various dosages and accompying prices that they can offer you.

 

[Ghoul]

Ugl from HYB I think is where I got it. I've seen zero drop since taking it.

Telm is very sensitive to degradation when exposed to air and humidity. Frankly, I wouldn't trust UGL to be effective.

At your level of BP, normally a combo of Telm 40 / Amlodipine 5 would be enough to bring you into the normal range.

Are you in the US? You can get a prescription easily online, and 90 x 40mg Telm would be $22 with Goodrx (or less if you have insurance).

40mg Telm + 10mg Cildipidine would likely be even more effective though.

AAS induced high blood pressure is largely from norepinephrine release, and Cildipidine blocks some of that.

1st, 2nd, 3rd (amlodipine) gen calcium channel blockers, L-channel, effects on the left. 4th gen Cildipidine adds N channel blocking effects on the right.

Basically it lessens rhe effects of stress / AAS "fight or flight" induced high blood pressure. It's almost like a CCB and Beta blocker combined, but instead of blocking receptors, it's blocking release of the hormone.

 

[aljowa]

Hey @Ghoul, I've seen you mention that there is a cilnidipine/telmisartan combo medication in existence. Do you happen to know what the dosage is of each substance in this combo? I got some cilnidipine delivered yesterday and I'm looking to take it in tandem with my telmisartan. I'm just curious what the Pharma ratio is of these so I can use it as a benchmark to go off of. Thanks.

 

[Uncle Bub]

Telm is very sensitive to degradation when exposed to air and humidity. Frankly, I wouldn't trust UGL to be effective.

At your level of BP, normally a combo of Telm 40 / Amlodipine 5 would be enough to bring you into the normal range.

Are you in the US? You can get a prescription easily online, and 90 x 40mg Telm would be $22 with Goodrx (or less if you have insurance).

40mg Telm + 10mg Cildipidine would likely be even more effective though.

AAS induced high blood pressure is largely from norepinephrine release, and Cildipidine blocks some of that.

Thanks. Yes US.

 

[Ghoul]

Hey @Ghoul, I've seen you mention that there is a cilnidipine/telmisartan combo medication in existence. Do you happen to know what the dosage is of each substance in this combo? I got some cilnidipine delivered yesterday and I'm looking to take it in tandem with my telmisartan. I'm just curious what the Pharma ratio is of these so I can use it as a benchmark to go off of. Thanks.

Most common by far is Telm 40/Cil 10.

Also Telm 40 / 5
Telm 40 / 20
Telm 80/ 10
Telm 80 / 20

40/10 typically brings patients down from 140 to 170 systolic and 80 to 90 diastolic into 120s / 70s

 

[aljowa]

Most common by far is Telm 40/Cil 10.

Also Telm 40 / 5
Telm 40 / 20
Telm 80/ 10
Telm 80 / 20

40/10 typically brings patients down from 140 to 170 systolic and 80 to 90 diastolic into 120s / 70s

Thank you for the information.

I forgot that I also have lisinopril. If one were to combine these three into a medication, what do you think a recommended starting dose would be? Maybe just take the minimum dose of each together?

 

[malfeasance]

Do not take ACE and ARB together

 

[malfeasance]

Google Search

 

[malfeasance]

Angiotensin-Converting Enzyme Inhibitor vs. Angiotensin Receptor Blockers

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are antihypertensive medicines used to treat high blood pressure.

www.news-medical.net

"It is not recommended to treat hypertension patients with both ACE inhibitor and ARB. The combination therapy is known to cause adverse clinical outcomes (hospitalization due to congestive heart failure) and higher mortality related to cardiovascular diseases, myocardial infarction, or stroke."

 

[Ghoul]

Thank you for the information.

I forgot that I also have lisinopril. If one were to combine these three into a medication, what do you think a recommended starting dose would be? Maybe just take the minimum dose of each together?

You are not supposed to combine ACE/ARB. One or the other, though increasingly ACE is being moved away from because of growing evidence of lung cancer risk.

 

[aljowa]

Angiotensin-Converting Enzyme Inhibitor vs. Angiotensin Receptor Blockers

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are antihypertensive medicines used to treat high blood pressure.

www.news-medical.net

"It is not recommended to treat hypertension patients with both ACE inhibitor and ARB. The combination therapy is known to cause adverse clinical outcomes (hospitalization due to congestive heart failure) and higher mortality related to cardiovascular diseases, myocardial infarction, or stroke."

You are not supposed to combine ACE/ARB. One or the other, though increasingly ACE is being moved away from because of growing evidence of lung cancer risk.

Ah, I definitely should have researched a bit more about combining them, lol. Thanks a lot to both of you for bringing this to my attention.

 

[malfeasance]

Why do you think I was asking so many questions about adding Cilnidipine?

I wanted to make sure there was not a similar risk.

 

[Ghoul]

Ah, I definitely should have researched a bit more about combining them, lol. Thanks a lot to both of you for bringing this to my attention.

One drug from each class, ACE/ARB are the same class, then there's CCBs, Beta Blockers, and Diuretics.

 

[malfeasance]

Amlodipine gave me edema also. Oddly enough only in my hands while I was sleeping. But it as bad. So I switched to Cilnidipine and I have had no issues. I take 20mg Telmisartan and 10mg Cilnidipine at night, then 10mg Nebivolol in the morning. So an ARB, CCB and a BB daily. Works great for me.

Did you add the Cilnidipine later?

I am just curious what the effect of adding that one 10mg dose of Cilnidipine on top of the others was.

I am on an ARB and BB already. I am curious what to expect from adding the CCB.

 

[Sampei]

Did you add the Cilnidipine later?

I am just curious what the effect of adding that one 10mg dose of Cilnidipine on top of the others was.

I am on an ARB and BB already. I am curious what to expect from adding the CCB.

Better decrease in BP compared to when you added the BB probably.

 

[Ghoul]

Why do you think I was asking so many questions about adding Cilnidipine?

I wanted to make sure there was not a similar risk.

You can't ask enough questions as
far as I'm concerned.

Although Cilnipidine doesn't have nearly the same amount of research behind it (it still has hundreds of studies, just not thousands like Amlodipine), that largely comes down to its use being limited to Japan and South Korea.

It's been around for 30 years though, and there's not been a hint of any serious issues in that amount of time. Japan and South Korea have robust 1st world medical systems, so they would've caught any indication of major problems.

At least that's how I view it from a risk tolerance perspective. It's not a "new" drug, is really my point, we have data from decades of use.