I'm switching to telmisartan from lisinopril (need advice)

FYI, in line with the most recent evidence of long term good health outcomes, 120-129/70-79 is now considered "Elevated" and consideration of treatment should start in that range. So if raising nebivilol gets you below that (and you're not passing out), it's actually preferable

yes but is nebivolol a good drug for reducing HR?
My bp now is 110-115/65-70 with telmi 40 and nebivolol 2.5mg on cycle
problem is HR is still 98-100
 
yes but is nebivolol a good drug for reducing HR?
My bp now is 110-115/65-70 with telmi 40 and nebivolol 2.5mg on cycle
problem is HR is still 98-100

I know this is an unsatisfactory answer, but the reasons there are so many beta blockers (around 10) still being produced and sold is because they all have characteristics that make them "better" for some and not others. For instance, Nebivolol significantly increases nitrous oxide. This lowers blood pressure a little by relaxing tiny blood vessels (and makes your dick work better). But what if you have high heart rate without high BP? That could be a problem, even causing a stroke. Then you'd want a more selective Beta blocker that doesn't lower BP. See what I mean?

In plain english, if it gets the job done, and doesn't cause you side effects, than that's the right one for you. Any that were clearly inferior options because something better became available have been taken off the market because no one would choose those.

See how 5mg works for you, and while you could go to 10mg, the general guidance for BP related meds is it's preferable to switch than go to max dose of a particular drug. So if 5mg doesn't lower heart rate enough, either you try 10mg and see if sides are tolerable, or switch to one of the many other options at that point and see if that's more effective and again, doesn't induce side effects.
 
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I know this is an unsatisfactory answer, but the reasons there are so many beta blockers (around 10) still being produced and sold is because they all have characteristics that make them "better" for some and not others. For instance, Nebivolol significantly increases nitrous oxide. This lowers blood pressure a little by relaxing tiny blood vessels (and makes your dick work better). But what if you have high heart rate without high BP? That could be a problem, even causing a stroke. Then you'd want a more selective Beta blocker that doesn't lower BP. See what I mean?

In plain english, if it get's the job done, and doesn't cause you side effects, than that's the right one for you. Any that were clearly inferior options because something better became available have been taken off the market because no one would choose those.

See how 5mg works for you, and while you could go to 10mg, the general guidance for BP related meds is it's preferable to switch than go to max dose of a particular drug. So if 5mg doesn't lower heart rate enough, either you try 10mg and see if sides are tolerable, or switch to one of the many other options at that point and see if that's more effective and again, doesn't induce side effects.
can you suggest me other drugs specifically targeting HR?
so I can start reading on them, less they reduce the BP the better, as the BP is very good right now and don't need it lower.
 
See what I mean?

Hello.
Better today or are you still a hormonal so and so?

Please answer and do not pretend you haven't read this, or I am going to flipping hate you forever.
Since everyone already does, you don't need this, too.
So.....
 
can you suggest me other drugs specifically targeting HR?
so I can start reading on them, less they reduce the BP the better, as the BP is very good right now and don't need it lower.

Well what you're asking for is the most "cardioselective" beta blocker, that specifically blocks adrenaline receptors in the heart without affecting other receptors. Nebivolol is actually the strongest EXCEPT for the vasodilation from the nitrous oxide it increases.

IMG_8900.webp

Bisoprolol is the next most cardioselective beta blocker, but does not open blood vessels.

IMG_8899.webp

A new drug might bring on new sides though (or not), and unless slightly lower BP is a problem for you, personally I wouldn't switch.

 
thanks man, you really dumbed it down for me. Gonna stay on 40telmi and try 5mg nebi and hopefully I can tackle this damn High HR
Well what you're asking for is the most "cardioselective" beta blocker, that specifically blocks adrenaline receptors in the heart without affecting other receptors. Nebivolol is actually the strongest EXCEPT for the vasodilation from the nitrous oxide it increases.

View attachment 295585

Bisoprolol is the next most cardioselective beta blocker, but does not open blood vessels.

View attachment 295586

A new drug might bring on new sides though (or not), and unless slightly lower BP is a problem for you, personally I wouldn't switch.

 
Hello.
Better today or are you still a hormonal so and so?

Please answer and do not pretend you haven't read this, or I am going to flipping hate you forever.
Since everyone already does, you don't need this, too.
So.....

I feel better in the company of curious. intelligent people.

Even if they disagree, which I actually welcome so I can improve my knowledge by being challenged, it's done respectfully, thoughtfully, and not the knuckle dragging proudly ignorant kind.

Nothing personal with you, the whole mob gets put on mute when that happens.
 
thanks man, you really dumbed it down for me. Gonna stay on 40telmi and try 5mg nebi and hopefully I can tackle this damn High HR

Thanks for the opportunity to get out and refresh my knowledge on this topic, If I were in your position, that's exactly what I would do. 80mg Telma will probably bring your BP down too much, while the Nebiv will just bring it closer to ideal, and hopefully get your heart rate where it should be. Remember it'll take a few weeks to settle in at the new dose, so be patient with any minor side effects as they may resolve in that time.
 
I feel better in the company of curious. intelligent people.

Even if they disagree, which I actually welcome so I can improve my knowledge by being challenged, it's done respectfully, thoughtfully, and not the knuckle dragging proudly ignorant kind.

Nothing personal with you, the whole mob gets put on mute when that happens.

No problem.
Glad to know you are OK, that's all.
thanks
 
The most up to date hypertension treatment guidance recommends starting with small dose combinations of something to block Angiotensin, along with a calcium channel blocker, to open blood vessels as much as possible. Then add a beta blocker if specific symptoms like chest pain, irregular heartbeat continue. Beta blockers are never a first choice treatment for high BP.

Roids + GH (when I even bother to take it) sent my resting (sitting down at my computer) HR to 75.

I know 75 doesn't sound high, but it makes me feel like shit. It's mainly from the GH.

I tried neb to bring it down, and I felt like even more shit. Couldn't do hard cardio in the gym.

I guess there's no point to my post but to whine.

Oh, and clen makes me feel like I'm going to die. That shit is awful. Jesus christ.
 
Unfortunately GoodRX won’t create a new RX for Telmisartan, only renewal of prior RX with documentation (photo of bottle or website of provider showing med, dose, and my name) of the prior script. They’re happy to RX new Tadalafil though.

Any other telemed providers you can think of that would RX Telmisartan? I’ve seen Push and Seasame Care ($29 visit with Costco discount).

Bonus if the telemed provider would give a referral for coronary calcium scan (CAC).

The cheapest way is to get an appointment for GoodRX Care.

[…]
 
Unfortunately GoodRX won’t create a new RX for Telmisartan, only renewal of prior RX with documentation (photo of bottle or website of provider showing med, dose, and my name) of the prior script. They’re happy to RX new Tadalafil though.

Any other telemed providers you can think of that would RX Telmisartan? I’ve seen Push and Seasame Care ($29 visit with Costco discount).

Damn man you got a crappy provider, I never had an issue(or heard of anyone who did) for a BP med.

Anyway, Sesame (esp with the costco discount), is excellent as well. Give them a try. I doubt you'll have an issue a second time. If they ask about a bottle (which has never happened to me), tell them it had no refills and was empty so you threw it away.
 
Unfortunately GoodRX won’t create a new RX for Telmisartan, only renewal of prior RX with documentation (photo of bottle or website of provider showing med, dose, and my name) of the prior script. They’re happy to RX new Tadalafil though.

Any other telemed providers you can think of that would RX Telmisartan? I’ve seen Push and Seasame Care ($29 visit with Costco discount).

Bonus if the telemed provider would give a referral for coronary calcium scan (CAC).
How much is telmisartan without a prescription in the US?
 
How much is telmisartan without a prescription in the US?

You can only buy it with a prescription in the US (or order from overseas. which isn't technically legal but not exactly a crime either).

With a prescription and no insurance (the "cash price") it's $5-$10 a month.
 
You can only buy it with a prescription in the US (or order from overseas. which isn't technically legal but not exactly a crime either).

With a prescription and no insurance (the "cash price") it's $5-$10 a month.
Like you can't find a pharmacy that gives it to you OTC? Really? What the fuck lol

It's really another universe compared to where I live here ahahah
 
I was prescribed Losartan for years. I researched Telmisartan and found some studies that compared the two. Telmisartan came out on top so I convinced my Doc to switch me.
 
I was prescribed Losartan for years. I researched Telmisartan and found some studies that compared the two. Telmisartan came out on top so I convinced my Doc to switch me.

Always nice to have a doctor without a big ego who'll go along with patient preferences.

All the "artan" drugs in the same class (ARBs), so are interchangeable, though they have different characteristics.

Valsartan is better for athletic performance, while Telmisartin offers better muscle strength and fat loss, for instance. Mainly though, they're usually switched to manage side effects.
 
[…] Sesame (esp with the costco discount), is excellent as well. Give them a try. I doubt you'll have an issue a second time. If they ask about a bottle (which has never happened to me), tell them it had no refills and was empty so you threw it away.
Trying again with SesameCare in an hour.
$29 for video visit with Costco discount.
 
Tell us more

I'm going to preface this by saying research in this area is thin, and what I'm going to present is based on what I've extrapolated as a layman, piecing together data from disparate sources. It's worth noting however, that Valsartan has long been banned by several sports anti-doping bodies.

I think the distinguishing "performance enhancing" characteristic of Valsartan is its ability to maintain lowered Central Systolic Pressure during exercise.

In brief, under physical stress, heart rate rises, arteries feeding peripheral muscles dilate, allowing blood to flow more freely, and therefore more oxygen and fuel is sent to where it's most needed.

Other blood vessels, specifically those going to internal organs and the brain constrict, to preserve available oxygen for muscles. The additional resistance causes a rise in Central Systolic Pressure, and the heart must work harder to overcome it.

During exercise, Valsartan keeps Central Systolic Pressure low, while not further lowering pressure in the extremities and maintaining proper resistance (which could cause you to pass out).

IMG_8910.webp

This removes a lot of workload from the heart, while still supplying muscles with the extra blood flow required.

Here's where it gets interesting.

During exercise, the natural regulatory system constricts arteries feeding organs to preserve available oxygen for muscles, presumably for good reason, ie, there's not enough for both under physical stress.

In patients with heart failure, performing rehabilitation exercises, those treated with Valsartan reported feeling it took much less effort, while actual endurance and performance didn't increase. Given their limited aerobic capacity, Valsartan is taking a load off their heart, but can't put more oxygen in their blood. In fact, performance was slightly LOWER in the Valsartan group. After all, some of their limited oxygen supply is being redirected to organs instead of muscles through the arteries Valsartan is relaxing. As to why they were less "exhausted" feeling? Exhaustion is psychological, triggered when the brain detects reduced blood glucose. With more blood being directed to the brain, it's getting more glucose, and despite not having enough oxygen to keep muscles working longer, it doesn't feel as taxing to them.

But what about healthy, aerobically fit athletes? Those with excess blood oxygenating capacity? Now with Central Systolic Pressure kept low, both muscles and organs (including the exhaustion sensing brain) are ALL getting extra blood flow from an exercise stimulated faster beating heart, which doesn't have to work as hard to move that blood through the constricted arteries feeding organs.

Unlike the heart failure patients (and in other studies, healthy, but aerobically unconditioned rodents), this group has oxygen capacity to spare.

The reduced heart workload, fully functioning internal organs, and a brain kept happy by a better supply of blood glucose and oxygen(leading to better response times, for instance), are all what I think make aerobically conditioned athletes experience Valsartan as a performance enhancer.

PS. While lowering BP generally is known to help with erectile dysfunction, Valsartan is known to significantly improve sexual satisfaction.

IMG_8911.webp

I think the ability to engage in vigorous bedroom "exercise" without quickly becoming exhausted may be in large part the reason for this, and the lessened stress (from performance anxiety) may even reduce psychogenic ED.

Improved orgasmic function could be from the brain continuing to get a full ration of glucose, instead of it being restricted as would otherwise happen, from the improved blood flow provided by Valsartan despite physical exertion, which would usually reduce it.



 
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