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

[lukiss96]

Not sure if I should've posted in male health section of the forum, but here this thread will get more attention.

So, I have been using lisinopril for a month now and it works well. It got my blood pressure from 150's/80 down to 130's, but it makes me a bit dizzy especially when driving. I take it at night and it still is kinda problematic. So therefore I read about telmisartan and heard many stories from you guys which made me want it even more.

My stats are 230lbs and about 14-16% body fat range, I plan to drop to 220 (100kg) or even a bit lower mainly through losing a bit more body fat, but I will lose some overall size. I take 250mg TU weekly, I planned to drop to 200mg, but right now I want to lean out on it and get a pro photoshoot of my body. So a bit more enhanced look "fake natural" like them social media followers say. Then later on I will see how my health does if it says no, then I will consider TRT at 150-160mg/week. Health is more important, but I want to balance it with looks and strength. Do things more moderately than I used to.

My main questions are:

-How should I switch from lisinopril 20mg to 40mg telmisartan? (My last pill was last night june 22nd, today is 23rd mid day, I'm thinking of skipping the dose today and start on 24th to let the half life of lisinopril clear)

-I hear it helps to flush extra water retention, does it interfere with creatine? I like creatine and it makes me fuller and stronger, I don't gain too much weight on it maybe 5-6lbs max.

-Can I combine it with say 5mg cialis daily?

-Should I avoid anything on it? Obviously alcohol only on holidays and I don't smoke or vape, so I guess apart from one smallest red bull can a day, I don't do any other toxic stuff.

-Anything else should I know before starting?

 

[narta]

Talk to your doc

 

[explodingHeart]

Any idea why your BP was so high in the first place on only 250mg test and 220 lbs?

 

[lukiss96]

Any idea why your BP was so high in the first place on only 250mg test and 220 lbs?

At 220lbs it's in the 140's. It used to be fine and stayed in the 130's zone until a year ago. Then I had issues whenever I stayed at my usual weight of 230lbs even on 250mg test, not to mention if I go heavier on cycle over 250lbs then it's really bad.

So my plan is to reach 220 pounds and use telmisartan to get myself in the 120's zone.

Talk to your doc

Usually I would and advise others too, but in this case I have to self medicate. I wouldn't ask.

 

[Aspirin 11]

I take 5 mg nebivolol, 40 mg telmisartan and 5 mg tadalafil. and my pulse and blood pressure are perfect.

 

[lukiss96]

I take 5 mg nebivolol, 40 mg telmisartan and 5 mg tadalafil. and my pulse and blood pressure are perfect.

Good to know, do you take creatine or any other supplements?

 

[Aspirin 11]

Good to know, do you take creatine or any other supplements?

I take many different supplements, but I take creatine, but I will use it, I don’t think it will change anything compared to the anabolic steroids that I use

 

[lukiss96]

I take many different supplements, but I take creatine, but I will use it, I don’t think it will change anything compared to the anabolic steroids that I use

Creatine is definitely not even comparable to steroids, but it still gives a bit more fullness and strength. I was asking more in terms of how creatine interacts with telmisartan and it seems it's neutral based on your experience.

 

[Fattyone]

Creatine is definitely not even comparable to steroids, but it still gives a bit more fullness and strength. I was asking more in terms of how creatine interacts with telmisartan and it seems it's neutral based on your experience.

I’m on telmi and 5mg cialis daily. I also just recently (~5 weeks ago) started creatine. Idk what you’re worried about haplening but I’ve never noticed anything from telmi or creatine other than my wallet getting lighter.

 

[lukiss96]

I’m on telmi and 5mg cialis daily. I also just recently (~5 weeks ago) started creatine. Idk what you’re worried about haplening but I’ve never noticed anything from telmi or creatine other than my wallet getting lighter.

Thanks, I thought it shouldn't be a significant factor, just that what I read on medicalnews got me thinking:

It also allows your kidney to get rid of excess water and salt. This helps lower your blood pressure.

Probably nothing major to worry about just my thoughts.

Source:

Telmisartan: Side effects, dosage, uses, and more

Telmisartan oral tablet is a prescription medication used to treat high blood pressure. For some people, it may also be used to lower the risk of heart attack, stroke, or death. The tablet comes as a generic drug and as the brand-name drug Micardis. Learn about side effects, warnings, dosage...

www.medicalnewstoday.com

 

[Liter O' Test]

telemisartan supposedly improves water retention because i think its main method of action is increasing potassium levels, i ithink you should just switch it normally, anything more complicated i think youre asking for trouble . this stuff is well tolerated you just have to watch out for high potassium levels, avoid direetics and i read nsaids.

i first managed my BP with lisinopril, then after a few years i switched to losartan which is the same class of drug as telemisartan, ARBs , ive been off that for a year but my BPs creeping back up on clen, and ive got some orals lined up, so ill be joining you on the telemisartan train, because telemisartan has better 24 hr coverage and penetrates cell membranes better than losartan along with all the studies about the heart that are beneficial for us gear users.

IIRC youre supposed to get like your electrolyte(?) panel every 6 months or so, just to make sure you dont have anything skewed from the potassium effecct of telemisartan. pretty sure if you take potasium sparing direcetics or take too much potassium in general, or take something that interferes with potassium clearing, potassium builds up and i think that can lead to like a heart attack or something crazy

 

[lukiss96]

telemisartan supposedly improves water retention because i think its main method of action is increasing potassium levels, i ithink you should just switch it normally, anything more complicated i think youre asking for trouble . this stuff is well tolerated you just have to watch out for high potassium levels, avoid direetics and i read nsaids.

i first managed my BP with lisinopril, then after a few years i switched to losartan which is the same class of drug as telemisartan, ARBs , ive been off that for a year but my BPs creeping back up on clen, and ive got some orals lined up, so ill be joining you on the telemisartan train, because telemisartan has better 24 hr coverage and penetrates cell membranes better than losartan along with all the studies about the heart that are beneficial for us gear users.

IIRC youre supposed to get like your electrolyte(?) panel every 6 months or so, just to make sure you dont have anything skewed from the potassium effecct of telemisartan. pretty sure if you take potasium sparing direcetics or take too much potassium in general, or take something that interferes with potassium clearing, potassium builds up and i think that can lead to like a heart attack or something crazy

Thanks for the info, I appreciate it. Telmisartan almost sounds too good to be true lol, but we will see maybe it's really that good. Time will tell.

 

[Ghoul]

telemisartan supposedly improves water retention because i think its main method of action is increasing potassium levels, i ithink you should just switch it normally, anything more complicated i think youre asking for trouble . this stuff is well tolerated you just have to watch out for high potassium levels, avoid direetics and i read nsaids.

i first managed my BP with lisinopril, then after a few years i switched to losartan which is the same class of drug as telemisartan, ARBs , ive been off that for a year but my BPs creeping back up on clen, and ive got some orals lined up, so ill be joining you on the telemisartan train, because telemisartan has better 24 hr coverage and penetrates cell membranes better than losartan along with all the studies about the heart that are beneficial for us gear users.

IIRC youre supposed to get like your electrolyte(?) panel every 6 months or so, just to make sure you dont have anything skewed from the potassium effecct of telemisartan. pretty sure if you take potasium sparing direcetics or take too much potassium in general, or take something that interferes with potassium clearing, potassium builds up and i think that can lead to like a heart attack or something crazy

Clen lowers blood pressure and increases heart rate.

 

[Ghoul]

Thanks for the info, I appreciate it. Telmisartan almost sounds too good to be true lol, but we will see maybe it's really that good. Time will tell.

Most importantly, this can't be emphasized enough:

For best long term health outcomes, 120/70 is the most well substantiated target BP for the vast majority.

It's the lowest hanging health protection measure you can take, with the biggest bang for the buck by a long shot in terms of low effort/high reward. So stick with the trial and error until you find something that gets you to target with no intolerable sides. After that it's one daily pill that you usually don't have to change for years or decades.

With BP meds in general when initiating treatment or changing dose or compound:

It takes 2 weeks to reach the maximum; stable reduction in BP.

It takes a month for the body to acclimate, and side effects to subside (the ones that will subside). Fatigue, occasional light dizzyness, and water retention in the extremities are the most common initially experienced with almost all BP meds until things stabilize. Many people give up prematurely and end up living with "the silent killer" instead. Reassess after a month.

If you're not getting there with 40mg Telmisartan, or any monotherapy BP med, the best strategy is not to increase the dose, which increases the risk and severity of side effects, but to switch to combination therapy of two low dose meds that reduce BP using different mechanisms.

For instance, instead of increasing Telmisartin from 40mg to 80mg, use generic Twynsta, a combination of Amlodipine (a calcium channel blocker) and Telm (An angiotensin blocker) at 5mg Amlodipine / 40mg Telmisartin. That combo has less likelihood of sides than 80mg Telm (or 10mg Amlodipine) while resulting in significantly more BP reduction than either med used alone at double the dose.

All of the "-artan" ARB class BP meds offer advantages and disadvantages. Telmisartan offers more visceral fat reduction, while Valsartan has a more positive effect on libido and sexual function, for instance. Telmisartan improves muscle function, Valsartan improves aerobic performance. They're both banned PEDs in sports, BTW.

I've tried Amlodipine / Telmisartan which increased hair loss for me, so switched to Amlodipine / Valsartan, and not only did the hair loss stop, I love the way the way it makes me feel. That was completely unexpected.

Both one pill combos, 5/80 Twynsta and 5/160 ExForge (the Aml/Valsartan combo brand name) brought me from 160/93 to a rock solid 120/70. (fyi ignore the dosages of different drugs even in the same class. 80mg Telm and 160mg Val are roughly equivalent for instance, there are charts that show equivalent doses to guide you when switching).

If you haven't already, get a home monitor, they're cheap, and keep an eye on your BP closely when trying a new BP med.

Finally, while Telm is widely available from UGL suppliers, it's not difficult to find any of the combo meds from India pharma and easily acquireable in the US with a quick $40 telemedicine call and just telling the provider you had been on (FILL IN BP MED HERE), it was working, but you lost your insurance, and need a prescription so you can get back on it. Use GoodRx to find the pharmacy with cheapest price before the appointment.

 

[Ghoul]

For anyone wanting more detail on how to choose what to use, this is a flowchart based on the most up to date guidelines. Doctor's have long used these, but more recently they have computer programs that look at a ton of factors and spit out a recommendation, the doctor updates it with the results at the next appointment, and it suggests changes if needed. It's very "step by step" until something works.

Note one of the biggest changes recently is that if you're over 150 systolic OR 90 diastolic they now recommend starting with a 2 combo med, ie, an ARB and a Calcium Channel Blocker. If it's not enough go from low to moderate dose. If that's not enough either go to the high dose (only if you have no side effects) or, preferably add a 3rd med (a diuretic) to the combo.

(this multi drug, low dose strategy has proven so effective, and with less side effects than high doses, there are a number of quad bp drug class combo pills coming to market, though that's not a step in the charts yet)

If you have minor side effects but your BP is being effectively lowered, from what I've read it's good practice to keep using that same class combination (ie calcium channel blocker/ARB), but change one of the two drugs in the combo and use an equivalent dose to what's working.

Flowchart:

UpToDate

www.uptodate.com

Medication selection chart:

UpToDate

www.uptodate.com

Original source:

UpToDate

www.uptodate.com

 

[Ghoul]

PCT24x7 has Telmaheal AM, 5mg Amlodipine / 40mg Telmisartin, a low dose "Step 1" treatment recommended in the charts above for anyone with BP over 150/90 (either).

It has a 72% chance of getting a patient below 130/80, so at or close to the 120/70 target.

$43 for a year's worth.

 

[OmL]

I’m unsure about a protocol for switching over, but when I am Cruising on my prescribed dose, my typical resting heart rate is 115/60. And when I use 20mg Telmisartan every day while on a blast my typical resting heart rate does be 125/80. I find that (with me) a little Telmisartan does a lot for me. I know some brand out there combine it with some sort of diuretic, and I’ve never wanted to try that. So I just use standard generic (from a pharmacy, not UGl) Telmisartan. At the end of my blast I just stop taking the Telmisartan and I have no effects from it, but that is probably due to the low dosage of it I take.

Off topic but on blasting I also combine it with 2.5mg rosuvastatin for that little extra support for how AAS affects our cholesterol.

 

[xrayphoton13]

For anyone wanting more detail on how to choose what to use, this is a flowchart based on the most up to date guidelines. Doctor's have long used these, but more recently they have computer programs that look at a ton of factors and spit out a recommendation, the doctor updates it with the results at the next appointment, and it suggests changes if needed. It's very "step by step" until something works.

Note one of the biggest changes recently is that if you're over 150 systolic OR 90 diastolic they now recommend starting with a 2 combo med, ie, an ARB and a Calcium Channel Blocker. If it's not enough go from low to moderate dose. If that's not enough either go to the high dose (only if you have no side effects) or, preferably add a 3rd med (a diuretic) to the combo.

(this multi drug, low dose strategy has proven so effective, and with less side effects than high doses, there are a number of quad bp drug class combo pills coming to market, though that's not a step in the charts yet)

If you have minor side effects but your BP is being effectively lowered, from what I've read it's good practice to keep using that same class combination (ie calcium channel blocker/ARB), but change one of the two drugs in the combo and use an equivalent dose to what's working.

Flowchart:

UpToDate

www.uptodate.com

Medication selection chart:

UpToDate

www.uptodate.com

Original source:

UpToDate

www.uptodate.com

What about for high RHR? I'm currently running 500mg test and 6iu HGH. RHR has gone up to 79bpm and I can't get it to go down. Currently I'm using 20mg telmisartan and BP is perfect. I may not even need the telmisartan. I was reading nebivolol can lower RHR. I ordered nebivolol and hctz. Not sure which I'll try yet but I didn't even think s about amlodipine.

 

[Ghoul]

What about for high RHR? I'm currently running 500mg test and 6iu HGH. RHR has gone up to 79bpm and I can't get it to go down. Currently I'm using 20mg telmisartan and BP is perfect. I may not even need the telmisartan. I was reading nebivolol can lower RHR. I ordered nebivolol and hctz. Not sure which I'll try yet but I didn't even think s about amlodipine.

Calcium channel blockers can slow
heartbeat but Amlodipine is the exception, which is why it's preferred for blood pressure control in people without tachycardia.

It doesn't sound like you even have high BP.

Metoprolol is a first line treatment for the kind of beta receptor induced tachycardia caused by steroids (adrenaline), and the normal dose is 50mg 2-3 times a day.

For high BP it's 50-100mg 2 times a day.

Personally I'd opt for the extended release, once a day tabs, start at 25mg, see how things are at two weeks, then titrate up to 50mg if necessary. Keep a close eye on BP to make sure it doesn't get too low. Stop at any signs of shortness of breath or chest pain, a sign. your heart is beating too slowly. Don't go over 100mg.

I've gotta say while any med can cause serious problems, the regular BP meds above are pretty safe. Slowing your heart with a beta blocker is a bigger deal, and there's a reason it's no longer considered a good idea to use beta blockers to lower BP unless tachycardia is present. It may only be a small risk, but obviously best avoided unless necessary.

Don't take it at the same time as Telm since you don't know how low your BP will drop once you start Metoprolol and your heart rate slows.

The reason metoprolol isn't on the chart for treating BP without tachycardia is because it introduces other risks, particularly strokes, though it's a very commonly prescribed med. Docs not up to date still reach for Metoprolol as a BP (without tachycardia) treatment, so the risks must not rise to the level of the FDA telling them to stop doing that.

If your BP ever gets high enough Metoprolol doesn't lower it sufficiently, it is available as a low dose combo with Olmasartan and other BP specific drugs, but it doesn't sound like you have particularly high BP.

PCT24 has Metoprolol Extended Release 50's and 100's called "Betabloc XL".

TLDR: Metoprolol Extended Release will slow your heart rate with a once a day pill, which will also lower your blood pressure,

But lowering blood pressure by slowing heart rate raises risk of a clog blocking blood flow (stroke, heart attack) vs opening vessels to lower pressure like the other BP meds do.

I wouldn't take any more Metoprolol than necessary to get to the correct heart rate, and use something else to bring BP down the rest of the way if necessary. .

 

[Avies48]

PCT24x7 has Telmaheal AM, 5mg Amlodipine / 40mg Telmisartin, a low dose "Step 1" treatment recommended in the charts above for anyone with BP over 150/90 (either).

It has a 72% chance of getting a patient below 130/80, so at or close to the 120/70 target.

$43 for a year's worth.

So if you say 140/80…. Could be changed with lifestyle choices perhaps?