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

[Sampei]

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

New ESC Guidelines on BP and Hypertension Shift Treatment Targets Lower

The recommendations, based on STEP, CRHCP, and ESPRIT data, are now more in line with US guidance.

www.tctmd.com

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

 

[Ghoul]

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.

 

[Sampei]

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.

 

[iris]

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.....

 

[Ghoul]

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.



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



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.

Beta blockers for cardiovascular conditions: one size does not fit all - bpacnz

bpac.org.nz

 

[Sampei]

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.

Beta blockers for cardiovascular conditions: one size does not fit all - bpacnz

bpac.org.nz

 

[Ghoul]

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.

 

[Ghoul]

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.

 

[iris]

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

 

[explodingHeart]

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.

 

[Supertrain]

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.

[…]

 

[Ghoul]

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.

 

[Sampei]

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?

 

[Ghoul]

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.

 

[Sampei]

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

 

[BamaCrazy]

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.

 

[Ghoul]

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.

 

[Millard]

Valsartan is better for athletic performance

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