Who here is on a statin?

[BamaCrazy]

No offense but you’re just saying nonsense. That is not remotely true or accurate.

I agree that when it comes to BP meds less is often more, and it’s better to do small doses of a couple than max dose of one, but to say that you will need a diuretic if you’re on 80mg of telmisartan and that it’s not a safe dose is just completely and utterly absurd and not backed up by the numerous trials on the drug.

I’m also not sure why you have such a hard on for indapamide, like all drugs (including telmisartan) it has risks just like any other drug.

I think the comment about the diuretic was in reference to out of range potassium levels which can be caused by high doses of Telmisartan. 1-2 months ago I doubled my dose of Telmisartan to 40mg and after 2 weeks got labs. My potassium was high so I dropped my dosage and took one tablet of HCTZ and hydrated well for the next few days. I added Amlodipine after that but I am about to swap that for Nebivolol tonight.

 

[Sicsemptyran]

I think the comment about the diuretic was in reference to out of range potassium levels which can be caused by high doses of Telmisartan. 1-2 months ago I doubled my dose of Telmisartan to 40mg and after 2 weeks got labs. My potassium was high so I dropped my dosage and took one tablet of HCTZ and hydrated well for the next few days. I added Amlodipine after that but I am about to swap that for Nebivolol tonight.

Which totally makes sense and I am not saying whatsoever that telmisartan can’t cause that, absolutely can. I was just responding to his assertion that essentially if you take 80mg of telmisartan it’s some sort of almost certainty you will need to be on a diuretic, which is just not true.

 

[BamaCrazy]

Which totally makes sense and I am not saying whatsoever that telmisartan can’t cause that, absolutely can. I was just responding to his assertion that essentially if you take 80mg of telmisartan it’s some sort of almost certainty you will need to be on a diuretic, which is just not true.

Yea. I agree. That’s nonsense. There are a lot of members here taking that dosage with no issues.

 

[MyNameIsJeff]

Does it means 80mg is not safe long-term?

80 mg is probably still fine, but I certainly would not go any higher.

 

[NotHuman]

Yes most of the time if you used a strong dose of telmisartan you will have to used a diuretic like indapamide hctz to lowered your potassium
That’s why i said that 80mg of telmisartan isn’t a safe dose

If i took 80 mg of that i will go hypotension
So no depend i don’t react verry good to this substance
I had also some symptoms with only 40mg of valsartan
It varies a lot from different individual but starting at 80mg is stupid
Always lowered then increase
10mg at 130/85 can be enough no be in the normal range

Yes amlodipine is weak but i didn’t say take it alone
But the compination of a sartan and amlodipin can be good
Even better than a strong dose of just telmisartan

And no in france there is only dose from 10 to 80mg of telmisartan
160mg is crazy high never seen that
And i work at the hospital i see strong prescription everyday but never this not even close

But this is your own personal anecdote. We can’t apply one specific individual to everyone. I even said earlier that I wasn’t comfortable with my diastolic BP when I took 80mg, but that’s only because I also take 5mg Nebivolol, so it would have been fine otherwise. For most people, 80mg Telmisartan is safe long term, and there are additional benefits that we may not see at a lower dose. So while everyone has to monitor their BP and potassium to make sure it’s within range, it should be ok for most people.

 

[Babygeei]

I just got results back from a cardio IQ (second screenshot) test and my results don't look to good. The first screenshot is from my last blast in June where I was taking 10mg of ezetimibe everyday and my lipid panel seemed to respond good to that dose. My LDL prior to that was 120. Unfortunately I don't have a cardio IQ test while taking ezetimibe. My question is, will ezetimibe alone help with my apo b and lipo a numbers?

 

[egruberman]

I take 40 mg rosuvastatin and 10 mg ezetimibe daily. I have been taking them for years since I have a family history of high cholestorol
these are my blood works from december 24th;

cholesterol PHOT 4.71 mmol/l < 5.18
HDL-cholesterol PHOT 1.53 mmol/l > 0.91
cholesterol/HDL 3.1 ratio
< 2: low risk
2-5: middle risk
> 5: high risk
LDL-cholesterol PHOT 2.54 mmol/l < 3.37

That’s a stiff dose of Rosuvastatin to still have LDL be that high. What’s your ApoB? Have you had a CT-CAC?

I’d consider adding bempedoic acid and/or a PCSK9 inhibitor.

 

[egruberman]

I just got results back from a cardio IQ (second screenshot) test and my results don't look to good. The first screenshot is from my last blast in June where I was taking 10mg of ezetimibe everyday and my lipid panel seemed to respond good to that dose. My LDL prior to that was 120. Unfortunately I don't have a cardio IQ test while taking ezetimibe. My question is, will ezetimibe alone help with my apo b and lipo a numbers?

ApoB of 99mg/dL doesn’t fall into the realm of extremely bad. Under 80mg/dL is preferable for those with no other risk factors, per Tom Dayspring. You could add another compound and probably be fine. Most bang for the buck will be low dose Rosuvastatin.

On the other hand, the Lp(a) number is quite concerning. It’s wholly the product of genetics and doesn’t respond to typical lipid management interventions. The only thing that helps is a PCSK9i. I would encourage you to get tested again to see if it’s an outlier. I’ve been doing the CardioIQ test for years and I have one anomalous result for Lp(a).

Lo(a) independently increases risk apart from ApoB, it’s extremely inflammatory and will increase the progression of atherosclerosis.

If the value is legit, I would encourage to to manage your lipids more aggressively, get a CT-CAC, and go easy on the AAS.

 

[markus holland]

That’s a stiff dose of Rosuvastatin to still have LDL be that high. What’s your ApoB? Have you had a CT-CAC?

I’d consider adding bempedoic acid and/or a PCSK9 inhibitor.

thank you for your information, I'll have to seen my GP about my bloodtest results next week, and will mention your suggestions

 

[lilhawk]

If i took 80 mg of that i will go hypotension
So no depend i don’t react verry good to this substance
I had also some symptoms with only 40mg of valsartan
It varies a lot from different individual but starting at 80mg is stupid
Always lowered then increase
10mg at 130/85 can be enough no be in the normal range

Yes amlodipine is weak but i didn’t say take it alone
But the compination of a sartan and amlodipin can be good
Even better than a strong dose of just telmisartan

And no in france there is only dose from 10 to 80mg of telmisartan
160mg is crazy high never seen that
And i work at the hospital i see strong prescription everyday but never this not even close

I don't even know what you're going on about here as I never said anything other than 80mg is a perfectly safe dose of Telmisartan, it's commonly prescribed by all the cardiologists I work with. The lowest dose I have ever seen prescribed is a starting dose of 20mg, but most everyone on it is either taking 40mg or 80mg. I never said anything about all the other doses and meds you're going on about. Your assertion in another post that just because someone is on 80mg they will need to be on a diuretic to lower potassium is just plain false. The overwhelming majority of patients on Telmisartan do not have problems with hyperkalemia anyway. If a patient had hyperkalemia a diuretic would not be the first choice to lower it anyway. Most of what you say is very ill informed and just plain nonsense.

 

[Anonymous35]

No offense but you’re just saying nonsense. That is not remotely true or accurate.

I agree that when it comes to BP meds less is often more, and it’s better to do small doses of a couple than max dose of one, but to say that you will need a diuretic if you’re on 80mg of telmisartan and that it’s not a safe dose is just completely and utterly absurd and not backed up by the numerous trials on the drug.

I’m also not sure why you have such a hard on for indapamide, like all drugs (including telmisartan) it has risks just like any other drug.

Because diuretics like thiazide lower the potassium that why when someone had strong dose of sartan there is most of the time a diuretic with it simple as that

It can also happened with betablocker

But what should i know after all it just my job

 

[Sicsemptyran]

Because diuretics like thiazide lower the potassium that why when someone had strong dose of sartan there is most of the time a diuretic with it simple as that

It can also happened with betablocker

But what should i know after all it just my job

Well then you’re bad at your job and I hope your patients get a second opinion. The idea that the majority of people on a max dose ARB need a diuretic for hyperkalemia is just patently false. If you work in a hospital with patients who have kidney failure then sure, maybe, but that’s not a normal patient population.

 

[Anonymous35]

But this is your own personal anecdote. We can’t apply one specific individual to everyone. I even said earlier that I wasn’t comfortable with my diastolic BP when I took 80mg, but that’s only because I also take 5mg Nebivolol, so it would have been fine otherwise. For most people, 80mg Telmisartan is safe long term, and there are additional benefits that we may not see at a lower dose. So while everyone has to monitor their BP and potassium to make sure it’s within range, it should be ok for most people.

It very rare people who take this kind of dose of BP didn’t have also a prescription of betabloquer

BP meds lower sodium lvl and increase potassium in fact they had a similar effect on the electrolytes as the sparing potassium diuretics like amiloride eplerenone and aldactone

 

[Anonymous35]

Well then you’re bad at your job and I hope your patients get a second opinion. The idea that the majority of people on a max dose ARB need a diuretic for hyperkalemia is just patently false. If you work in a hospital with patients who have kidney failure then sure, maybe, but that’s not a normal patient population.

I’m not bad at my job moron, as a pharmacy technician we delivered and control the prescription from doctors
All patients are getting bloodwork daily
So no it’s not just kidney failure
But also problem with the hearts too
Heart failure cause edema btw

I just say that writing on a forum that 80mg of telmisartan is perfectly safe
That can be read by everybody in the world is dangerous that’s it
Hyperkalemia can kill you

 

[Anonymous35]

For BP med, you should always start at a lower dose telmisartan is 20mg then increase after 2 weeks if it’s not enough and your bloodwork is okay and you will good.
If not then change medicine

But if you feel good then up to 40mg ..
If it’s not enough add amlodipine 5mg …
But very important to do the bloodworks noted the potential sides effects

Because some of you say that it’s ok to go straigh to 80mg nope
Maybe you will go hypotension and thats a risk for your kidney

Remember you take AAS so your not the kind of people who participate in those studies
Remember that

 

[Sicsemptyran]

For BP med, you should always start at a lower dose telmisartan is 20mg then increase after 2 weeks if it’s not enough and your bloodwork is okay and you will good.
If not then change medicine

But if you feel good then up to 40mg ..
If it’s not enough add amlodipine 5mg …
But very important to do the bloodworks noted the potential sides effects

Because some of you say that it’s ok to go straigh to 80mg nope
Maybe you will go hypotension and thats a risk for your kidney

Remember you take AAS so your not the kind of people who participate in those studies
Remember that

Literally not a single person in this thread has said just start off on 80mg. You’re arguing against a person who doesn’t exist.

 

[Sampei]

I’m not bad at my job moron, as a pharmacy technician we delivered and control the prescription from doctors
All patients are getting bloodwork daily
So no it’s not just kidney failure
But also problem with the hearts too
Heart failure cause edema btw

I just say that writing on a forum that 80mg of telmisartan is perfectly safe
That can be read by everybody in the world is dangerous that’s it
Hyperkalemia can kill you

Pharmacy technician ahahahahhahahaha

This is like nurses trying to play doctor

 

[Anonymous35]

Pharmacy technician ahahahahhahahaha

This is like nurses trying to play doctor

This is clearly not the same thing
But our job is the same as a pharmacist
They get just more money but thats it we did the same job

 

[Anonymous35]

Literally not a single person in this thread has said just start off on 80mg. You’re arguing against a person who doesn’t exist.

No one talk about increased dose after few week
You only talk about the safety about 80mg telmisartan

 

[Sampei]

This is clearly not the same thing
But our job is the same as a pharmacist
They get just more money but thats it we did the same job

And a pharmacist is nothing special either, mostly a dispenser of medicines.