You're 28 and you're taking max doses of 2 blood pressure meds?
I'd understand 20mg of telmisartan alone.
MESO-Rx
Anabolic Steroids
Blood Pressure
- Thread starter gilmarpersonal
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I'd understand 20mg of telmisartan alone.
Gonz0
Member
I’m not taking the max dose of nebivilol, just the telmisartan but while on cycle my systolic gets really high. I do my cardio and monitor sodium, it’s just my systolic that gets out of range
Ghoul
Member
Early onset familial hypertension is usually the resistant type, needing combos of more than 2 bp meds.
Gonz0
Member
Started the nebivilol at 25 before I used any peds. It’s weird because a lot of guys my age get freaked out about taking anything for blood pressure, like they’ll have no issues running the harshest orals they can come across but the second you mention blood pressure meds they get all weirded out lol. I know the goal isn’t to take one drug to treat the side effects from another drug but I feel like blood pressure is something you shouldn’t mess around with , especially seeing how mild some of the medications are (not amlodipine , that shit is no bueno)
Ghoul
Member
I freaked out at 40, lol.
It's a psychological hurdle.
PEDs are exciting, feel empowering. .
BP meds break the illusion of immortality, independence.
But you're right. Somehow many of us compartmentalize... health damaging drugs from sketchy sources, no prob. Thoroughly tested blood pressure meds from regulated pharma that we know will protect your health? "Keep it away I'm not getting on any pills!".
Half the time this is from dudes taking a dozen supplements. almost as unregulated as UGL.
My Indian has Ciln/Telmi 10mg/40mg incredibly cheap. I guess I should order some.
Are you taking 2 per day - 20mg/80mg? Anything else for blood pressure?
Where do you get it? It seems only approved in Japan and my Indians don't have it.
Ghoul
Member
I take one 20/40 day. If you want the same dose and have 10/20 just take a Ciln 10 at the same time. 10s are very cheap. Both Ciln and Telm are best when taken once a day at the same time.
5mg Minoxidil / 10mg Tadalafil
I don't take these two for BP, but they do have a small effect, and use different mechanisms of action to improve blood flow so technically I'm taking 4 classes of BP meds. Lower dose, more classes, is the preferred approach. It minimizes the risk of sides vs larger doses of any one while being synergistically more effective than merely adding their effects. (Daily tadalafil has the added benefit of lowering all cardiovascular and cerebrovascular risk by boosting nitrous oxide in vessels),
Efficacy and safety of a four-drug, quarter-dose treatment for hypertension: the QUARTET USA randomized trial - Hypertension Research
New approaches are needed to lower blood pressure (BP) given persistently low control rates. QUARTET USA sought to evaluate the effect of four-drug, quarter-dose BP lowering combination in patients with hypertension. QUARTET USA was a randomized (1:1), double-blinded trial conducted in federally...
www.nature.com
Why Tadalafil instead of nebivolol? Also 10mg seems high, no? Isn't the daily use 2.5mg or 5mg? I know for me, that will probably give me a headache.I take one 20/40 day. If you want the same dose and have 10/20 just take a Ciln 10 at the same time. 10s are very cheap. Both Ciln and Telm are best when taken once a day at the same time.
5mg Minoxidil / 10mg Tadalafil
I don't take these two for BP, but they do have a small effect, and use different mechanisms of action to improve blood flow so technically I'm taking 4 classes of BP meds. Lower dose, more classes, is the preferred approach. It minimizes the risk of sides vs larger doses of any one while being synergistically more effective than merely adding their effects. (Daily tadalafil has the added benefit of lowering all cardiovascular and cerebrovascular risk by boosting nitrous oxide in vessels),
Efficacy and safety of a four-drug, quarter-dose treatment for hypertension: the QUARTET USA randomized trial - Hypertension Research
New approaches are needed to lower blood pressure (BP) given persistently low control rates. QUARTET USA sought to evaluate the effect of four-drug, quarter-dose BP lowering combination in patients with hypertension. QUARTET USA was a randomized (1:1), double-blinded trial conducted in federally...
I've lately been under the impression that low dose combos are better than high dose of a single med, but it seems like everyone is going to high dose combos. I guess if your blood pressure is in range, then that' your proof. But I'm wary of fatigue and cognitive side effects.
BamaCrazy
Banned
Sent you a DM
malfeasance
Member
Did you have edema previously? It can take up to 3 weeks to clear after stopping amlodipine from what I've read, but should be sooner.
Developing it that quickly, just 3 doses means you're very sensitive.
That said, if you decide to try Cilnidipine, in studies of patients who developed edema on amlodipine, between 97%-100% get complete resolution after they switch. I was actually surprised it had that high of a success rate in stopping edema.
View attachment 342933
Remember, for the same BP reduction. you need 2x the dose of Cilnidipine, so 10mg.
Cilnidipine for Amlodipine Induced Pedal Edema and its Anti-hypertensive Effect in a Tertiary Care Teaching Hospital of Western Nepal - PubMed
The newer L and N type CCB, Clinidipine has comparable efficacy with amlodipine and well tolerated in our population. Though the incidence of pedal edema is low but can occur with clinidipine especially with higher doses.pubmed.ncbi.nlm.nih.gov
Bookmarked for later reading.
Curious to see how difficult this is going to be to get in a post de minimus age, since it is not a US prescription item and domestic sources do not carry it.
VakarianSK
Member
Same @Ghoul, I sent a few messages but never heard from you.
I’ve been taking 10 mg of nebivolol for the last year or so. It’s been keeping my bp decent. 130ish/ 60-70 usually, on blast. I recently switched to telmaheal 40/5 and I got massive blood pressure spikes. Now I’m taking 80/10 and not feeling any better. Bp has been 150-160 at times and I feel like absolute shit. I’ve always just self treated my Bp but so far, telmisartan and amlodaline has been terrible for me. My swelling in my feet has come back. (Used to get some edema from hgh 5iu but eventually subsided). Not really sure where to go from here. Doctors always seem like a pain in the ass. I used to add 80 mg telmisartan to my nebivolol and I loved what it did for my hct. Maybe I should switch back to that combo
Ghoul
Member
Forget amlodipine. You're clearly sensitive to edema and don't want to accumulate damage.
Because nebiv lowers BP by two mechanisms, heart rate reduction on nitrous oxide induced relaxation of blood vessels it important to figure out if one or both of those effects are what's making it work for you, when considering alternatives.
The reason is essentially no other BP med or combo offers both effects. Which makes your options somewhat limited.
What other drugs have you tried to lower bp?
Is your heart rate normally high?
Have you used other beta blockers before? Did they lower your bp? Was nebiv the first thing that worked?
Having a strong response to nebivolol and not other bp meds suggest either high aldosterone (driving high cardiac output) or seriously dysfunctional endothelium in your blood vessels preventing nitrous oxide release (hardened arteries from diabetes or severe plaque buildup).
Aldosterone has recently become recognized as a major driver of treatment resistant bp. You can have that easily tested(and you should for reasons below) , and a new drug that lowers production of that hormone to normal levels has shown amazing results. Instead of taking a combo of bp drugs, just reducing aldosterone into normal range brings bp into normal range and significantly improves heart and kidney function. which are all under stress when aldosterone is too high.
Although high aldosterone can be genetic, it can be a sign of other problems, from relatively benign. like potassium deficiency, to adrenal tumors, kidney or liver disease so you should take the opportunity to get it checked, just in case.
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adrenalytic
Member
oh shit, is that what that's from? I just thought my allergies were kicking up, even got my inhaler refilled just in case. But I started 5mg Cialis last week, didn't even know that was a side effect.
Ghoul
Member
Very common. Blood vessels feeding sinus's relax, so now your nose has the equivalent of a hardon that feels like congestion. The body will selectively constrict those back down as it acclimates to daily tadalafil, leaving other vessels relaxed, and relieving the symptom permanently for 98% within the first month.
Ghoul
Member
Speaking of aldosterone, it's the next "big thing" in hypertension. A major overlooked cause (having trouble lowering BP with "normal" meds like ARBs and CCBs is strong sign aldosterone is involved).
Here's a recent important bp treatment guideline update your primary care physician probobly won't catch up with for another 10 years, but you can do yourself ($70 aldosterone/renin at ultalabs, or request from your doc):
www.medscape.com
Here's a recent important bp treatment guideline update your primary care physician probobly won't catch up with for another 10 years, but you can do yourself ($70 aldosterone/renin at ultalabs, or request from your doc):
Screen All With Hypertension for Primary Aldosteronism
In a new clinical practice guideline, the Endocrine Society advises universal screening of those with hypertension by measuring renin and aldosterone.
www.medscape.com
