No side effect reported.
Most of the side effect of ED are mostly from BB.
Btw indapamide brings hypokalemia.
Means it lowers your potassium level. Maybe it will make you able to keep telmi at 40mg
maybe...
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MESO-Rx
Anabolic Steroids
Nebivolol for lowering RHR
- Thread starter y777
- Start date
Most of the side effect of ED are mostly from BB.
Btw indapamide brings hypokalemia.
Means it lowers your potassium level. Maybe it will make you able to keep telmi at 40mg
maybe...
Yeah on the other hand I have read extensively on how many BB have depression as one of the main side effect, except nebivolol
xrayphoton13
Member
I checked pct24x7 price list and they only have lercanidipine but it's fairly pricey. I guess you have to special request cilnidipine through email? Didn't see any of the three on cosmic
BamaCrazy
Banned
Yep. Just ask for it in an email. 24x7 is cheaper than the Zone. I requested a quote from both.
I deleted the prices but send me a DM if you need them
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Fairly cheap ask via email
BamaCrazy
Banned
Is posting prices and naming sources outside the UG allowed?
BamaCrazy
Banned
Crap. Deleting prices now
Ghoul
Member
Please DM them to me.
BamaCrazy
Banned
Done
Sicsemptyran
Member
@Ghoul, nearly same exact situation as you - I’d almost certainly swing for Nebivolol (or one of the other similarly selective 3rd generation BB’s) before reaching for a diuretic.
If it was a diuretic or propranolol/metoprolol, the risk reward gets a bit dicey. But not sure why you’d want to risk the kidney/electrolyte/insulin sensitivity issues that can come with diuretics when the 3rd generation BB’s have better side effect profiles than even the CCB’s.
If it was a diuretic or propranolol/metoprolol, the risk reward gets a bit dicey. But not sure why you’d want to risk the kidney/electrolyte/insulin sensitivity issues that can come with diuretics when the 3rd generation BB’s have better side effect profiles than even the CCB’s.
Ghoul
Member
I've posted prices of BP meds, and how to acquire them cheaply in threads discussing health over 40 with Millard participating. I don't think this falls under the same catagory as PEDs,
So (credit to @BamaCrazy) but if this is a problem it's on me.
It's just for a ballpark reference anyway, and will hopefully motivate someone to treat their hypertension that might not otherwise for concern over cost, or edema,
The Amlodipine equivalent is half these doses, ie, 2.5mg, 5mg, 10mg.
5 mg x 10 tabs - 0.60$
10 mg x 10 tabs - 0.80$
20 mg x 10 tabs - 1$
So we're talking $25-30 for a year's supply, Incredible.
Top quality international pharma company as well. My BP meds come from them.
So (credit to @BamaCrazy) but if this is a problem it's on me.
It's just for a ballpark reference anyway, and will hopefully motivate someone to treat their hypertension that might not otherwise for concern over cost, or edema,
The Amlodipine equivalent is half these doses, ie, 2.5mg, 5mg, 10mg.
5 mg x 10 tabs - 0.60$
10 mg x 10 tabs - 0.80$
20 mg x 10 tabs - 1$
So we're talking $25-30 for a year's supply, Incredible.
Top quality international pharma company as well. My BP meds come from them.
If only I could get it for fuck sake
damn EU custom with pharma India
They don't have cliniheal, they have clinilyv not sure how good it is as a brand
Ghoul
Member
To be blunt, it's because all the guidelines seem to recommend when adding a third compound, use a diuretic, and reserve a beta blocker for a fourth if necessary for resistant hypertension.
I don't know why diuretics are considered preferable to Beta Blockers, I haven't done my due diligence to be honest, I just assume it's evidence based and they have a good reason. But I know that's a lazy shortcut, there are always exceptions that may apply to me, and outsourcing my judgement may take me down the wrong path.
I've been convinced by the arguments made here that I need to do more homework before going with the diuretic instead of a bb as the third compound,
Ghoul
Member
This may seem like a basic question, but I can't find a straightforward answer,
I can tell you a dozen ways high bp causes damage over time, making the benefits of lowering it clear,
But all I've seen with RHR is that you just need to keep it below a certain number (based on age), as higher than that increases risk for cardiac death,
Everyone seems interested in keeping it far lower than the guidelines say requires treatment.
What's the rationale behind keeping it as low as possible without going too low. Some seem to suggest "limited beats over a lifetime" which sounds a little far fetched, but I can't say that's untrue.
Please, fill in me in on the benefits of "optimal RHR", and what do you consider that to be?
I can tell you a dozen ways high bp causes damage over time, making the benefits of lowering it clear,
But all I've seen with RHR is that you just need to keep it below a certain number (based on age), as higher than that increases risk for cardiac death,
Everyone seems interested in keeping it far lower than the guidelines say requires treatment.
What's the rationale behind keeping it as low as possible without going too low. Some seem to suggest "limited beats over a lifetime" which sounds a little far fetched, but I can't say that's untrue.
Please, fill in me in on the benefits of "optimal RHR", and what do you consider that to be?
Sicsemptyran
Member
As you are hyperaware, guidelines are woefully behind in many situations. Less so when it comes to blood pressure, but certainly when it comes to lipid therapies and many other things (vitamin D, appendicitis, etc).
3rd generation beta blockers firmly fall into this camp. Most of the reasons the guidelines are against beta blockers is due almost entirely to the fact that
1. CCB's, ARBs/ACEs, and diuretics have better outcomes as first line agents. That's true, and why they should almost always be 1st line.
2. Side effect profiles of traditional beta blockers are bad. Erectile dysfunction, insomnia, insulin issues, kidney issues, the list goes on.
#1 is debatable but still likely true with all but diuretics when it comes to 3rd generation BB's, but #2 is patently false and I'm not sure why the guidelines haven't caught up. I'm sure they will in the next 10-15 years.
When you're looking at a 2nd or 3rd line agent, a 3rd generation beta blocker is a completely reasonable choice - Especially when taking into account their ability to mitigate LVH and lower sympathetic burden.
Sicsemptyran
Member
I do not think there's actually good evidence beyond a certain threshold. There's plenty of evidence 60 is much worse than 90, but is asymptomatic 45 better than 60? Much less evidence, and most of the evidence is likely just conflating the lifestyle factors that led to that person having a 45 RHR over that 60 RHR person.
In lieu of great evidence, I stick to the idea the lower the better to prevent development of AFIB and other tachycardia related arrythmias as well as LVH. I am incredibly biased though because I used to have a RHR in the 30s, so for me when I see 65 I assume I have the flu.
I do not chase super low numbers anymore, but feel good touching the upper 40s overnight and staying in the 50s during the day. If that starts to change (barring many years of aging, decade+), I'd adjust what I'm doing to keep that.
Ghoul
Member
Could you point me to a source to establish what "optimal" RHR wound be based on age, by *your* standards, since I don't know which chart to believe in that regard?
Or formula? I have no idea how to find a credible "optimal" number outside of conventional standards.
BamaCrazy
Banned
Cilniheal is what they sold me. It gets delivered tomorrow or Tuesday so I’ll know then.
