#101

Thanks for that info! I continued researching this with Claude (so possible AI error grains of salt), and this was the summary:

Here’s a summary of the blood pressure reduction effects of Telmisartan and/or Amlodipine:

Telmisartan 40mg typically reduces BP by 19.8 / 8.8 mmHg.
Telmisartan 80mg may provide an additional 2-4 / 1-2 mmHg reduction.

Amlodipine 5mg usually lowers BP by 15-25 / 10-15 mmHg.
Amlodipine 10mg may offer an extra 2-5 / 1-3 mmHg reduction.

Combinations:
Telmisartan 40mg + Amlodipine 5mg: ~23.7 / 10.3 mmHg reduction
Telmisartan 80mg + Amlodipine 5mg: potentially 25-28 / 11-13 mmHg reduction
Telmisartan 40mg + Amlodipine 10mg: possibly 26-30 / 12-15 mmHg reduction

These figures are averages. Combination therapy generally provides greater BP reduction than monotherapy, with the Telmisartan/Amlodipine combination showing particularly good efficacy and tolerability.​​​​​​​​​​​​​

In the studies I reviewed the most common dosage was Telmisartan 40mg + Amlodipine 5mg in bold above.

In my case (I provided some additional details) it estimates a reduction from:
138/88 unmediated
to
122/78 which is nearly ideal. I’m waiting for my Amlodipine to arrive and will add it then report back in about 4-5 weeks.

Studies referenced (and I’d appreciate any relevant additional or more recent studies):

  1. The main study we analyzed in detail: “Clinical data analysis of telmisartan for hypertension management in Indian population” (Bioinformation 17(6): 652-659 (2021))
  2. TEAMSTA-5 Study (2011): Published in the Journal of Clinical Hypertension
  3. EXCEL Study (2012): An 8-week randomized controlled trial
  4. Meta-analysis by Xu et al. (2014)
  5. PIANIST Study (2014): A large-scale observational study
  6. Barrios et al. Study (2015): A pooled analysis of data from multiple studies
  7. Goyal J et al. study (2014): Published in the Journal of Clinical and Diagnostic Research
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#102

Before or after cardio? According to Wikipedia:

“Telmisartan’s activity at the peroxisome proliferator-activated receptor delta (PPAR-δ) receptor has prompted speculation around its potential as a sport doping agent as an alternative to GW 501516.”

5 Likes
#103

Are you splitting the 80 mg days AM and PM?

#104

@adssx

I’ve been taking Telmisartan for about 6 weeks. Started at 40mg. Moved up to 80mg after 2-3 weeks. My reduction in BP has been fairly negligible. Maybe reduced it by 10 systolic and 5 diastolic. I’ve considered adding amlodipine 5mg but I’m concerned about ankle edema being a very common side effect of amlodipine. I have a little ankle edema now. Although, I read a study that says most of the ankle edema caused by amlodipine monotherapy is mitigated by adding Telmisartan: Effect of telmisartan addition to amlodipine on ankle edema development in treating hypertensive patients - PubMed Have any of you taking amlodipine noticed ankle edema?

Also, I started taking a supplement called “Carditone”. Seems to have dropped my systolic another 15mm/hg taking 1 per evening after just two days. Not sure if this will be transient. Too early to tell. Was wondering if anyone could share their thoughts on this supplement.

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#105

That’s not negligible!

Yes telmisartan 80 mg + amlodipine 2.5 mg or 5 mg has a very low rate of edema. But it’s still a risk. So if you already have an edema you might not want to take that risk. Or you can give a try to 2.5 mg and see?

In European and American guidelines they recommend a thiazide for people you don’t want a DHP CCB. Something like indapamide 1.5 mg SR. It takes 3 months to see indapamide’s full BP lowering effect. It can increase glucose in some people.

Alternatively you could try lercanidipine. Same family as amlodipine but I think it does not cause edema. But I don’t know if it’s as good as amlodipine overall.

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#106

Carditone (Reserpine) fell out of favor due to the side effects of depression and GI issues

I think I heard somewhere it acts on neurotransmitters but don’t quote me.

I do find it interesting it’s available as an OTC supplement now.

2 Likes
#107

I take 120mg telmisartan and 2.5 mg amlodipine. This combination got me from 120s systolic to 115-119. No ankle edema on that combo.
If I take 5 mg of amlodipine I get ankle edema, even with 120 mg of telmisartan.

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#108

I’ve looked up subjective reports on this, and the consensus seems to be that athletic perfomance is negligibly impacted, at least at the commonly used doses.

Too bad, because if there was a cardarine without cancer links and even potentially pro-longevity, that would be an incredible molecule.

4 Likes
#109

I tested it before a workout, and it clearly reduced my performance. Telmisartan didn’t suit me in other ways either, so I stopped using it.

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#110

How are your serum potassium levels on that amount?

#111

Funny you should ask. Potassium came back a little high at 5.4 recently. But in August it was 4.3, and I’m pretty sure I was already at telmisartan 120 at that time. I will recheck in March.

#112

Hmm. I would re-test it to confirm. 5.4 is a bit higher than I would be comfortable with I think.

@DrFraser would you say a Potassium level of 5.4 is high enough to reduce the dose?

#113

I’d tend to get it redrawn as handling of the specimen is critical with potassium levels. If indeed it remains at 5.4, that is not ideal. Having higher range potassium seems healthier until your get over the upper reference level (some labs 5.0, others up to 5.4). Interestingly we see an increased rate of cardiac events in individuals with potassium levels that are elevated - especially if on diuretics. However, it probably matters on what the cause is (e.g. bad kidneys = bad blood vessels = high potassium).

5 Likes
#114

Thanks all. I will get it redrawn. I suspect/hope its just handling. Typically it’s more in the 4-4.5 range. My kidneys have never been deficient.

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#115

It looks like if you have atrial fibrillation vulnerability, 40mg telmisartan lowers BP, but doesn’t affect AF. In contrast 80mg telmisartan lowers both BP and AF:

Conclusion: The results indicated that telmisartan in low doses was as effective in controlling the blood pressure as in high doses, but high doses of telmisartan had beneficial effects on preventing the recurrence of AF in hypertensive patients.

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#116

It’s an Egyptian paper. However the results appear interesting.

The dose of Telmisartan is 80 mg. HBA1C is reduced by 1.5 (along with variability) which is quite significant!

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#117

I decided to start telmisartan and I had 40mg on Dec 8, then I missed the dose on Dec 9, and then I took 40mg each of the past 4 evenings (including tonight).

Early in the evening yesterday I noticed I felt pretty good. Then I felt really great all day today, and I noticed that I was talking to way more people (at the gym, in a store I went to, and even to a parking lot attendant). Whether I’m consistently initiating conversations with random strangers is probably my best marker for if I’m truly in a good mood.

Anyways, maybe it’s the telmisartan? I remember a couple people in this thread mentioned it positively affected their mood and reduced apathy.

2 Likes
#118

I never started the Amlodipine because my BP has continued downward average and now averaging:
117/77

I know some see slightly lower as ideal but for me this is PHENOMENAL!

After nearly 2 decades 140/95 averages at the doctor with excuses like “it must just be white coat syndrome” sort of denial, along with “just drop some weight and salt and let’s check in in a few months”.

I dropped the weight (averaged 270 pounds for many years, highest was 329, sometimes crash dieted to 240s) with Tirzepatide and the final few pounds switching to Retatrutide (maintaining health BMI and BRI at 180 pounds, 9mg Reta/week). But even weight loss only dropped BP averages to mid-130s/upper-80s.

40mg daily Telmisartan (thanks @adssx !) and Reta 9mg/week (which has its own BP lowering impact) seems to have gotten me to distance!

Shocked and thankful. Not sure what I’ll do with the year supply of Amlodipine from India now but for less than $70 I’m happy for it to sit unused.

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#119

The telmisartan mood phenomenon is a bit difficult to describe, isn’t it, but your experiences are very much the same as mine. I like your observational metric. It formal tests, it might demonstrate good predictive and discriminant validity.

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#120

This is a brief report for those interested. A month ago, I increased my dose of telmisartan from 40 mg at bedtime to 80 mg at bedtime. I can detect no symptoms and my BP readings are the same as they were on 40 mg. For me, the initial dose led to a drop from high normal/borderline high to the current state of mid- to low normal, maybe an average drop of 15-18 points SBP and little drop in DBP because it was already mostly in the low normal range.

The most significant benefit I’m seeing in telmisartan is a significant reduction the standard deviation of the distribution of my readings. As one example, I no longer see those high morning spikes typical of pre-telmisartan. The worst case now is a reading of 122/70. I believe this reduction in variance could be more significant to reducing ASCVD events than merely lowering mean BP by 10-15 points.

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