Long term use of Telmisartan

[Reno911]

Taking 80mg daily?

Yes, started at 40mg for a month or so then moved to 80mg

 

[Bobik]

Is the combination of 100mg aspirin and Telmisartan okay? or rather stop taking aspirin. Thx

 

[TheOtherOne55]

Yes, started at 40mg for a month or so then moved to 80mg

Reno, did you end up having your consultation with Victor?
Such a knowledgeable guy. Very interested in how that went.

 

[MyNameIsJeff]

https://www.ehealthme.com/gdc/telmisartan-vs-losartan-potassium/

Side effects for long term use of both Telmisartan and Losartan include...

Telmisartan

1. Renal Failure Acute (rapid kidney dysfunction)
2. Hyperkalaemia (damage to or disease of the kidney)
3. Dehydration (dryness resulting from the removal of water)
4. Interstitial Lung Disease
5. Renal Failure (kidney dysfunction)
6. Cerebral Infarction (less blood supply to brain resulting tissue damage)
7. Renal Impairment (severely reduced kidney function)
8. Chronic Kidney Disease
9. Hypotension (abnormally low blood pressure)
10. Asthenia (weakness)
11. Pyrexia (fever)
12. Renal Failure Chronic (long lasting kidney dysfunction)

Out of the top 12 side effects, 6 are kidney related. There are other kidney issues listed farther down the list.


Losartan

1. Chronic Kidney Disease
2. Renal Failure (kidney dysfunction)
3. Dizziness
4. Renal Injury (kidney injury)
5. Depression
6. Diarrhoea
7. Gastrointestinal Haemorrhage (bleeding gastrointestinal tract)
8. Hypotension (abnormally low blood pressure)
9. Arthralgia (joint pain)
10. Anxiety
11. Myocardial Infarction (destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle)
12. Dyspnoea (difficult or laboured respiration)
13. Hyperkalaemia (damage to or disease of the kidney)

4 out of the top 13 are kidney related. There are more further down the list.

I don't know how common any of these are. They may have happened in a small amount of people. I'm just putting the information out there. I take Losartan so I'm interested in the comparison to Telmisartan. Here's a study comparing the two... https://pubmed.ncbi.nlm.nih.gov/12900588/ This was the conclusion of the study...

Conclusions: Telmisartan 40/80 mg is superior to losartan 50/100 mg in controlling DBP and SBP during the last 6 h of the 24-h dosing interval.

These reports by people really shouldn't be called 'side effects'. Of course long-term users of Telmisartan experience renal impairment and renal failure, but that is because Telmisartan is prescribed as a treatment to slow the decline in renal function in those with diagnosed chronic kidney disease. The Telmisartan does not cause those 'side effects' (again, a misnomer), in fact, it reduces them.

It's like calling cancer a side effect of chemotherapy, makes no sense.

There is a shit ton of studies that show that Telmisartan is kidney-protective and slows the decline in renal function in those with CKD (at any stage). And this effect is only partially due to its blood-pressure lowering effects.

Clinical studies have demonstrated the efficacy of irbesartan, losartan, telmisartan and valsartan in the management of CKD. All ARBs tested to date have proved effective in improving at least some aspects of renal dysfunction. Few within-class comparative studies exist. Telmisartan provides superior reductions in proteinuria to losartan, however, even when blood pressures are equalized with concomitant antihypertensives. This superiority is probably linked to higher receptor affinity, longer plasma half-life and higher lipophilicity of telmisartan compared with other ARBs. The reduction of proteinuria with ARBs is also linked to improved cardiovascular outcomes. After a decade of research, there is now substantial evidence to show that the use of ARBs provides an efficacious treatment option for the prevention of renal disease progression in patients with hypertension and/or diabetes.

Renal protection with angiotensin receptor blockers: where do we stand - PubMed

The increasing burden on health care providers from chronic kidney disease (CKD) is due to the escalating prevalence of obesity, hypertension and type 2 diabetes. The gradual decline in kidney function in the presence of these risk factors is also associated with increased cardiovascular...

pubmed.ncbi.nlm.nih.gov

Proteinuria decreased significantly from 3.6+/-3.4 to 2.8+/-2.8 g/24 h (P=0.01). A decrease in proteinuria depended significantly on a decrease in SBP at the end of the study (P=0.044). Each decrease in SBP of about 10 mmHg led to a decrease in proteinuria of about 0.79 g/24 h (95% CI 0.02-1.56 g/24 h). Serum creatinine increased from 1.96+/-0.79 to 2.08+/-0.89 mg/dl (P=0.01), whereas creatinine clearance did not change significantly.

Conclusions: Telmisartan effectively and safely reduced blood pressure and brought about regression of proteinuria in diabetic and nondiabetic, hypertensive, proteinuric patients with chronic kidney disease, even in those with mild-to-moderate chronic renal failure.

Effect of telmisartan on blood pressure control and kidney function in hypertensive, proteinuric patients with chronic kidney disease - PubMed

Telmisartan effectively and safely reduced blood pressure and brought about regression of proteinuria in diabetic and nondiabetic, hypertensive, proteinuric patients with chronic kidney disease, even in those with mild-to-moderate chronic renal failure.

pubmed.ncbi.nlm.nih.gov

The addition of telmisartan to conventional antihypertensive therapy is associated with significant improvement in kidney outcome without increased incidence of adverse effects, even in patients with advanced CKD.

Renoprotective effects of telmisartan in patients with advanced chronic kidney disease - PubMed

The addition of telmisartan to conventional antihypertensive therapy is associated with significant improvement in kidney outcome without increased incidence of adverse effects, even in patients with advanced CKD.

pubmed.ncbi.nlm.nih.gov

This study demonstrated that telmisartan effectively and safely reduces proteinuria in chronic kidney disease patients.

Effect of telmisartan on kidney function in patients with chronic kidney disease: an observational study

Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the ...

www.ncbi.nlm.nih.gov

 

[MyNameIsJeff]

Is the combination of 100mg aspirin and Telmisartan okay? or rather stop taking aspirin. Thx

Aspir 81 and telmisartan Interactions - Drugs.com

A Moderate Drug Interaction exists between Aspir 81 and telmisartan. View detailed information regarding this drug interaction.

www.drugs.com

The combination should be fine most of the time, but check with your doctor regardless. Why are you taking the Aspirin?

 

[whacked]

Man I needed to read that!
Thank you for posting Jeff

 

[Reno911]

Reno, did you end up having your consultation with Victor?
Such a knowledgeable guy. Very interested in how that went.

Yes, Had a nice chat with Victor. He said the question has come up lately with clients/consults about increased creatinine and kidney damage while on ARB's.

In regards to ARB's causing kidney harm/damage. Here's an excerpt from the study below that we discussed.

"Although this association seems a reasonable conclusion, one must carefully examine the following: (1) the baseline level of eGFR and (2) the duration of previously uncontrolled BP. These are key factors that would distinguish true reduction in kidney function from a hemodynamic resetting of eGFR. Clearly, from these data, there is no evidence of permanent kidney injury. These are important variables to assess and confirm before drawing any conclusions about kidney injury."

Here is the study:

Consequences of Overinterpreting Serum Creatinine Increases when Achieving BP Reduction

Hypertension is a known risk factor for cardiovascular (CV) death as well as the second most common cause of ESRD in the United States. Systolic BP reductions to levels below 140 mm Hg and even 130 mm Hg are associated with a slower decline in kidney function over the spectrum of kidney disease

cjasn.asnjournals.org

 

[Reno911]

Here's some more info. I beat Lats to the punch.

" Telmisartan can cause an increase in Serum Creatinine levels, suggesting this Drug maybe Kidney Toxic "
Fourth time I have had a client ask about this, after reading a thread on Professional Muscle.
I am very emphatic to guys that struggle to understand discussions that their own Dr is probably not well informed on.
In summary,
Intensive blood pressure control is associated with cardiovascular benefits. During intensification of hypertension therapy, changes in glomerular baseline hemodynamics may lead to increases in serum creatinine that do not reflect kidney tubular injury.
So Step 1
This is NOT ARB or ACE-I specific, its certainly not Telmisartan specific
This is a consequence that is seen in aggressive lowering of Blood Pressure Levels
In such instances “presumed Accute Kidney Injury” should not prompt immediate discontinuation of anti-hypertensive therapy, but rather efforts should be made to identify factors contributing to creatinine elevation.
ie simply ask the question
" Why did Creatinine Levels rise here "
Think before depriving yourself of a potentially beneficial therapy.
Changes in Serum Creatine levels following aggressive Hypertension Treatment are most likely due to changes in renal plasma flow rather than structural kidney injury.
Dozens of studies you could read here
This is one that says it best
Consequences of Overinterpreting Serum Creatinine Increases when Achieving BP Reduction

Consequences of Overinterpreting Serum Creatinine Increases when Achieving BP Reduction

Hypertension is a known risk factor for cardiovascular (CV) death as well as the second most common cause of ESRD in the United States. Systolic BP reductions to levels below 140 mm Hg and even 130 mm Hg are associated with a slower decline in kidney function over the spectrum of kidney disease

cjasn.asnjournals.org

Telmisartan is Renal Protective - more here

https://www.facebook.com/victor.black.muscleandiron/posts/2920253828247085

Casey Reed perhaps you can add something to the Professional Muscle Forum on this
Victor Black

 

[Bobik]

Aspir 81 and telmisartan Interactions - Drugs.com

A Moderate Drug Interaction exists between Aspir 81 and telmisartan. View detailed information regarding this drug interaction.

www.drugs.com

The combination should be fine most of the time, but check with your doctor regardless. Why are you taking the Aspirin?

Thx Jeff... I am taking Aspirin to prevent blood clots. My Hematocrit is usually 55-57 on my cycle.

 

[MyNameIsJeff]

Here's some more info. I beat Lats to the punch.

" Telmisartan can cause an increase in Serum Creatinine levels, suggesting this Drug maybe Kidney Toxic "
Fourth time I have had a client ask about this, after reading a thread on Professional Muscle.
I am very emphatic to guys that struggle to understand discussions that their own Dr is probably not well informed on.
In summary,
Intensive blood pressure control is associated with cardiovascular benefits. During intensification of hypertension therapy, changes in glomerular baseline hemodynamics may lead to increases in serum creatinine that do not reflect kidney tubular injury.
So Step 1
This is NOT ARB or ACE-I specific, its certainly not Telmisartan specific
This is a consequence that is seen in aggressive lowering of Blood Pressure Levels
In such instances “presumed Accute Kidney Injury” should not prompt immediate discontinuation of anti-hypertensive therapy, but rather efforts should be made to identify factors contributing to creatinine elevation.
ie simply ask the question
" Why did Creatinine Levels rise here "
Think before depriving yourself of a potentially beneficial therapy.
Changes in Serum Creatine levels following aggressive Hypertension Treatment are most likely due to changes in renal plasma flow rather than structural kidney injury.
Dozens of studies you could read here
This is one that says it best
Consequences of Overinterpreting Serum Creatinine Increases when Achieving BP Reduction

Consequences of Overinterpreting Serum Creatinine Increases when Achieving BP Reduction

Hypertension is a known risk factor for cardiovascular (CV) death as well as the second most common cause of ESRD in the United States. Systolic BP reductions to levels below 140 mm Hg and even 130 mm Hg are associated with a slower decline in kidney function over the spectrum of kidney disease

cjasn.asnjournals.org

Telmisartan is Renal Protective - more here

https://www.facebook.com/victor.black.muscleandiron/posts/2920253828247085

Casey Reed perhaps you can add something to the Professional Muscle Forum on this
Victor Black

Hadn't heard of this Victor Black guy, but based on what he writes there, I'm very impressed!

 

[Reno911]

Hadn't heard of this Victor Black guy, but based on what he writes there, I'm very impressed!

Definitely take some time on watch is stuff, follow on IG, etc.

Here's what I like about Victor:
- He's 53, looks the part, and is all about risk mitigation for those older (and younger) guys that still want to use PED's.
- Breaks the science/research down into understandable layman's terms.
- Puts out a nice amount of free content and his subscription, coaching, and consult prices are very reasonable IMO.
- Not arrogant and super dogmatic like some "experts" can be.


Here are few links to some podcasts w/ Victor

 

[whacked]

Nice. Thanks for sharing. Will be checking him out for sure.

 

[madg]

Reno thank you brother

Much appreciated ! <3

 

[The_Yellow_Boy]

This thread is great. Have read all the pages of this thread..

What do you guys think about potassium intake in our diet while taking Telmisartan?

Since Telmisartan tends to make Hyperkalemia, Can we eat potato, banana, sweet potato, orange juice, etc. (high potassium content food) in our diet while we are taking Telmisartan ?

 

[Reno911]

This thread is great. Have read all the pages of this thread..

What do you guys think about potassium intake in our diet while taking Telmisartan?

Since Telmisartan tends to make Hyperkalemia, Can we eat potato, banana, sweet potato, orange juice, etc. (high potassium content food) in our diet while we are taking Telmisartan ?

For a few months I was at 1+lbs of potatoes a day and 80mg Telmisartan. Potassium levels were fine. Over the years I've had a few potassium readings off and most of those times it was when I was on Tren.

Other times while not on Tren I've had high potassium but that was most likely due to Hemolyic rupture during the draw because when I had it retested within a week it was in normal range.

My last set of labs in March (no potatoes in diet) 4.8 on 80mg. In Dec and Feb, it was 4.1 and 4.8 with 1lb+ of taters daily. (80mgs Telmisartan daily)