Telmisartan
Telmisartan is a long-acting angiotensin II receptor blocker (ARB) licensed for hypertension and cardiovascular risk reduction. Among PED users it is a favoured blood-pressure agent on cycle because of its very long half-life, once-daily control and partial PPAR-gamma agonism, which is thought to offer mild metabolic benefits. It has robust clinical trial support for its licensed indications.
01 Overview
Telmisartan blocks the AT1 receptor, preventing angiotensin II from causing vasoconstriction and aldosterone release, which lowers blood pressure and reduces renal and cardiac strain. Its half-life of roughly 24 hours is among the longest of the ARBs, giving smooth 24-hour coverage that survives a missed or late dose better than shorter agents.
PED users on aromatising or otherwise pressor cycles use it to manage the hypertension that accompanies fluid retention and raised haematocrit. Its partial PPAR-gamma activity has generated interest for possible favourable effects on insulin sensitivity and lipids, though this is a secondary consideration. It is generally well tolerated and, unlike ACE inhibitors, rarely causes cough.
02 Mechanism
Selective angiotensin II type-1 (AT1) receptor antagonist; blocks angiotensin-mediated vasoconstriction and aldosterone secretion. Also a partial agonist of PPAR-gamma.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| On-cycle BP control | 20–80 mg/day | Oral | Titrated to home blood-pressure readings. |
| Hypertension (label) | 40–80 mg/day | Oral | Standard once-daily antihypertensive dose; 20 mg starting in sensitive users. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Lowered blood pressureReliable 24-hour blood-pressure reduction, well documented in hypertension trials. | ~10-15 mmHg systolic | Clinical | |
| Renal / cardiovascular protectionARBs reduce cardiovascular and renal endpoints in at-risk populations. | outcome data | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Hypotension / dizzinessLight-headedness, especially on standing or if volume-depleted. | Moderate | Common | Clinical | |
| HyperkalaemiaRaised serum potassium, more likely with kidney impairment or potassium supplements. | Moderate | Uncommon | Clinical |