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Taking Targit for high BP, groin stiffness, medication changed to Nusar. Is Telmistran or Losartan a safer medicine?

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I am taking Targit 40(Telmistran) for my HIgh BP for last 10 months ,at the start of my treatment my BP was 150/90 which gets down to 130/80 for last 6 months,i was feeling no major side effect of this medicine except i think i should not have started BP medicines before trying natural ways to reduce BP i.e exercise,weight reduction,less salt intake etc.Anyway i has been feeling stiffness in my right groin for last 7 days,i have visited another doctor who prescribed to undergo Ultrasound but he changes my BP medicine from Targit 40 mg(telmistran) to Nusar 50 mg(losartan),the doctor gives the reason for changing medicine as Targit is old medicine and may cause urinary tract
infection and may be the cause of pain in my right groin.I would like to know which is more safer medicine Telmistran or Losartan?which has lesser side effects? Also my previous doctor says that Targit is the most light and safer medicine for hypertension,i am very confused pls help,pls tell whether i continue with Targit 40(telmistran) or should i start Nusar(losartan),Is Bp of
130/80 is ok or it has to more less than this?
Posted Sat, 9 Jun 2012 in Hypertension and Heart Disease
Answered by Dr. Ravindra L Kulkarni 4 hours later

As per your history you are on regular antihypertensive treatment.

Regarding your queries:
1. Non pharmacological ways like diet exercise are important in management of hypertension. In your case though you are on drugs you should follow these measures even now. This will help you to reduce dose of drugs or to stop it in future

2. Regarding the change of drugs both telmisartan and losartan are same class of medicines that is ARB s. Both have same mechanism of action. The choice depends upon decision of treating physician. Telmisartan is newest in this class.

3. Regarding urine infection, I have not experienced or read through such a relation with any of the two medicines you mentioned. In this case it is advised to have clinical check up, simple lab test like urine examination can confirm the infection. If identified you need a proper doses of antibiotics.

4. In case you are not tolerating telmisartan or losartan, you can discuss with your physician and consider another class of anti hypertension drugs. Some better alternatives are calcium channel blocker, beta blockers etc.

5. 130/80 mm of Hg is good target BP to maintain.

6. Also continue with low salt diet and regular exercise. Maintain your BMI in normal range.

7. Also discuss need of preventive cardiac check up tests like lipid profile, renal profile and Echocardiography with your clinician. These are routine screening tests and ideally to be done once a year.

Hope this update will help you. Please feel free to ask any query if you have.
Wish you a good health.
Above answer was peer-reviewed by
Follow-up: Taking Targit for high BP, groin stiffness, medication changed to Nusar. Is Telmistran or Losartan a safer medicine? 17 hours later
Thanks but still i am confused whether to continue with Telmistran(Targit-40 mg) or change over to losartan (Nusar-50 mg),i want to know which has less side effects out of these two drugs.
1.Also i read that Telmistran has Biological Half Life of 24 hours whereas losartan has biological Half Life of 2 hours ,does it means that Telmistran is lighter medicine than losartan and easy to reduce/stop the dosage.I would like not to be dependent on BP medicines for life time,so pls suggest which is the lighter yet efficient as well as having less side effects out of these 2 drugs?what will you suggest?
2.what do you think at which BP reading i can think of reducing the dosage or stopping the dosage?

Answered by Dr. Ravindra L Kulkarni 9 minutes later

Regarding the selection of drug, telmisartan has long half life so once daily dose is sufficient to have good control of BP over 24 hours. While in losartan as half life is short you may have to take it 2 times a day if BP is not controlled with single dose.

Half life of drug is not associated with what you mean by Lighter medicine. Nothing such thing exists in drug. Half life of drug gives us idea about duration of action and its effect, also helps us to select dose and dose timings.

Telmisartan is newer in ARB group of anti hypertensive drugs so you can safely continue with that.

As we had discussed 130/80 is good target for BP. You can consider reducing dose of drug only when the steady blood pressure control is achieved. But let your physician take decision about changing dose or stopping the drug. Self dose adjustments are not advisable.

Hope this will help you.
Above answer was peer-reviewed by
Follow-up: Taking Targit for high BP, groin stiffness, medication changed to Nusar. Is Telmistran or Losartan a safer medicine? 24 hours later
Thanks for useful reply!i will continue with Targit 40 mg.i have some more queries:
I have informed about feeling of hardness in my right groin for which i have undergone ultarsound but my ultrasound report is very much ok.i have gone for urine and blood test,as per report my blood sugar was 123,and as per urine report pus cells has been found in urine for which my doctor(who advises me losartan) prescribed me Prulin for 5 days alongwith urine culture test.I have gone for blood test after undergoing ultrasound on empty stomach and then i have eaten 2 toasts with vegetable before going for blood and urine test i.e blood sugar is test is performed after 30 minutes of eating toast.Is blood sugar reading of 123 is ok or i have to check once gain on fasting or i have to check my blood sugar after 1.5 hours of regular breakfast(as advises by doctor).Secondly pls give me advise on Prulin medicine or should i go for urologist?is there any need to test the functioning of my kidney as i am experiencing frequent urination alongwith hardness in my right groin for some days?
Thirdly my doctor prescribed me to take diabevit alongwith my BP medicines as it will help me in lowering BP/Weight,pls give ur advise
Answered by Dr. Ravindra L Kulkarni 15 minutes later
Hi and thanks again.

Regarding your queries;

1. It is good to know that you are continuing with Targit .

2. Regarding the test reports, it looks like Urine test reveals urine infection. Prulin (prulifloxacin) is broad spectrum fluroquinolone antibiotic and is a good choice in such infection. Urine culture will also be useful in selection of antibiotics, especially when there are frequent such episodes.

4 If you have repeated infections or urine culture and urine examination still shows evidence of infection after treatment, you can consider consultation with Urologist. At present you are receiving proper treatment.

5 Added tablet - Diabevit is multivitamin, trace elements and minerals supplement. You can safely continue that as per your treating physician's advice.

Hope I have answered all your queries. If you do not have any further queries, please close this discussion.

Above answer was peer-reviewed by
Follow-up: Taking Targit for high BP, groin stiffness, medication changed to Nusar. Is Telmistran or Losartan a safer medicine? 20 hours later
Thanks!yes u have answered all my queries just last query:
yeah i know i have to reduce or stop dosage of BP medicnine as per my doctor consultation ,i just want to ask At which BP reading should i expect i may be able to stop taking Targit 40 or reduce the dosage of it(as Targit 40 daily is the minumum dose does reducing dose means i may take half Targit 40 daily if my BP reaches minimum acceptance level),what i guess BP reading of 120/75 is ideal point for reducing or stopping my BP medicine,pls advice
Answered by Dr. Ravindra L Kulkarni 2 hours later
Hi and thanks again,

Blood pressures are not constant always, even in normal individuals. It can vary depending on various circumstances. So there is no fixed blood pressure to reduce blood pressure medications.
Stopping or reducing dose mainly depends upon your BP chart and clinical judgement of treating physician.

You also need to know that stopping the drug doesn't mean you are not treating hypertension. You need to continue strict lifestyle and diet to keep your blood pressure constantly in control. Also there can be instance where the need for antihypertensive again arises.

That being said, in your case I will consider blood pressure of 130/80 mm Hg as acceptable. If I were to be your treating physician if your blood pressures are constant I would consider stop or reduce the blood pressure tablet dose and continue with non pharmacological ways to control BP.

120/80 is normal and ideal. 120/75 is too much to expect. Aim at stopping or reducing dose when diastolic blood pressure reaches to 80 and maintains steady over a period of time.

If we cannot make dose of Targit as 20 mg a day, we still have options to use low dose from other class of anti hypertensive drugs. There is no fix formula for that.

Hope it is clear to you now.
Please close this discussion and rate it if you have no other queries.

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