AboutBarbara Judge Expertise Outpatient pharmacy and general health. I have recently completed a Pharmceutical Care Certificate Program offered by Purdue University (Spring 1999 completion). I have personal experience dealing with terminally ill persons and their needs, as well as their families` needs. I graduated in 1984 from Pharmacy School and have been a Licensed Pharmacist since then. I have 18 years retail pharmacy experience. Prior to my pharmacy training I have 3 years hospital experience as a Nurse`s Aide.
Expert: Barbara Judge Date: 10/17/2007 Subject: Toprol XL vs Metoprolol
Question I have taken Toprol XL 50 mg for 4 years. When I refilled my 90 day supply recently, I was presented a much lower co-pay amount because my health plan had switched me to the generic equivalent. My wallet was better ; my stomach wasn't. Within 15 minutes of taking the first oblong ( not round like Toprol ) tablet, I had a bad taste in my mouth, felt nauseous, dizzy ; I began having terrible nightmares during sleep. My pharmacist said that possibly there was an ingredient in the filler that was causing these "rare" symptoms and to give the new med a couple days. After 5 days, I could no longer take the stomach problems. I am now back on the Toprol XL, my wallet took a "hit" but it's much more tolerable than the side effects of this generic. Is it possible that the filler composition is different between the name brand and the generic ? If so, is something missing from the generic to make the active ingredients less tolerable ? Or is there possibly something in the filler that causes these symptoms ? Thanks for your time and interest.
Answer I would recommend that you recheck the tablets you obtained if at all possible. It is very rare for a change from brand to generic to cause such rare side effects such as sleep problems, immediate nausea, and immediate dizziness. The inactive ingredients, or fillers, can differ from brand to generic but this rarely causes such severe reactions. Also the sizes and shapes of the generic Toprol XL tablets that have been available to us at the pharmacy where I work are very similar to the sizes and shapes of the same strength of Toprol XL they are comparable to.
Generally the fillers in tablets, such as starch, calcium phosphate, calcium carbonate, cellulose, glucose, and mannitol, are relatively inert and cause few reactions. That is why they are chosen. This is an unusual reaction for essentially inert materials.
