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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > Toprol vs. generic
Expert: Barbara Judge
Date: 12/4/2007
Subject: Toprol vs. generic
Question
QUESTION: Ever since being switched from Toprol XL 100mg to the generic about six weeks ago I have been experiencing all kinds of symptoms - metallic taste in mouth, constant stomach irritation, frequent dizziness and light-headedness, and my BP has been running higher than it ever was on Toprol.
I have asked both my MD and a pharmacist and they both counseled giving it a few weeks. I just stumbled upon your recent answer (17 Oct.) to someone having nearly the identical symptoms and I am curious if you have any additional info or advice on this.
Thanks!
ANSWER: There is (hopefully) a significant difference between your problem and the previous question. The size and shape of the tablets dispensed to the person in the previous question from October 17 had changed along with the change from brand to generic. At that time there was only one generic manufacturer and the tablets looked identical to Toprol XL 100mg. There are now several companies manufacturing generic Toprol XL 100mg. It is still unusual for someone to report the kind of side effects that you are having just from changing from brand name to generic. It isn't impossible because the drugs can differ in "fillers".
I would reverify the tablets to make sure you do have the correct medicine. If the medicine is correct I would recommend keeping a diary of your blood pressure readings to show your doctor so you have documentation for him/her that you may need to change your prescription back to Toprol brand name.
Thanks
Barb Judge
---------- FOLLOW-UP ----------
QUESTION: Barb:
Thanks for the reply. I have since Googled this more extensively and discovered that there are plenty of others experiencing similar side effects. The coincidence between the switch of meds and the onset of my symptoms is circumstantially evidential to me, and while I am not foolish enough to substitute a search engine for medical care I was impressed by the anecdotal evidence reported by others (including other symptoms which I was also having but did not connect with this entire episode). I contacted my M.D. today and he agreed that I should switch back immediately. He was especially concerned that, on top of the side effects, my BP was remaining high (avg. 155/105) despite doubling the dosage (of the generic), especially since the combination of Toprol and a (generic) ACE inhibitor had always controlled it quite well (I am obviously not afraid of generics per se!)
I am glad that you are not an alarmist, but neither am I (nor is my G.P.) He was shocked to receive my call as I've never called him before (12 yrs. as a patient) between regular appointments.
F.Y.I. I have kept a record of BP over the past 5 weeks (thrice daily) and took the (mail order) tablets to a local pharmacy where the pharmacist verified that the tablets were what the label stated they were.
Thanks again.
Answer
Sustained release medications are more difficult to achieve true therapeutic equivalence. The very first version of Toprol XL was actually manufactured by the same company as Toprol. I would guess you did not receive medication from this manufacturer. It is obviously best for you to stay with brand name Toprol XL.
Thanks
Barb Judge
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