Generic Anti-Hypertensive Differs from Original and May Raise Blood Pressure

An investigation by of generic versions of the popular anti-hypertensive Toprol XL reveals that generics sold by two companies appear to differ from the original drug in how they dissolve and in their inactive ingredients.  These differences may help explain complaints by consumers who have been switched to a generic version.  Prior to generic competition, which began in late 2006, annual sales of Toprol XL were $1.7 billion according to IMS Health, placing it among the top-selling anti-hypertensive medications.

Dramatic increases in blood pressure and increased heart rate are among the complaints reported by people switched to generic versions of Toprol XL.  Other reported side effects include nausea, dizziness, hives and headaches, including migraines – most of which do not typically occur with Toprol XL.  The reported symptoms generally subside when returned to the original drug. has received complaints through its report form at  Complaints received by The People’s Pharmacy appear at’s report compares Toprol XL to generics sold by Eon Labs (a division of Sandoz), Ethex (a division of KV Pharmaceutical), and Par Pharmaceutical.  Some of the generics contain multiple inactive ingredients not present in Toprol XL, a potential issue for people with chemical sensitivities. also found that some generics sold as “Metoprolol Succinate Extended-release Tablets USP” may not comply with the official USP dissolution test. This is of concern because the rate at which a generic dissolves may affect the rate at which it enters the blood.  If blood levels for a generic differ from that of its counterpart original, it may not perform the same way.   Use of “USP” in the name of a generic may also lead pharmacists and physicians to believe that it behaves like the original Toprol XL, when that may not be the case.

The new report is found at  In addition to product comparisons, the report provides useful strategies for obtaining a desired brand at low cost.

Have you had a problem with the generic version of Toprol XL? We want to hear about your experiences! Share your story below: 

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  1. J R
    West Virginia

    I have experienced the exact same symptoms as a number of the other posts. I was taking Toprol XL50 mg and it was controlling everything as it should. I was switched to a Generic and then my doctor started wanting to increase the dosage of the Generic because my heart rate was too fast and my blood pressure went out of control. I convinced my Doctor to go back to the Brand and everything went back to normal. I do have a slight occasional heart twinge if the dosage of the Brand is increased, but works great at the current dosage.

  2. B

    I cannot express how happy I am that I found this site when I did. I’ve been having heart issues for years now. Toprol xl has been one of my medications since the beginning. For over two years I had gone back and forth between the generic toprol xl and also the strength changes of it, finally the 50mg twice daily of the brand name toprol xl worked. The generic gave me multiple problems, I have an arrhythmia, high blood pressure, history of heart attacks etc. I had so many problems with the generic toprol, I had chest pain, rapid heart rate, higher blood pressure, was sick all the time feeling horrible for most of the two years. In between times when I was switched back to toprol xl I felt good, but for whatever reasons I was put on the generic under doctors care.
    For years now, I’ve been on toprol xl and doing much better, the thing is, our insurance isn’t paying for the brand name, it’s costing me 180.00 as opposed to the 12.00 of the generic. That’s just not right, but it’s the reality of it. But, until the insurance companies show a little compassion, I’ll do without something else in order to live as well as I can with health issues.
    I did want to add that I have talked to more than one pharmacist about this issue, two of them agreed that generics are not exact as the name brands are, they are just a percentage, so they’re not as affective. I hope something happens in our favor soon so that we may eat and take medication that we can afford.

  3. db

    I had the exact same thing happen to me. I have been on Lotrel and Bystolic for years which worked great but Bystolic is not offered in generic and I was having to pay the full cost. Dr. replaced Bystolic with Toprol XL so I could get the generic Metoprolol 50mg. Within five days of taking this medicine my BP went from 128/78 to 189/117 with pain in my left arm, severe headaches and an abnormal heart beat. I called Dr. and he switched me back to Bystolic immediately and took me off Metetoprol. I am still having trouble with BP now trying to get it to regulate again. I believe that if I had taken one more dose, it would have killed me. This medicine is dangerous!

    • Ld

      It happened to me to when I was on Toprol 100mg once a day. My blood pressure was 130/72. I started taking the generic brand, and my pressure went up to 200/100. I ended up in the hospital.

  4. Jo Ann

    The generic almost killed me. Heart beat pounding in my ears waking me up at night..unbearable headaches..chest pain..told my Pharmacist who told me NEVER to take it again. Back on Toprol xl 50…doing great!

    • karen

      Agree 100% with JoAnn about the pounding in ears! Stay away from Metapropol Succinate. It is n-o-t the same as Toprol XL!

  5. M A

    I was prescribed Metropolol for blood pressure issues. I experienced discomfort while I was prescribed Metropolol and my BP was not controlled by this medication. I asked to be taken off of it by a doctor who was filling in for the cardiologist who originally prescribed it. I experienced nausea and other uncomfortable symptoms. I am no longer on Metropolol. I feel there should be a way for blood pressure to be lowered naturally. I am definitely not a fan of this drug or any type of drug. What’s even worse, is that when I try to explain my symptoms to a doctor when taking a drug, the doctor’s response is “this drug does not cause you to feel the way you do”. Then they tell me to continue to take it. That’s when you, as the patient, must use your common sense and Godly wisdom to find another doctor, or learn to wean yourself off of the medication. Do not suffer if the drug you’re taking makes matters worse.

  6. Carol H

    I’ve been taking this since having a heart attack (extremely mild) about a year ago. Since then, I’ve been sweating profusely. Initially I broke out in this weird rash. It was like prickly heat over my entire body, y regular Dr. said he’d never seen anything like it. Now I have weird lesions on my body, mostly my arms which have left severe scarring and seem impossible to get rid of. My blood pressure is not particularly well controlled and my cholesterol seems to have shot up – it was 145 at the time of my heart attack, now it’s 195.
    Is anyone else seeing these side effects? Then of course, there’s the weight gain despite going to the gym 4-5 times a week. I, too have a slight cough, and have never sneezed or burped so much in my life. While none of these are life threatening of course, they are all annoying and uncomfortable.
    I guess what bugs me most, is since I didn’t have any warning signs or markers for a heart attack at 56, and therefore cause is unknown, I’m given all these meds that I’m not sure are actually necessary. Instead of cookie cutter protocols for patients wouldn’t investigation be more prudent before prescribing all this stuff?

    • sw

      I have been taking Metoprolol (generic Toprol XL) for over a year now, currently 300mg 1x a day. I’ve gained over 75 pounds within the past year.

  7. jrb

    I have noticed that taking the generic Toprol, I have a consistent, slight cough. On requesting the name brand, the cough goes away within just a fews days. Hair loss is also very limited, unlike taking the generic.

  8. Af

    I was put on generic toprol 200 mg and my bp shot up very high. I had to go to the e.r. I was put back on regular toprol xl 200 and after a couple of days my bp was back under control. I tried the generic again about six months later and again ended up in e.r. Back on toprol xl 200 and b. P. Back under control. I will not take generic toprol again. My medicare part d was paying part of the cost and I was paying $95.00 for 30 pills filling them once a month. Now I see that for 2014 toprol xl has been taken off the blue rx prescription formulary so I will have to pay over $158.00 each month for this drug.
    The e.r. Visits each cost $4,000. They also took Diovan off the 2014 formulary and there is no generic for it. I am already paying $95.00 a month for this with insurance coverage. Now I will have to pay even a larger amount.
    I can probably find a different plan to cover part of the Diovan but it looks like none of the programs are covering toprol xl.
    I need these two drugs to keep my b.p. Under control. It will cost me $300 or more per month for these drugs in 2014. This is unfair. I do not qualify for prescription help and still work part time but these costs are a hardship for me.
    I would rather pay a little more for a prescription plan that would cover these drugs that I need.

    • terry

      Go to AstraZeneca’s web site, you can now get Toprol XL Brand for $30 for a 90-day supply, delivered direct. They have a partnership with a pharmacy and do this for a few of their medicines and it is brand. You need to enroll, get a prescription, no prior authorization required and no insurance necessary. I imagine AZ is doing this because patients are sick of the generic-flavor-of the month and recalls.

  9. JK

    I am taking the generic for Toprol XL. Can you still purchase the brand name Toprol. A pharmacy told me they no longer could purchase the brand name of Toprol. So I took the generic. I do not feel as well. It causes shortness of breath. Do you know of a store that carries the brand name Toprol in the Katy, TX area. Thank you JK

  10. Ray A.

    I was taking Toprol XL 100mg since 1999. Now since 2008 or so, I was placed on generic Metoprolol. That is when the bad side effects started. My PVC’s increased, vision blurred, bouts of weakness, lethargy, hives and a feeling of uneasyness. Also, I had an increasing feeling of a rubber band around my chest.
    I went for my annual visit to my doctor just 4 days ago and insisted he refill my prescription with the Brand Toprol XL by AstraZeneca. I told him to cut me down to 50MG since I had lost 30 lbs.
    I am thrilled to report that I feel like a million bucks!!!!!!!!!!! None, and I mean none of the side effects I had with the generic. My PVC’s have slowed way down and when I have them, I do not feel them. Oh, by the way, to help curb PVC’s or PAV’s, take chelated magnesium and chelated calcium. Almonds and almond milk is great for the natural calcium also. I love Toprol XL!!!!!
    My heart as I write this is beating like a clock now!

  11. Clarence

    I was put on Lantus about 2 months ago and I wish I would have started it long before BUT last week I went into AFIB while out in the yard working and had to be shocked to get it back normal. When I read that Toprol may cause side effect with Lantus I have been asking my doctors and they have never heard of it. I still wonder if this caused my condition?
    As I read everyone’s comments on generic I wonder too because I’ve had some of the same things like my eyes running for no reason. I think I’ll go back to the expensive Toprol to see if things change.
    Thanks for the info..

  12. jpb

    I was a generic mfg brand of toprol xl. The pharmacy changed over to a different mfg of the same generic toprol xl within a couple of weeks my B/P started to go up and I was having headaches and vision blurring. The doctor changed my presr. back regular toprol xl non generic I hope this will resolve my problem…

  13. ng

    I was on toprol xl 25mg and then one day I don’t know if they were out of the Brand name or not but they gave me a generic and I started having chest pains real bad I called the Drs office and told them what had happen and was advised to not take any more of that drugs it just about put me under so the Drs said I could not take the generic any more and I have been taking for a few years now and I take the brand and do not have any trouble. So when they say that it is the same I am here to tell you it is not and there are a lot more that is not also. thanks

  14. SR

    I’ve taken metoprolol for years for arrhythmia. My pharmacy usually dispenses the Par generic, which works fine. A couple of times recently, they’ve given me the Watson generic, because “that’s what our supplier sent us”. The Watson is only marginally effective, and after a few days on it, I can tell that my pulse and arrhythmia have increased.

  15. HP

    I was taking Toprol 50mg an happy with the results. My insurance company switched me to Metroprolo an I immediately started having PVC’s an had to visit the ER. I’m now on Atenolol 50mg an it seems to work plus it’s on Walmarts cheap drug list.

  16. peg

    Pharmacy switched me to generic at first okay then developed headaches, severe more than migraines, never had a headache in my life, my right eye was sagging headache so severe couldn’t stand, store lights even with sunglasses bought window tint put in my sunglasses, husband put after shave on out on the porch wanted to die went to doctor since the sympathetic nerve was involved he felt I had a stroke or heart attack or some other major occurrence, he ran every test known to man (which my insurance company paid thousands for) sent me to a specialist who diagnosed “cluster headaches” I was put on all types of drugs one pain pill was 150 which insurance co wouldn’t pay for but it helped headache lasted 6 months
    The doctors nor us did not associate the generic with my headaches till the pharmacy made a mistake and changed my dosage down to the lower pill but did not say take two to make up the difference, so I googled the drug and guess what it had been taken off the market in the dosage I was taking due to Headaches (time release) I called my doctor who put me back on Toprol no generic and have been in pretty good shape ever since, course I have to pay 100 every refill it is not covered I guess they would rather pay thousands for medical tests.
    By the way the lower dose of generic was also removed for a short period of time they were having quality production problems in one factory so we all got to suffer.
    I feel the damage that was done is somewhat permanent since occasionally I will get a headache (small) and my eye begins to sag and my voice drops I know it is coming I had always felt very lucky not to get headaches since my mother and my grandfather both had migraines

  17. L.O.

    I have had the same problem with my insurance company now requiring a doctor to justify using the brand name instead of a generic, even with brand written on the Rx. What puzzles and outrages me is that in all this time with all these complaints, the FDA has still done nothing about these generics that not only do not work but cause new problems.

  18. J.W.

    My spouses insurance carrier (AHSS) will only cover the generic at the normal co-pay, so tried it for a few months, and I developed heart palpitations, and fainting.
    For the world I couldn’t figure out what was wrong and I’m a medical professional. I began to examine my medications and discovered the “replacement”. I went back to my primary and cardiologist and after a few test they wrote to only distribute the brand name drug. You would think the carrier would comply, it took more than 2 hours to convince the insurance company that they were serious about not dispensing the generic. To sum it up I have to pay 90% of the expense for the prescription my physicians say I need and every re-fill they send the generic out.

  19. c. hart

    I was on name brand toprol xl 25 for several years. My dr wrote the refill as generic. My blood pressure shot up and my heart felt like it was going to explode. I went back to dr for another script for name brand. For some reason the pharmacists nor the dr believes it makes a difference. I have been switched three times to generic toprol.
    Last time I was flat on my back for several days because of fast heart rate. I have had to increase dosage from 25 to 50 mlg. We could not get bp back to where it was before taking generic. Why don’t they pull the stuff off the market? My ins company BCBS. No longer pays for name brand toprol. I sincerely believe if I take a generic toprol again it would have severe consequences.

  20. CT

    Glad to see I wasn’t the only one. I’ve been on Toprol XL for over 30 years by the way…since my 20’s.
    Two years ago I switched to the generic because I have to pay full price. I ended up with at least 4 emergency room visits in which my heart went nuts. It was great. Thousands of dollars. I switched back. Kept being told it was because I was going into menopause. right.

  21. b.mireles

    I’m 30 6’1 254 lbs and have been taking bp meds for many years 6-7 I was taking toprol xl 100 and benicar 20 both once a day until my bp was going into the low 110/60 I was getting headaches and feeling dizzy at work so they 86’d the benicar and kept up w the toprol xl and today I had an an ekg something w/ my t wave small variations I have an echo next week and a stress echo a week later but my cardiologist started me on bystolic amd kept me on topr xl 10) mg and after reading everything online I’m getting kinda worried causeI take all my bp meds at night what if I croak in my sleep!!!

  22. Mira R

    I have been taking the generic drug Metoprolol ER 50 mg made by Watson Labs for the past couple of months. My blood pressure would increase dramatically AFTER taking the drug — the systolic rising from around 128 to 158 a few hours after taking the drug. My PVCs also returned. I monitored my blood pressure for a couple of weeks and realized that the pill was not working at all. I returned the bottle of pills to the drugest and insisted I be given Toprol XL (the non-generic drug made by Astrazeneca), which immediately worked.
    I am going to make a complaint to the FDA — it is unconscionable that a drug company would play with people’s lives like this. Not everyone monitors their blood pressure closely. Mistakes like this by a drug company can cost someone their life. This drug company should be put out of business.

  23. mcw

    I had been on TOPROL XL since January, 2003 after a double by-pass. I never had a complaint about any medication I took, (except LEXAPRO) I just finished reading each and every comment sent to you about TOPROL XL. Then called MEDCO to ask why I was switched to a generic. The pharmacist told me that I am really taking TOPROL XL but it is under the generic name and if I am really having all the problems I claim to have, then it must be because of some other medication.
    I am having EXACTLY the same symptoms mentioned by everyone who wrote to the People’s Pharmacy, soooo, is the pharmacist lying to me? I believe that he is, otherwise, why am I having all the problems on the Astrazeneca made TOPROL/GENERIC? Believe me, I do not create illnesses that I don’t have, I’m too busy for game playing of that sort.
    I made an appointment with my cardiologist and the fur will fly if I am not given TOPROL XL back to me! Thank you for providing the space for allowing all of us who are being cheated out of good health all for the love of GREED. Shame on the American manufacturer. There is nothing sacred anymore.

  24. lly

    I have been on Toprol for 8 years to treat b/p and a-fib, now my insurance will not pay so for 2 months I been taking the cheaper brand of Toprol and my a-fib is back, no one can tell me the cheaper brands are the same as brand, you get what you pay for. How dare these insurance companies do this to us?

  25. fran t.

    I have been on toprol 50mg for many years. I never had a problem. About a year ago, my prescription was changed to metoprolol. I had a funny feeling when I took it — ears ringing, it just felt different. I switched back to Toprol. BP was fine. No strange feeling. Just two days ago, my pharmacy gave me Metoprolol (now on Medicare). Since I am on losartan 50 mg at night, I am going to try metoprolol again and see if it works. I am trying to give it a chance. we will see. I will let you know.

  26. mal

    I was prescribed toprol xl 50 mg. I get the generic metoprolol.. Gives me extreme dryness of my mouth… I have been diagnosed with xerostomia… anyone else out there have xerostomia… What do you do for it and does it get worse? Does this drug cause this?

  27. wjt

    Hi glad I found this high blood pressure heart beat rapid at times labored breathing-the drug is toprol xl generic by par I think. I take tambocor for arrhythmia which works great-also head aches the generic toprol xl. I have asthma also and could not get what was going on. Finally I read from cvs the med- I usually take the blue generic metropolol. I was taking albuterol inhaler nebulizer to feel ok. Lucky me has 60 pills left from a previous script. Gonna call doc to get other meds. I have 3months supply 270 pills. For real anybody who thinks this med problems are in your head…uh oh..again glad I found your site for info.

  28. MLP

    My physician prescribed Toptol XL for tachycardia. It resolved my tachycardia almost immediately. Since the cost has increased significantly, my physician suggested that I try the generic. It did nothing for my tachycardia and I had to go back to the brand and pay the much higher cost. With my insurance, I have to pay $270.00 more than the generic of $8.00.

  29. EM

    I use it and developed little black spots floating in front of my eyes. Got off of it and back on regular toprol and no problem.

  30. P Mc

    I started taking the generic because my new insurance provider, Humana would not help pay for the Topral XL. I had been taking the brand name for several years without an issue. So after the first month I could not tell, because I got terribly sick, all of a sudden with shingles. The second month, I told my pharmacy that I was having problems keeping my balance, & was vomiting in the mornings on occasion.
    I seemed to never feel good.
    So I started cutting the pill in half and taking only half the amount. Because they did not care at all, so I figured I had to take care of myself. I finally gave up, I could not cut the pill to the exact half, which left me taking more, then less on given days. My last visit to the doctor I told them of my problem, & they changed my prescription back to the brand name. Granted, I have to pay a lot more now, like $170.00 verses $21.00 out of my own pocket, & I’m on Social Security. But I might live a little longer!!!
    In my opinion, our system is trying to force people into taking the generic by not covering some brand names under their plan. What is happening to Humanity???

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