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. Melissa Jias

    I have been taking the metoprolol for some time now, from the same pharmacy. When my insurance ended, I had to switch to a different pharmacy. I still have the metoprolol but it has to be from a different manufacture. My blood pressure is so high and it is never been, along with my heart racing non-stop. I am going to the pharmacy this weekend to try and figure this out. It’s absolutely horrible. How can one manufacture be so drastically different from another??

  2. louise2

    I just had a hypertensive crisis BP 203/102 and went from the ER to the hospital. The only change in my routine was that my metoprolol prescription was from a different Mfg. (carac). A stress test found no problems. It wasn’t until I came home that I realized that could have been the problem. I plan to contact my cardiologist and my pharmacist.

  3. Barbara

    Does anyone have problems with excess sweating with Metoprolol? I am only taking half of a 25 mg tab now. It used to be worse but I still sweat more than I did. It’s embarrassing and uncomfortable.

  4. Anna

    I began taking 12.5 mg of the generic metoprolol once a day, made by PAR, in April after having afib. It worked well in keeping my heart in sinus rhythm, but the side effects were tough- fluctuating blood pressure- often very low- throughout the day, dizziness, nausea.

    I decided to try switching to the brand name, Toprol xl- it is far better, side effects have become very minimal. My one concern, though, is that the brand & the generic are absolutely identical in appearance. It’s confusing & gives no assurance that you are getting what you paid for. I don’t understand how the FDA can allow this.

    • Kathleen

      When you received the generic (metoprolol succinate) manufactured by Par Pharmaceuticals, you were actually getting the brand name drug Toprol XL. That’s because AstraZeneca, the pharmaceutical company that makes Toprol XL, also makes the “generic” version that is sold by Par. Par was selling what is known as an Authorized Generic — which is identical to the brand name medication in active ingredients as well as inactive ingredients. Other generics have the same active ingredients but can, and do, have different inactive ingredients. What you experienced when you switched to the brand name Toprol XL (no longer having “fluctuating blood pressure- often very low- throughout the day, dizziness, nausea”) was undoubtedly a “placebo effect.” You thought you would be better on the brand name, so you were. But in reality, you were taking the exact same thing.

  5. Richard
    Orlando FL

    I read a lot of the comments on Toprol/metoprolol tart 50 mg. and didn’t see even one like what I’ve experienced. I had wild dreams during which I grunted, groaned and kicked and hit my wife several times. My doctor suggested that I stay on the generic, but ask the pharmacy to change manufacturers (Teva Labs). I’ve tried two other manufacturers and still have wild dreams, but no violent outburst

  6. Pam

    I have been taking the generic form of Toprol XL for several years. I should have put two and two together when my hair started falling out. I had a LOT of hair, so it took years to realize just how much hair I have lost. I just called my pharmacist and refilled my Rx with the name brand, which is cheaper than it used to be years ago. I am hoping that this will resolve my hair issue. I have spent a LOT of $$$ on thyroid, blood and hormone tests, even made an appt. with a dermatologist for my hair loss. Hoping for the best!

  7. Gene

    I took Acebutolol for years and was doing fine until our insurance company quadrupled the copay. I had the doctor switch to another drug and he gave me Metoprolol Tartrate 25 mg (mfg by Mylan). I seem to be doing fine but I read all the bad things about Metoprolol generic.

    Now I wonder if my Metoprolol Tartrate should be suspect also. I do know that even though it is made by Mylan that the ingredients may be imported from India. What do you think? I am going to ask the pharmacy but I doubt if I will get an honest answer, or maybe they don’t even know.

  8. Dorothy

    I had to switch to metoprolol succinate. it is the drug from hell. I have so many side effects I want to go back on the brand name. I am an 83 year old widow on SS an can’t affort it.i get blurred vision .the generic comes from different manf.and each one is worse.they effect the the neurothopy in my feet to the point where I can’t walk.I only take 1/2 of a 75 mg pill once a day.I researched metoprolol succinate on the internet and printed 4 pages of side effects.My life is not worth living. Until my late 70’s I was a Ballroom and laten dance teacher.

  9. Corie

    I took metoprolol and palpitations and chest pain continued and worsened. I called my pediatric cardiologist to find out what rx i was taking as a teen because that medication worked well. Found out i was taking toprol xl. I recently started taking the toprol xl again and have had NO symptoms! The generic metoprolol was not a good fit! There is certainly a difference between the two

  10. Kathleen

    I am so disgusted with generic drug compared to brand Toprol LX..I have been switched by cardiologist with the advise its all the same , you will be fine….what a joke…with in 3 days I could not take a deep breath, heart rate was fast, PVC’s,,weakness to say the least of the symptoms..blood pressure sky high…..called cardiologist and they said its fine just keep taking it….I said NO..I got brand name Toprol LX and in days was feeling better….this is poison at best….how to get it off the market …we the paying people are getting the bad deal!!!! Help get it out of circulation….please beware people!!!!!

    • Frances

      Have been taking Toprol XL for years and last year they increased the meds but gave me the generic because the brand name had gotten so expensive. The past several months I have experienced nausea, dizziness, diarrhea and my hair has been falling out. Just saw my doctor and we did a thyroid test because of hair loss and it came back normal. I also have been in remission for cancer and went to see my oncologist and am still in remission. Since the only meds I take is for blood pressure he said it had to be the Metoprolov. My blood pressure has increased to 170/100 since taking the generic. Why don’t doctors keep better informed? The pharmacist told me the generics aren’t made with the same FDA guidelines and many are made out of the country. I will be switching back as soon as I can get ahold of my primary care physician on Monday.

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