a sphygmomanometer (blood pressure monitor), popular blood pressure pill

Q. My doctor prescribed Toprol-XL several years ago and it worked well. Last week my pharmacist refilled my prescription with generic metoprolol succinate. Two days later my blood pressure shot sky high to 190/100.

Luckily, I found some leftover pills of the brand name Toprol-XL. My blood pressure came down to 140/90–high but okay.

Is there a problem with this new generic? This has never happened to me before.

A. Toprol-XL (metoprolol) is a slow-release beta blocker prescribed to control high blood pressure and irregular heart rhythms. Many other readers have reported rapid heart rate and higher blood pressure after switching to some generic forms of metoprolol succinate.

One patient experienced pounding headaches with blood pressure of 225/125 after one week on metoprolol. Another wrote:

“I have bouts of ultra-fast heart beats, atrial fibrillation, and severe PVCs (premature ventricular contractions) which have been controlled with Toprol-XL for years. On the generic, it is as if I’m not taking anything.”

We urge anyone having a problem with generic beta blockers (or any generic drug) to discuss the problem with the prescriber. The FDA insists that all generic drugs are equivalent, but our readers describe varied reactions.

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  1. SR

    My pharmacy seems to alternate between the Par and Watson generics. The Par works fine for me… the Watson is noticeably less effective at controlling my pvc’s. The pharmacy (a chain) says they just use what they get from their supplier. I need to find a pharmacy that can consistently supply Par, or else go back to Toprol and pay the huge co-pay.

  2. ph

    I was prescribed Toprol XL by my cardiologist several years ago for hypertension & arrhythymia & like just about everyone else here I got switched to generic metoprolol. There are several manufacturers of the generics out there, unfortunately, some of them don’t even come close to original Toprol. Sometimes it was so bad I had to return/exchange my ‘left-over’ pills to my pharmacist because of untoward side effects.
    I have found that the ‘Par’ brand of the generic metoprolol works very well for me with no side effects. I have asked my pharmacist to give me only the Par brand in the future.

  3. Vanessa

    I understand how everyone is feeling because the same thing has been happening to me… I don’t know about the brand name toprolol because I have always been on the generic from day one… I was put on metoprolol succ er 50mg by mylan (walgreens brand) in Jan. 2008. I switched to cvs because walgreens didn’t pay for other brand name medicines that I use… I was on the 50mg by par starting Dec. 2010 and had not had a problem until recently..a year later Nov. 2011 I started feeling dizzy/lightheaded so my doctor switched me to 25mg 1x day… my cardiologists said it was probably due to my low bp… after switching to the 25mg 1x day my heart has been racing and bp up to 158/94 and I could literally feel my heart beating… so I called my heart doctor and he put me on 25mg 2x’s a day… this is my 2nd day.. 12/30/2011 on this schedule… the pharmacist told me that stress could be causing this problem…but I told the pharmacist I have been stressed before and this has never happened to me… not the pounding heart and the high bp… what the heck is going on here…
    All II know is that everyone with heart issues need to band together and pray for a miracle so we do not need medicine anymore… I’m seriously thinking about a heart (ablation)..look it up..I

  4. LW

    I need to know if cutting generic Metoprolol er in half diminishes effectiveness (label says do not crush or chew) and also if cutting it in half might exacerbate side effects.

  5. Rose

    After taking Toprol XL for over 10 years I was switched to a generic and now my BP is 162/62. This doesn’t make since, they also switched my Norvasc to a different generic and I feel like I am not taking anything to control my BP.
    Why my lower # is so low I do not know. Guess I don’t understand BP #’s. The insurance companies don’t care they still charge you a fortune for the Brand Name Drug.
    I will have to go back to the Brand just to have peace of mind and have normal BP.

  6. Kathy

    Wow, I thought I was crazy. Toprol XL has been working for me for a long time. I even have taken some generics with no ill effects. But just last week my prescription was refilled and they looked different. My heart has been beating irregularly (a dependable indication that my BP is elevated). So I’ve been monitoring it and it’s quite high. Whereas I could depend on my mid morning bp to be 110/75 or there about now it is 168/94. I thought the pharmacist had made a mistake. I just got them to refill with brand name topral XL. I’ll report back in.

  7. sherry

    I too was switched to metropol succinate and feel more tired with headaches and just kind of more blah than with the toprol xl. My son said it was all in my head but I don’t think so. My eyes have also been somewhat affected. I was looking at the side effects and they were a little different than with the toprol xl side effects. I would like to get switched back to what I had.

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