“After discharge, I returned to the unused brand name drug (Toprol XL) and have had no further problems.” Nancy, March 20, 2007 There were no other differences in my daily life. “After taking the daily dosage for five days, I began having more and more arrhythmias to the point of having to be admitted to the hospital. “After taking Toprol XL with good results for three years to control cardiac arrhythmias, I was given a generic substitute three weeks ago when I switched pharmacies. My pharmacy gave me generic metoprolol in December and within two weeks I started having irregular heartbeats.” Stephanie, Feb. “Generic metoprolol ER is not the same as Toprol XL. By the second day my BP was back to normal.” Roger, December 9, 2007 “I had my cardiologist switch me back and I started feeling better right away. She stated that Toprol XL is a time-release formula & metoprolol succinate is not. “The pharmacist told me that she has heard a ton of complaints about metoprolol succinate and that it is not the same as Toprol XL. I also had difficulty breathing and anxiety. I started having dizziness & numbness on the left side of the face. All was well for a while but then my blood pressure shot way up. When the generic (metoprolol succinate) came out, I was switched to that. “I had been taking Toprol XL for six years with no problems. Nevertheless, over years we continued to receive complaints from patients who maintained that there were generic metoprolol formulations that were not working the same way the brand name Toprol XL did. We heard nothing from the agency that year (or in following years) about its investigation into generic metoprolol. Gary’s response: “We are investigating all aspects of this issue.” FDA Inaction on Generic Toprol XL (The Metoprolol Mess): On October 21, 2007, we informed Gary Buehler (then director of the Office of Generic Drugs) and other FDA executives that there was a problem with the generic formulation of this and certain other important medications. As more and more complaints poured in, we contacted the FDA about our concerns. In 2007, we started receiving messages from visitors to this website that generic metoprolol was not working as well as Toprol XL had. We suspect that some generic drug manufacturers have had problems coming up with their own gradual release formulation. The XL in Toprol XL stands for extended release. When AstraZeneca developed its brand of metoprolol succinate, it created a unique polymer microencapsulation process to deliver the active drug gradually.
Generic Toprol XL (Metoprolol Succinate) Creates Confusion: You can read about the scandal we uncovered at this link.
The matrix some companies developed released the active ingredient differently and that led to all sorts of complications. The generic products had to come up with a different kind of formulation. Even after the patent was lost on the API bupropion, the brand name manufacturer retained the patent on the special membrane formulation technology. This brand name medicine releases its active ingredient, bupropion, gradually over many hours. We learned about this because of the antidepressant Wellbutrin XL 300. Coca-Cola does not reveal its formula to other soft drink makers and brand name pharmaceutical manufacturers do not share their secrets with generic drug companies. The way the brand name manufacturer makes its pills is a deep, dark secret. We suspect that many health professionals think that when a drug loses its patent the secret sauce is revealed to the generic drug companies so they can duplicate the brand name product exactly. They are designed to gradually release the active pharmaceutical ingredient (API) over time. What very few physicians, pharmacists or patients realize is that sustained-release formulations are unique. The Secret of Sustained-Release Screwups: A sustained-release formulation, Toprol XL, was introduced in the US by AstraZeneca in 1992. The drug was originally sold under the brand name Lopressor. This beta blocker is prescribed for patients with hypertension and heart problems such as angina pectoris, heart failure, rapid pulse and/or irregular heart rhythms. We have been writing about problems with generic metoprolol for more than a decade.
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