Here we go again: another generic metoprolol recall from an Indian drug company. Reddy’s metoprolol succinate 25 mg extended release tablets and the company is in the process of recalling 1,356,000 pills. Toprol-XL (metoprolol) is a beta blocker in the same family as atenolol and propranolol. Tens of millions of people swallow beta blockers every day to control heart rate, reduce the risk of a second heart attack, prevent migraines and ease the pain of angina. The original brand name medicine was developed under the name Lopressor and was an immediate release product. That means it had to be taken up to four times daily. The extended-release formulation, Toprol-XL, was approved in 1992 and was given once daily, making it far more patient friendly. We first suspected that there might be problems with generic extended release metoprolol succinate in 2007. Readers of our newspaper column and visitors to our website began reporting therapeutic failures when they were switched from Toprol-XL to metoprolol succinate. Here are just a few of their reports: “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. I have a blood pressure cuff that records my last 100 readings. “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 discharge, I returned to the unused brand name drug (Toprol XL) and have had no further problems.” Nancy, March 20, 2007“I have been taking brand name Toprol XL for quite some time without any problems. During about the first 12 hours after taking it, my blood pressure was way too low. prednisone vs budesonide Harry Lever, a cardiologist at the Cleveland Clinic, has been warning nearly anyone who would listen of his growing suspicions about generic versions of a widely used heart drug, Toprol XL. “The doctors in this country need to know what’s going on, because we’re ultimately writing the prescriptions and we’re responsible,” Dr. “There’s been this assumption that one generic is the same as another. Patient after patient, he said, would visit his office complaining of chest pains or other symptoms after switching from the brand-name version, made by Astra Zeneca, to a generic product, often one made in India. Reddy’s Laboratories, have announced recalls over the last two months totaling more than 100,000 bottles because their products were not dissolving properly — therefore probably not working as they should. is taking a closer look at the quality of generic drugs, which now account for more than 80 percent of prescriptions in the United States. Not in this case.”Representatives for Wockhardt and Dr. When he switched them back to the brand — or to another generic — the symptoms disappeared, he said. Lever wrote a letter outlining his concerns to the Food and Drug Administration in 2012, and this year, he traveled to Washington to try to get the attention of Congress. Lever could not prove that the generic drugs were to blame. The drug is a beta blocker that treats high blood pressure and heart ailments. The number of recalled bottles is relatively small compared with the 38 million prescriptions for the drug, known generically as metoprolol succinate, that were filled in the United States in 2013, according to the research firm IMS Health. Reddy’s did not return calls or reply to an email seeking comment. thoroughly vetted generic drugs and a “bioequivalence designation assures U. patients and caregivers that generic medicines, regardless of the geographic location of origin, are the same medicine with the same active ingredients as the brand but at a lower cost.”Mr. “You see enough people and you get a feel, but it’s anecdotes,” he said in an interview Monday. The recalls are the latest in a string of recent problems involving generic drugs, especially those made in India. The recalls are considered Class II, meaning they may cause temporary health problems but are unlikely to pose an immediate safety threat. Ralph Neas, the president of the Generic Pharmaceutical Association, the industry trade group, said the F. Neas also noted that generic companies supported a 2012 bill that increased funding — through industry-generated user fees — to scrutinize generic manufacturing, especially overseas. undertook a “multidisciplinary investigation” of the efficacy and quality of each of the versions of metoprolol succinate available in the United States. Wockhardt, for example, is now banned from exporting drugs to the United States that were manufactured in two Indian plants where F. Generic manufacturers have repeatedly stumbled in their attempts to copy Toprol XL, which lost its patent protection in 2006. The agency concluded then that all of the versions, including those made by Wockhardt and Dr. Earlier this year the agency put a call out to researchers to investigate the efficacy of generic versions of metoprolol succinate, which is best known by Astra Zeneca’s brand name, Toprol XLEven as the agency has stepped up its scrutiny of generics, however, it has maintained its long-held position that generic drugs are generally as safe and effective as the brand-name versions. Lever and other critics of generic drugs say the agency needs to be more frank about the potential downsides to generics. The agency is also more closely studying all extended-release products, like the two recalled products, which are more technically difficult to make. Cialis with finasteride Safe place to buy clomid Prednisolone acetate cost Metoprolol, marketed under the tradename Lopressor among others, is a medication of the. the risks. Metoprolol tartrate is a generic version of Lopressor, which was licensed and authorised on June 6th 1997 to Novartis Pharmaceuticals. where can i buy viagra in atlanta Metoprolol Succinate ER 50 mg Tablets Generic Toprol XL Unfortunately our full catalog may not be displayed in your state. If you contact our Customer Support by one of the methods below, we will be able to assist you in locating the product you are looking for. Generic for Toprol* Metoprolol is used to treat chest pain angina and high blood pressure hypertension. By lowering high blood pressure, Metoprolol helps prevent kidney problems and strokes. This medicine belongs to a group of drugs called beta-blockers, which is also used to treat or prevent heart attacks. (metoprolol succinate) has been manufactured with quality and commitment for more than 20 years. Once-daily TOPROL-XL is a beta-blocker indicated for the treatment of hypertension, alone or in combination with other antihypertensives. TOPROL-XL maintained consistent plasma levels vs immediate-release metoprolol and immediate-release atenolol over 24 hours. TOPROL-XL and its authorized generic,* metoprolol succinate (distributed by Lannett Company, Inc.), are available in extended-release tablets with oral administration, providing 24-hour hypertension treatment with 1 dose daily. Switching from immediate-release to extended-release: Use same total daily dose of metoprolol Switching between oral and IV dosage forms: Equivalent beta-blocking effect is achieved in 2.5:1 (oral-to-IV) ratio Dizziness (10%) Headache (10%) Tiredness (10%) Depression (5%) Diarrhea (5%) Pruritus (5%) Bradycardia (9%) Rash (5%) Dyspnea (1-3%) Cold extremities (1%) Constipation (1%) Dyspepsia (1%) Heart failure (1%) Hypotension (1%) Nausea (1%) Flatulence (1%) Heartburn (1%) Xerostomia (1%) Wheezing (1%) Bronchospasm (1%) Anxiety/nervousness Hallusinations Paresthesia Hepatitis Vomiting Arthralgia Male impotence Reversible alopecia Agranulocytosis Dry eyes Worsening of psoriasis Pyronie’s disease Sweating Photosensitivity Taste disturbance Lopressor and Toprol XL only Ischemic heart disease may be exacerbated after abrupt withdrawal Hypersensitivity to catecholamines has been observed during withdrawal Exacerbation of angina and, in some cases, myocardial infarction (MI) may occur after abrupt discontinuance When long-term beta blocker therapy (particularly with ischemic heart disease) is discontinued, dosage should be gradually reduced over 1-2 weeks with careful monitoring If angina worsens markedly or acute coronary insufficiency develops, beta-blocker administration should be promptly reinitiated, at least temporarily (in addition to other measures appropriate for unstable angina) Patients should be warned against interruption or discontinuance of beta-blocker therapy without physician advice Because coronary artery disease (CAD) is common and may be unrecognized, beta-blocker therapy must be discontinued slowly, even in patients treated only for hypertension Use with caution in cerebrovascular insufficiency, CHF, cardiomegaly, myasthenia gravis, hyperthyroidism or thyrotoxicosis (may mask signs or symptoms), liver disease, renal impairment, peripheral vascular disease, psoriasis (may cause exacerbation of psoriasis) May exacerbate bronchospastic disease; monitor closely Beta blockers can cause myocardial depression and may precipitate heart failure and cardiogenic shock Sudden discontinuance can exacerbate angina and lead to MI and ventricular arrhythmias in patients with CAD Worsening cardiac failure may occur during up-titration of metoprolol succinate; if such symptoms occur, increase diuretics and restore clinical stability before advancing the dose of metoprolol succinate; it may be necessary to lower the dose of metoprolol succinate or temporarily discontinue it Bradycardia, including sinus pause, heart block, and cardiac arrest, has been reported; patients with 1° atrioventricular block, sinus node dysfunction, or conduction disorders may be at increased risk Increased risk of stroke after surgery May potentiate hypoglycemia in patients with diabetes mellitus and may mask signs and symptoms Avoid starting high-dose regimen of extended-release metoprolol in patients undergoing noncardiac surgery; use in patients with cardiovascular risk factors is associated with bradycardia, hypotension, stroke, and death Long-term beta blockers should not be routinely withdrawn before major surgery; however, impaired ability of the heart to respond to reflex adrenergic stimuli may augment risks of general anesthesia and surgical procedures Metoprolol loses beta-receptor selectivity at high doses and in poor metabolizers If drug is administered for tachycardia secondary to pheochromocytoma, it should be given in combination with an alpha blocker (which should be started before metoprolol is started) While taking beta blockers, patients with history of severe anaphylactic reaction to variety of allergens may be more reactive to repeated challenge Extended release tablet should not be withdrawn routinely prior to major surgery Hydrochlorothiazide, can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma, which can lead to permanent vision loss if not treated; discontinue hydrochlorothiazide as rapidly as possible if symptoms occur; prompt medical or surgical treatments may need to be considered if intraocular pressure remains uncontrolled; risk factors for developing acute angle-closure glaucoma may include history of sulfonamide or penicillin allergy Caution in patients with history of psychiatric illness; may cause or exacerbate CNS depression Beta-blockers can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease There are no adequate and well-controlled studies in pregnant women Limited data on the use of metoprolol in pregnant women Risk to fetus/mother is unknown; because animal reproduction studies are not always predictive of human response, use if clearly needed Bioavailability: 40-50% (immediate-release) ; 65-77% (extended-release) relative to immediate release Onset: 20 min (IV), when infused over 10 min; onset may be immediate, depending on clinical setting; 1-2 hr (PO) Duration: 3-6 hr (PO); duration is dose-related; 24 hr (ER); 5-8 hr (IV) Peak plasma time: 1.5-2 hr (immediate-release); 3.3 hr (extended-release) Therapeutic range: 35-212 ng/m L The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Metoprolol generic for Metoprolol Davis's Drug Guide, Metoprolol Succinate ER 50 mg Tablets Generic Toprol XL Metoprolol for atrial fibrillation Azithromycin dosing instructions Where can i buy zovirax acyclovir 5 cream Mar 17, 2008. investigated the products on the market. What we found will shock you. Certain generics contain very different ingredients. Toprol XL vs. Generic Metoprolol Succinate Extended-release ER. Generic for Toprol Metoprolol 25/50/100mg, Generic for. Lopressor, Metoprolol Succinate ER, Metoprolol Tartrate. Trust in the reliable technology of original TOPROL-XL® metoprolol succinate. TOPROL-XL and its authorized generic,* metoprolol succinate distributed by. cipro for epididymitis Mg generic; 50mg generic, Lopressor; 100mg generic, Lopressor. who are taking metoprolol succinate ER tablets at a dose of 25-200 mg PO qDay. Apo-Metoprolol Metoprolol belongs to the class of medications called beta-blockers. Metoprolol is used to treat high blood pressure and prevent the symptoms.