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Gordon Fox • February 6, 2023
Problems with generic metoprolol
All generic drugs are not equal.

Background

Many HCM patients have issues with metoprolol, the beta-blocker most widely prescribed for HCM. There may be multiple reasons for this, but a key one has been known for some time: many generic formulations of metoprolol succinate have time-release mechanisms that do not work in a similar fashion to the brand-name Toprol XL.

Consequences

The result is that patients receive doses that are not equivalent to what was prescribed. Some develop symptoms as a result.

A good summary of the problem

A new blog post by pharmacologist Joe Graedon on The People’s Pharmacy blog describes the problem well.

Causes

The HCMA has been aware of this problem for quite some time. It’s caused by lax oversight of generic drugs by the FDA, especially those manufactured in other countries.

How patients can protect themselves

What can HCM patients do? Dr. Lever emphasizes:

  • Check the manufacturer of your prescription. It is usually on the pill bottle. If not, you can check using the number on the pill, on https://drugs.com
  • If you do well on your prescription, insist on the same manufacturer.
  • Ask your doctor to write the prescription for that particular manufacturer.

Further information

You can find useful information in our video library, especially in these interviews:

HCMA Blog

March 24, 2025
Who should have genetic testing, and when?
A photo-realistic image of  heart, lit from behind, on a black background.
March 11, 2025
Health educator Sabrina Cuddy discusses common arrhythmias in HCM, like atrial flutter/fibrillation, ventricular tachycardia/fibrillation, left or right bundle branch block, PVC, PAC, and others. Some arrhythmias are harmless, while others are serious and need treatment.
Chart representing mavacamten trial results with total patients, and results in blue bar format.
By Gordon Fox March 10, 2025
Camzyos provided significant reduction of obstruction. Initially all patients were obstructed (that is, they had gradients of at least 30mmHg after valsalva maneuvers). After 3 months on Camzyos, about 57% were no longer obstructed. After 6 months, about 70% had no obstruction.
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