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

By Erica Friedman June 26, 2025
Investigative journalists Debbie Cenziper, Megan Rose, Brandon Roberts and Irena Hwang from Pro Publica and NPR have concluded a 14-month long investigation into the quality of generic drugs coming into the United States from overseas. Among the many voices that spoke up for American patients was HCMA Founder and CEO, Lisa Salberg who has felt the effects of low-quality drugs personally. Salberg believes that fixing this problem is something we can do, even in this time, when even health care is highly politicized. Read the key takeaways from ProPublica’s 14-month investigation into the FDA’s oversight of foreign drugmakers in Threat in Your Medicine Cabinet: The FDA’s Gamble on America’s Drugs .
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