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High Blood Pressure

Pulse is normally 70-75

01/24/2008

Question:

I have been on toprol-xl since august 2007. Now generic metoprolol 50mg once a day and my bp is always normal 120/80 or better. My concern is and I told my doctor by phone that I don`t feel right when my pulse is 90-96. I feel yucky -- not me. So he told me to reverse taking it in the mornings and take it in the evenings. So I take it around 5pm for the last week or so and when I wake up in the morning my bp is fine but my pulse is 90-96. So sir, what should I say to my doctor? I know and he knows that 60-100 is normal -- maybe for others but not me? And should I take the name brand rather than the generic? Thanks for listening.

Answer:

Metoprolol does slow the pulse rate in most patients when taken, so the fast heart rate is unusual. One explanation is that Toprol XL is an extended release form of metoprolol which delivers the drug over a 24 hour period. However, generic metoprolol has a much shorter duration of action and is usually recommended to be given twice a day for high blood pressure. It may be that your symptoms and heart rate are occurring after and as a result of the generic metoprolol being eliminated by the body before the next dose is taken. In this case, you may ask your provider to consider prescribing the generic metoprolol more frequently.

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Response by:

Jackson T Wright, MD, PhD, FACP Jackson T Wright, MD, PhD, FACP
Professor of Medicine
School of Medicine
Case Western Reserve University