Name Brant vs Generic

I have been taking Metoprolol ER for many years.  Over the last couple years I have been having increased (almost daily) heart palpitations when I lay down to sleep.  I feel like my heart is pounding out of my chest.  As I drift off to sleep I will suddenly feel a rush of adrenaline and wake up with my heart pounding which then leads into a panic attack (increased blood pressure/ pulse will go from the mid 60's to high 90's or low 100's/heart palpitations/shaking/chills).  Last night I did not sleep at all as I could not rest with my heart pounding.  In February 2009 I had a 24 hour heart holter done, a stress test (non nuclear) and an echocardiogram - all was normal other than PAC/PVC.  I was wondering if there was any difference between taking the generic as opposed to the name brand to possibly lessen these symptoms?  I was taking 25mg for years but with the increased panic attacks and heart palpitations my doctor increased it to 50 mg once daily about two months ago.

[Sandra Y, RPh]

There is no difference between taking the generic as opposed to the name brand.    By law, pharmaceutical companies must meet specifications for identity, strength, quality, purity, and potency of generic drugs.  Manufacturers of the brand name drugs conduct expensive clinical trials in order to get the drug approved.  Once it is approved, a generic manufacturer does not have to pay money to conduct more clinical trials – the evidence stating the drug works is already completed for them.  This is why generic drugs a far less expensive than name brand drugs.  

The mechanism behind the palpitations you are noticing at night may be a slowing of the heart due to natural fatigue at bedtime.  This is normal, however I would recommend visiting your doctor since the frequency of your palpitations seems to be increasing.  It is possible that the palpitations may be worsened by any anxiety you may have over the palpitations themselves.