Symptoms on different generic manufactured version of lisinopril?

[Anomalouspapillary]

Hi all,

This is my first post! So just for a little background, I've been on Toprol XL since 1998 to manage the pounding heart, shortness of breath, and severe jaw pain I'd get which worsened after I started trying to jog (not knowing my lifelong exercise-induced jaw pain was from a heart condition). Anyway, now after a couple surgeries and a replaced mitral valve, I'm still on Toprol XL, 50mg, and Lisinopril 10mg (which had been added in 2010 when I became super symptomatic after starting yoga and which eventually led to the correct diagnosis and second surgery.)

So I've been better than ever in my whole life since the December 2010 surgery, no longer always aware of my heart beating, and able to exercise with no jaw pain! Amazing! In fact, the only times I've experienced any symptoms at all in the past year have been twice while doing yoga: sudden pounding heartrate/palpitations, weakness, trembling, shortness of breath, feeling like I'm about to pass out. This is not a result of the yoga persay, since I've been going 5 times a week since April and this has only happened twice, first time in June, which the only thing I could find to attribute the symptoms to was that the pharmacy had provided me with a different version (a white round pill marked W929) of the 10mg lisinopril I usually take (a peach oval one marked e101). Of course I consulted my cardiologist, who had no explanation for the symptoms. I switched back to my usual lisinopril and whether or not that was the cause, the problem was solved.

Then it happened again! A little over a week ago my pharmacy gave me a different version of lisinopril, this time a round unmarked pink tablet. I didn't think anything of it, having forgotten about the episode in June. Well, a few days later, again during yoga, I felt I was going to pass out and could not catch my breath, shaking all over, pounding heart. This time it lasted for hours after the yoga class, could barely walk home, lay in bed, eventually took one of my oval lisinoprils and within 2 hours felt fine. Been back on the ovals ever since and feel great. Called the cardio, who again said he could see no reason for any of this, but will be going back in for followup echo this month.

So my question is whether any of you have any kind of similar experience with generic versions of the medications causing problems. I'm not someone who generally cares about generic vs. brand meds, I used to even order my meds from Canada (not now though). And it seems ridiculous that 10mg of lisinopril should have such an effect anyway. But I can't see what else it might have been.

 

[debster913]

Hi, and welcome!

I can't really say that the generic drug may be causing your symptoms. I'm no pharmacist/doctor...but perhaps it could just be coincidence? I'm glad that you are going back to see your cardiologist for an echo. Mine is pretty good about taking my symptoms seriously, even as minor as they may seem.

I hope someone else here on VR can be of help to you with this issue. I hope you find an answer soon!

Best,
Debi

 

[Bill B]

I would be suspicious of something else....your symptoms sound a lot like a hypoglycemic reaction (low blood sugar). Was there any difference in you meal patterns on the days this occurred. Had you skipped breakfast? Just conjecturing here, but perhaps when it happens next time, get some OJ or something to give you a quick jolt of sugar, if you think I could be on to something. I don't see this as related to the lisinopril pills.

It is POSSIBLE that you are allergic to an excipient used in compounding one tablet but not present in the other. But I would expect a more classical pattern to the reaction, not somehting sporadic like this. Also, if there were some basic difference in the lisinopril availability, I would expect something more consistent.

All this notwithstanding, I prefer to stick with one manufacturer of generic drugs. It's confusing and raises questions like this when the pills change color or shape. In nearly all cases this does not really - they are equivalent - but for everyone's comfort, it's better to stick with one brand.

Bill (retired pharmacist)

 

[Rebecca]

My mom takes a lot of prescription drugs and she is on a fixed income. With one of her prescription drugs she would not get the generic drug because it would make her sick. She thinks it is because of the red dye in the generic drug. One day she went to a different pharmacy to get her drugs and the pharmacist told her that the one drug was much cheaper in the generic brand. My mother told him that the generic brand made her sick. The pharmacist told her that their generic brand was made by a different company. She tried their generic brand and it did not make her feel sick and it also saves her money. The main ingredient maybe the same but the filler ingredient can be different.

 

[Anomalouspapillary]

Thanks for your responses! It's just so unsettling to suddenly have symptoms, having spent the past several months since the last surgery feeling "normal" for the first time ever. I've been racking my brain trying to find some related factor, and since that had only happened once before, again after just a few days on a different drug version, it seemed the most likely culprit...hypoglycemia seemed unlikely since I had actually eaten a turkey sandwich a couple hours earlier, whereas usually I tend to feel more energetic exercising without having eaten anything that day other than some coffee, coconut water, fish oil capsules, vitamin D chewies, and the toprol & lisinopril. Other things I've considered is that I had been taking a lot of zinc (120mg daily) for 3 days to fight a cold, or maybe I was dehydrated...also, that yoga class was particularly strenuous and involved breath retention work, which I've decided is probably not for me, this heart needs all the oxygen it can get in any case, I should know within a few days if it is the lisinopril, since I ran out of the oval ones and am stuck with the round pink ones (which are actually marked lupin 10). So now if the same thing happens again in a day or two, that would be just too much of a coincidence! In any case, thanks again and I will update after I have the echo and meet with the doc. Good to be here!

 

[Ovie]

...and here I was thinking about joining yoga classes after my surgery, maybe not so much anymore.

Just kidding, I can't offer any information for I'm relatively new here and in the waiting room myself.

However welcome! Glad to have you here and hope you find out the cause to what's going on.

Cheers!

 

[D.C.]

My wife has one drug that makes her sick if it is generic. She does OK with the brand name drug. I think it is the binders or other stuff in the pill. The insurance company always tries to give the generic. Have to fight with them about once every year.

 

[Jkm7]

Massachusetts has law if the drug you need has a generic, pharmacy must dispense it unless doctor specifically overrides that with reason. Insurance companies decide whether to pay or not.

 

[Anomalouspapillary]

Ok, quickie update, I'm convinced it was the lisinopril switch! After a couple days back on the round lupin ones, I was way weaker & having palpitations during exercise, and even afterwards, pounding heart kept me awake at night unless lying on my right side, felt almost as bad as before the amazing surgery that gave me an active life in the first place (after a 3 week coma...). So I went back to the pharmacist who gladly exchanged my pills for the Sandoz generic oval ones I usually take, and just like that within an hour I was back to normal and have been normally active with no problems since Friday. So weird. Don't see how it could be the fillers if taking the other version rids the symptoms so quickly. Kind of freaky to be this dependent on one version of lisinopril, gotta stock up I guess...hopefully doc will have some insight, even if it's just why 10mg of that med should be making such a huge difference! Echo tomorrow...

 

[Jkm7]

Happy you have worked out the problem.

What did the pharmacist say about this reaction? Had (s)he heard of anyone else responding that way?

Very interesting.

 

[Anomalouspapillary]

Hi all, thanks again for your responses
Nothing really resolved, echo showed everything's great with no changes from the last one almost a year ago. Pharmacists didn't seem too surprised, said they have seen bizarro stuff like this with other meds...MD suggestion was just to stock up on the Sandoz lisinopril, no way to explain why it makes such a difference. But did find out that the price increased Jan 1 on the Sandoz version and now every pharmacy I've called in the area no longer stocks it...hmmm. But have been able to special order it and also get an override with the insurance company for mail order supply, so all's well for now, just hope Sandoz keeps making it so I can keep exercising, I guess!

 

[Bina]

My father has been on a med for angina for the past couple of years; then out of the blue he had severe chest
pain to the point of having to lie down. When I asked about his meds, he noticed that the pills were "different",
and I told him to have them changed. After the pills were swapped back to name brand, he was fine. Now his
doctor marks "no substitutions" on the prescription.
Glad to hear that you have solved your issue too