I am 65 year-old male, and have been successfully batteling haeart disease since I was in my early 30's when I had my first CABG. I had an MI in '84 (3000 miles from home in CA by Simon Stertzer ) which happened during a 2nd attempt 2 weeks after the first, failed PCTA attempted to insert a balloon and a circumflex artery split open. I was rushed to an emergency CABG that was successful, althoug there was heavy damage to the left side. The good news is that was more than 20 years ago, and even though I have had bouts of angina, and had further PCTA- attempts, I am still here and feeling in great health.

That is the background.

Lately as with most of us, the health insurance carriers are sticking it to us and the doctors. They have been disallowing many brand name meds Ive bneen taking and used to, and substituting generecs. Since some of these changes I have been having problems with getting dizzy as well as passing out on a few occasions. An ICD was implanted 4 years ago and replaced a year later as a result of Medtronics recall. I have not yet had any shock, and they tell me that the pacemaker is rarely kicking in.

Since the change to
generecs I have been feeling lightheades a lot - very tired with less energy and taking naps often. I just rertuend fro Mt Sinai NY for testing. They had a internest, cardiologist (Velentin Fuser), neuroligist, pulminologist test me in many ways. None of the results were remarkable.

My cardiologist, who was the head guy, determined after a conversaton with all the ohters that the only common denominator is the meds. He felt that lisenaprol 25mg and tenormin 50 mg were probably too high and wantes me to make changes. E has ˜ø˜? Substututed tenormin with Toprol-XL (Metoprolol-ER) and lowered the lisinaprol down from 40 to 10mgs - saing that the results on my heart sill be as good with the lower doses but m BP will not be as low as it has been. ((normal in past 95- 105 - yet often down to 80/50 and a few weeks after a about with diareah it went to 60/40 and I was dehydrated and was told to drink 1 gallon of Gatoraid in 2 hours. It apparently helped raise the extremely low and dangerously low BP.

My Question: Has anyone else had similar problems? Has the cange to generecs in any way canged or created new symptoms?

ALSO WHY WHY WHY don't the government of even just the manufacturers standerdize generecs. I get some that are 3x the size of the Brand, different color etc. Then another generec of the same drug looks again toaally different, and I alsays worry that I am taking the right pill as I am presently taking 20 pills a day that includes 6 fast-acting 500mg Niacin 1/2 AM 1/2 PM.

Thanks in advence for any assistance.

Problem here is that you really haven't substituted a generic for a brand name. Sounds like you were on Tenormin (brand name of the generic atenolol) and have been changed to Toprol XL (brand name of the generic metoprolol). While both are beta1-selective adrenoreceptor blocking agents, they have different pharmacokinetics (the way the drug is absorbed/metabolized/excreted). So, it may be likely that the symptoms you are experiencing are from changing medications, not substituting a generic for a brand name. BTW, you can get generic atenolol in place of your Tenormin. Ask your cardiologist if there was a particular reason you were switched from atenolol to metoprolol.

The above is for information purposes only and is not intended as medical advice. You should always contact your personal physician with any questions or concerns.

:confused: Thank you for your explanation. I think the reason for the substitution of the tenormin atenalol was twofold. 1 to reduce the effect on BP so not to reduce it as much. And 2 - they said as I have CHF that the new drug is added help for that other symptom.
INTERESING OBSERVATION: I rerturned home on Friday, checked my BP 3x a day and watched it rise from below 90 to now today 122/70. Then during the afternoon I was with a friend at the house, and out of nowhere I started to feel dizzy and unsteady on my feet. I was scared, and thinking of calling the doctor who I assumed would tell me to come in... I went for a glass of orange juice - - and within a few minutes the symptoms started to go away... and finally I felt normal again. I was thinking... maybe my problem is sugar related not BP!! I thought that back and remembered that in the past I'd often get an urge for sweet when I was feeling "odd" - and it seemed to make me feel better... but I never gave it a 2nd thought, I did faint a few times over past few years, and in one instance 6 months ago, I felt the room spinning, I knew I was going down, I must have grabbed something to hold me, when the next thing I knew I wan on the floor and the thing I apparently grabbed, but didn't remember, was smashed on the floor next to me. I have an ICD but it dit not shock me, so it was not tachycardia...

I wonder what your feelings are about this sweet thing... Thanks Peter

I'm sure that with your previous hospitalizations you've been thoroughly checked for diabetes, but low or high blood sugar should be easy enough to check, either in the doctor's office or if you have a friend with a glucometer. Next time you feel that way, a simple fingerstick can give you an accurate blood sugar reading. You didn't happen to check your blood pressure during your last episode of dizzines, did you?