Side effects from different brands of generic Amplodipine

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A few months ago when my wife had all problems with the shingles/labyrinthitis episode one of the "baby" doctors at the surgery checked her blood pressure and decided that it was "on the high side". I think it was around 165 over 75 or something like that. Rather than suggesting an initial diet/lifestyle approach to see if that could help reduce the figure she immediately prescribes 5mg Amlodipine daily, These were prescribed as generic 5mg tablets from one manufacturer (Can't remember which)

Everything was fine for the first few weeks with no major side effects to speak of. She then had to renew her prescription and was given tablets from a different generic supplier (Somax) and within a day or so she started to feel pains and cramps in her legs and was generally fatigued. She thought this was probably normal as fatigue is listed as a potential side effect of Amlodipine.

However with her next renewal she was prescribed another generic brand (not sure if it was same as first one) and the fatigue and cramps disappeared. Last week she had another new prescription and was back on the Somax generic offering and within a day or so she experienced the leg cramps and fatigue.

Is this something others have experienced before? Essentially generic actives should all be provided to a BP spec so should not in theory produce different side effects. However could the formulations differ in some way that causes the drug to be delivered at a different rate or be released at a different point in the GI tract?

My wife spoke to the practice nurse last night when she went for her shingles jab and she seemed to accept that differences could occur and to ask the pharmacist to avoid prescribing the Somax version. (Not sure how feasible that is as I gather that they may be required to source the cheapest generic available at any one time)

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  • Posted

    I have found calling the pharmacist is very rewarding and they will look into the issues in detail and probably recommend an alternate prescription
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  • Posted

    Hi

    My wife can only tolerate the Besylate salt of Amlodipine. Originally to save money back in 2005 they put her on  the maleate salt. Shortly after she developed palpitations. At the time, we didn't link the palps with the medication but, after various heart monitoring tests, she eventually sussed out that it was the maleate so her GP agreed to put her back on the besylate. Lo and behold, the palpitations disappeared. The GP wasn't convinced that the medication was the problem so, with my wife's agreement, he tried the maleate again. Guess what - the palpitations recurred. From that point on, she's been on the Besylate (despite attempts by the pharmacy to give her alternatives).

    In recent times (despite being on the besylate), she's developed atrial fibrillation which is a known side effect of Amlodipine. To counteract the AF, she had an ablation done about 15 months ago but it hasn't been successful probably because the electrophysicist had to abort the procedure 1/2 way through after injuring the phrenic nerve (which is important for proper functioning of the diaphragm). It took about 12 months for the injured nerve to recover and she's now looking to get the ablation procedure finished off some time next year.

    I also take Amlodipine for blood pressure control and, as far as I'm aware, I seem to be able to tolerate all of the various salts - besylate, maleate and mesylate. Horses for courses I suppose.

    If your wife is having problems tolerating some brands of Amlodipine I would be inclined to try another type of medication altogether. You might also want to make sure she really does have a blood pressure problem by taking it when she's relaxed and not subject to the "white coat" syndrome. A blood pressure monitor is well worth considering - they're relatively cheap to buy..

    TC

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    • Posted

      Hi tcpace

      Tks for the input. Was not aware of the diufferent salts that can be prescribed. Will check if possible what salt is in the Somax manufactured version. That could be the reason if it differs from the generic vesions she's had which produce no side effects.

      BTW, we do have a home BP monitor and over recent weeks her BP has averaged 120 over 64. I'm convinced that the GP should not have gone straight to drug therapy and might try to persuade my wife to try a few days (or weeks) without the Amlodipine to see if her BP goes up significantly

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    • Posted

      I was on Amiodipine prior to having an Cardioversion, first week of 3 a day, second week, 2 a day then one every day then Cardioversion. I was booked in for the Friday, but had to go to my practice on the Monday fir bloods pre Cardio. I git a frantic phone on the Wednesday, had to admitted to the Neal ward, and pack my bags, panic! !!!! It turns my renal funcion is dangerously low , stopped Amiodipine immediately. On the balance to have dialysis, then maybe Steriods. I have never drank or smoked in my life, so to say I am gutted, is angry!!!! I am now in limbo, no Cardioversion, on BetaBlocker, and not tolerate this either, so where to go, one thing this drug is dangerous.!!!!
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    • Posted

      Have now established, ironically, that, in my wife's case, the problem Somax Pharma generic amlodipine is the besylate salt. Not sure what the earlier forms were where she had no side effects but will check the next time she gets her prescription renewed.

      She spoke to the pharmacist yesterday and he has af=greed to put a flag on her records to avoid issuing the Somax version when her prescription is renewed. She got the distinct impression that he was sceptical about her experiences with the different versions.

      He said he was not able to swap her existing supply so she will just have to persevere unless she wants to get the GP involved to force a change.

      Will watch carefully to see if her request is acted upon

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    • Posted

      My wife's GP was also sceptical until he tried putting her back on to the problem medication (the maleate in her case) so I can understand the pharmacist's reaction in your wife's case. Keep us posted on how things work out.
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  • Posted

    Mine was changed from white tablets to light blue/  within 2 hours I was so dizzy I was unable to walk.  3 days for testing at  ENT and audiologist office for vertigo.  Parmacist said to go to ER. I refused as they only bombard with CAT SCANS as dignostic tools to cover themselves for liability.  I received testing results yesterday.  ENt WAS ARROGANT, UNFEELING.  Made mewait 4 days before he called with results.  I had questons.  After 4.5 minutes he putmeon hold for 20 minutes.  I guess he hoped I'd hung up.  1 more minute on phoneand I asked if this generic drug could be te source for dizziness.  He sid no.  He said take prednosone and see a neurolgist as the audiology tests shwed inflammation in ear. I asked if it was the vestibuar canal..He sid no then asked to please hold.  5 more minutes on hold.  I hung up and called the office and asked them to mail me the reports.  I pray that they do.  WITHOUT taking steroids and kOFF this nightmare drug since Oct28th (today is Nov 10)  I'm feeling less and less dizzy.
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