A Cautionary Tale

More than a decade ago I had neck surgery involving discectomy and fusion on four levels of my neck. One of the odder results of that surgery was  that I had hypertension and tachycardia during the procedure. So my physicians put me on a beta blocker right away and then changed that to an ACE inhibitor to control the hypertension. I developed an allergic reaction to the ACE inhibitor and was then switched to an angiotensin II receptor blocker combined with a diuretic. All of that is background for what happened this year when my medication went from the proprietary form of the drug to the generic. Usually I am not an alarmist about generics since theoretically the formulas are the same.

This time, as it turns out, the two pills were not the same. Although more in depth research would need to be done to show the exact differences, right off the bat physician, pharmacist, and patient (me) knew that there was one visible difference in the pills--the generic did not have a coating on it. I didn't think that much about it; I had been taking the original drug for a decade with good results and few if any side effects. So I didn't connect what happened next right away to the switch from proprietary to generic. I started feeling sick all the time, sort of like morning sickness without being able to vomit. My heartbeat started to accelerate as well. Since I had been a competitive swimmer most of my life, my normal resting heart beat was well under 60 beats a minute and now it was running between 70 and 85. That's when I started to monitor my blood pressure more often, several times a day in fact. After two months on the generic, it was very low, around 90/50. Believe me, it is weird to have bp that low.

I went to my doctor who changed my prescription to the generic version of the drug that does not have the diuretic in it. Yesterday I had a follow up visit with her. My bp is still lower than she would like--about 110/65--but not as low as before so I feel better. My nausea is gone which is a big relief for me. My heart rate is still higher than I would like it to be, about 70 beats a minute, but not in any range that a physician would worry about. My doctor recommended sticking with this version of the drug but alternating half a pill a day with a full pill since she wants my bp to be about 120/80. We'll see if this regimen works.

Anyway, I learned a lesson about making assumptions and taking advice for granted. Anytime your medication changes, pay attention to what your body does. I needed the surgery since I had lost most of the sensation in my hands, but I am still dealing with the aftermath ten years later.

Update 8/31--Taking a half pill didn't work out. I am back to the full pill and blood pressure averaging around 110/65. That's fine with me. Funny thing though--my physician said I should meditate. I told her I didn't need to--I quilt.