Medication query

[Gowers]

My cardiologist prescribed Adizam (also known as Diltizam) 180mg Xl capsules. but, when I picked up my 2nd box of these yesterday they were a different brand and MR was on the box. When I looked up the difference it said XL = extended release and MR = modified release. After speaking to our in-house pharmacist she re-did the prescription (even though she thought XL and MR had the same slow release properties) to what the cardiologist had originally put in his letter to the surgery. When i asked the dispensing chemist he said they are both the same.

Anyone else been advised that XL/MR are in fact the same please?

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Also been told it is important to have the same brand/manufacturer each time. But I have found in the past that the mfg company are often different as chemist doesn't always have same "brand" in stock. I also notice there are quite a lot of different "fillers" used in the capsules - which also vary from one brand to another.

It would be interesting to know if anyone has noticed any difference in the effect or the side effects if any having different brands have had on them please?

[BobD Volunteer]

Somme people do claim to have bad side effects from some brands of a particular drug against others. Diltiezem is one I can't tolerate so never take but most of the other drugs I take come in a variety of brands and I have never noticed any difference. I guess it depends a lot on one's own sensitivity.

[Gowers in reply to BobD]

Thanks for the reply BobD - ive only been taking it for a month so undecided if its going to help at the moment

[cassie46]

Hi there - I take Viazem XL 180 mg written on box under this is Diltiazem HC1 180 mg. I have always been supplied with this brand made by Thorton & Ross since 2015 when I started taking it ( I think Thornton & Ross it is actually written on my prescription). I know nothing about the difference between XL and MR.

I have had side effects from one maker of Bisoprolol (it was a food colourant they used as a filler which is banned in some countries) but have had many different manufacturers of Biso over the past 4 years (now on Nebivolol). I think a few people on here have said that different fillers in tabs have caused side effects.

Cassie

[Gowers in reply to cassie46]

Thanks for the reply Cassie-46.

Its the list of food colourants that suprised me + talc! + sucrose. I have only been on it a month after taking Bisoporol (which seemed to cause a lot of ectopics). They have said I will now have same brand in the future. It's certainly difficullt getting the meds right though!

[KMRobbo]

Today is diltiazem day, second query today!

I had 3 types of diltiazem over 10 months: Tildiem LA which is prolonged release, adizem-xl prolonged release and slozem also labelled prolonged release.

So far as I could tell they were the same:

Yes the same bad side effects off all three!

More seriously when I switched from Tildiem to adizem, which I think was owing to availability issues, my cardiologist spent ages with her head in a book of drug tables to get the same as the Tildiem. Sorry I dont know the detail but she was matching something so there must be some differences between the available drugs.

Cheers

[Gowers in reply to KMRobbo]

Yes, the pharmacist in-house at gp surgery took a while to sort out brands/strengths etc but in the end if came down to which ones they are allowed to prescribe. They have a list with the costs involved. So quite a few factors involved it would seem

[sleeksheep]

I take Diltiazem CD 240mg , I have had another Brand once even when my script says not to be substituted but didnt notice any difference. CD is slow release.

Been on them 3 and a half years.

[Gowers in reply to sleeksheep]

Thank you for reply - Not heard if cd slow release before - did you start on lower dose before taking 240 please?

[sleeksheep in reply to Gowers]

No - that was the starting rate . Its called Vasocardol CD 240mg and is made by Winthrop Pharmaceuticals - extended release formulation. So most likely the same as the XL branded one.

[Gowers in reply to sleeksheep]

Thank you - interesting to read your experience. i seem ok on the 180mg at the moment but it seems the capsules have to be ordered each time as pharmacist doesn't keep them in stock. It seems cardiologists have different ways of prescribing - i thought 180mg was a high dose but he said it wasn't and said he can increase it if needed. Has it helped you with the af?

[sleeksheep in reply to Gowers]

No real way of telling as I have to take it because I am on Flecainide which requires a calcium channel blocker. Definitely doesnt do any harm side affect wise.

Sotalol which had a dual use affected me greatly so its a vast difference in energy, no lethargy or nausea . My only concern is it "may" retard insulin production in the pancreas. Seeing my Dr. this week so hope to have more information on this.

[beardy_chris]

My pharmacist recently told me that the Tidiem Retard 90mg that I usually have was not available so my doctor switched me to Adizem-SR. I didn't notice any difference. I'm back on the Tildiem again now. But, you're right, it is recommended that you don't switch.

[Gowers]

Thank you for reply - interesting you are on 90mg - i have started on the xl 180mg and cardiologist said if tolerate it to increase to 240mg. After 2 days on the 240gm but i had af episode - so gp suggested going back on 180mg. It's interesting reading through the various posts on here what a variety of medications, brands and strengths suit one person and not another.