Metoprolol tartrate vs. metoprolol succinate

Drugs
Metoprolol tartrate and metoprolol succinate are different salt forms of the same active ingredient, metoprolol. Although these medications are similar, they have slightly different uses and effects.

Metoprolol belongs to a class of drugs called beta-blockers. These drugs work by slowing down a person’s heart rate and lowering their blood pressure.

Doctors often prescribe beta-blockers for people with cardiovascular conditions or those who have had a heart attack. Both metoprolol tartrate and metoprolol succinate are prescription-only drugs.

In this article, we explore the differences and similarities between these two drugs.

Uses

Woman taking a pill
Metoprolol tartrate and metoprolol succinate can both treat high blood pressure and angina.

Doctors prescribe metoprolol tartrate to treat people with the following health conditions:

They use metoprolol succinate to treat the following health conditions:

Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe only metoprolol tartrate to prevent further heart attacks in people who have already experienced a heart attack. For heart failure, they prescribe only metoprolol succinate.


Forms and dosage

The appropriate dosage of both metoprolol tartrate and metoprolol succinate depends on a person’s condition and how well that condition responds to the medication.

Metoprolol tartrate

Metoprolol tartrate is available either as an immediate-release tablet, as an intravenous injection, or in liquid form.

People using the immediate-release tablet may need to take it several times a day, and doctors advise that they do so either with or directly after a meal. The recommended dosage of metoprolol tartrate ranges between 100–450 milligrams (mg) daily.

One full dose of the intravenous injection provides 15 mg of the drug. If an individual tolerates this dose, the doctor may recommend that they switch to using metoprolol tartrate tablets instead.

Metoprolol succinate

Metoprolol succinate is available as an extended-release tablet, which means that people only have to take one tablet a day.

The initial dosage of metoprolol succinate ranges from 25–100 mg per day. If the person experiences no problems on the initial dosage, a doctor may increase the dosage to a maximum of 200 mg per day.


Who might benefit from these medications?

A person may benefit from taking metoprolol tartrate if they have:

  • experienced a heart attack
  • high blood pressure
  • angina

Metoprolol succinate may benefit people who have:

  • high blood pressure
  • angina
  • class II or III heart failure


Side effects

Woman with a headache and fatigue at her desk
Side effects of metoprolol tartrate can include fatigue and dizziness.

Although beta-blockers are generally safe and effective drugs, they may cause unwanted side effects in some people. However, the side effects of metoprolol tartrate and metoprolol succinate are usually mild and temporary.

Side effects of metoprolol tartrate can include:

Side effects of metoprolol succinate can include:

  • very low blood pressure
  • dizziness
  • difficulty sleeping
  • fatigue
  • difficulty breathing
  • depression
  • sexual dysfunction
  • rash
  • constipation
  • nausea
  • vomiting
  • dry mouth
  • rash

Risks

While metoprolol tartrate and metoprolol succinate are both generally very safe, people may experience problems if they abruptly stop taking them.

Suddenly stopping beta-blockers can lead to worsening chest pain, increased blood pressure, and heart attack. If someone wishes to end their treatment, they should speak to a healthcare professional first. A doctor will usually advise people to lower the dosage gradually over 2 weeks.

People who have diabetes may need to take care when taking any form of metoprolol medication because it can conceal symptoms that indicate low blood sugar, such as a rapid heartbeat.

However, research has shown that beta-blockers can help control high blood pressure in people with diabetes.

Beta-blockers can also affect how the heart responds to general anesthesia. A doctor may recommend temporarily withdrawing from beta-blocker treatment before undergoing major surgery.

People should always consult their doctor before stopping or starting any new medications or supplements.


Drug interactions

Metoprolol tartrate and metoprolol succinate contain the same active ingredient, so these medications have similar drug interactions. People should inform a healthcare professional if they are taking any other prescription or over-the-counter drugs or supplements.

Metoprolol tartrate and succinate can interact with a range of medications, including:

Blood pressure drugs:

  • amlodipine (Norvasc)
  • hydralazine (Apresoline)
  • ephedrine
  • guanethidine
  • betanidine
  • clonidine

Heart condition medications:

  • digoxin (Lanoxin)
  • furosemide (Lasix)
  • quinidine gluconate

Antipsychotics:

  • haloperidol (Haldol)
  • chlorpromazine (Thorazine, Largactil)
  • fluphenazine (Prolixin)

Antidepressants:

  • phenelzine (Nardil)
  • selegiline (Eldepryl)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)

Other medications:

  • atorvastatin calcium (Lipitor)
  • aspirin
  • abiraterone acetate (Zytiga)
  • acetaminophen (Tylenol)
  • ergot alkaloid
  • fingolimod (Gilenya)
  • guaifenesin (Theocon Elixir, Brondelate)
  • insulin glargine (Lantus)
  • sildenafil (Viagra)

Summary

Metoprolol tartrate and metoprolol succinate belong to a class of drugs known as beta-blockers. Both drugs are different salts of the same active ingredient, metoprolol. However, despite being similar, they do have different uses.

Both drugs are effective in treating people with high blood pressure and angina. However, doctors prescribe metoprolol tartrate for people who have had a heart attack and metoprolol succinate to treat individuals with type II and III heart failure.

The two medications share similar drug interactions, so it is essential that people make their doctor aware of any medications or supplements that they are currently taking.

Both forms of medication also share similar warnings. People should not stop taking these medications abruptly as this can lead to worsening symptoms and even heart attacks in some people.

People with diabetes should take care when using beta-blockers because these medications can mask some symptoms of low blood sugar.

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