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Metoprolol Succinate vs Tartrate
Introduction
Metoprolol Succinate and Tartrate are both medications prescribed to manage cardiovascular conditions such as hypertension (high blood pressure) or angina (chest pain). They're a type of drug known as beta-blockers which function by blocking the effects of the hormone adrenaline, also known as epinephrine. This helps to lower heart rate, blood pressure, strain on the heart, and help improve blood flow.
The primary difference between Metoprolol Succinate and Tartrate lies in how long they last in your system. Metoprolol succinate is an extended-release form that needs only once-daily dosing whereas tartrate is a short-acting drug requiring twice-a-day dosing. The selection depends largely upon patient-specific factors including their specific medical condition and lifestyle preferences.
Metoprolol Succinate vs Tartrate Side By Side
| Attribute | Toprol xl | Lopressor |
|---|---|---|
| Brand Name | Toprol XL | Lopressor |
| Contraindications | Should not be taken with certain drugs that slow down the heart rate like digoxin or amiodarone for irregular heartbeat. Abrupt withdrawal is not recommended without doctor's supervision. | Should not be taken with certain drugs that slow down the heart rate like digoxin or amiodarone for irregular heartbeat. Abrupt withdrawal is not recommended without doctor's supervision. |
| Cost | For brand name, approximately $130 for 30 capsules of 50 mg. Generic versions can vary significantly but typically fall between about $14 and up to over several hundred dollars per month supply. | For brand name, 100 tablets of 50 mg averages around $80. Generic metoprolol tartrate ranges from about $4 to $10 per month supply depending on the pharmacy and dosage. |
| Generic Name | Metoprolol Succinate | Metoprolol Tartrate |
| Most Serious Side Effect | Signs of an allergic reaction, slow heart rate or weak pulse, sudden weight gain or feeling short of breath, lightheadedness like you might pass out. | Signs of an allergic reaction, chest pain or discomfort, lightheadedness leading to fainting spells, slow or irregular heartbeats. |
| Severe Drug Interactions | Can interact dangerously with drugs that slow down the heart rate or with amiodarone for irregular heartbeat. | Can interact dangerously with drugs that slow down the heart rate or with amiodarone for irregular heartbeat. |
| Typical Dose | Oral dosages range from 25-200 mg/day, typically taken once daily due to its extended-release formulation. | Treatment often initiated at a dosage of 50-100 mg twice daily. The dose can then be increased to up to 200-400 mg/day, divided into two doses. |
What is Metoprolol Succinate?
Metoprolol Succinate (also known as Toprol XL) and Metoprolol Tartrate are medications that belong to the class of drugs known as beta-blockers. These drugs were a significant advancement upon their predecessors, primarily used for treating hypertension (high blood pressure), angina (chest pain), heart failure, and other cardiovascular conditions. Metoprolol Succinate was first approved by the FDA in 2001. It works by blocking the action of certain natural chemicals in your body, such as epinephrine on the heart and blood vessels, resulting in lowered blood pressure, heart rate, strain on the heart and helps it to pump more efficiently. Unlike Metoprolol Tartrate which is taken multiple times a day due to its shorter half-life; Metoprolol Succinate is an extended-release version usually given once daily because of its longer duration of action. This results in maintaining steady levels throughout the day with fewer side effects than other beta-blockers that require frequent dosing.
What conditions is Metoprolol Succinate approved to treat?
Metoprolol, both in its succinate and tartrate forms, is approved for the treatment of several cardiovascular conditions:
- Hypertension or high blood pressure
- Angina pectoris or chest pain due to heart disease
- Heart failure (specifically metoprolol succinate)
- Reducing the risk of death from recurring heart attack
How does Metoprolol Succinate help with these illnesses?
Metoprolol Succinate manages high blood pressure and angina (chest pain) by reducing the amount of workload on your heart. It does this by blocking certain receptors in the heart called beta-adrenergic receptors, which are responsible for increasing the rate and strength of your heartbeat when activated. With these receptors blocked, your heart doesn't have to work as hard, leading to a lower blood pressure and less chest pain. Metoprolol succinate is an extended-release version of metoprolol, meaning it is released into your system more slowly throughout the day for continual effect.
On the other hand, Metoprolol Tartrate serves similar purposes but differs in its absorption rate. Unlike its counterpart Metoprolol Succinate which has a slower release mechanism ideal for once-daily dosing, Metoprolol Tartrate requires multiple doses per day due to its immediate-release formulation that gets absorbed quickly into one's bloodstream. Therefore by limiting extensive workload on the heart at different intervals throughout each day with multiple doses as needed or prescribed rather than just once daily dose; Metoprolol Tartrate helps patients manage their condition and stabilize their cardiovascular health.
What is Tartrate?
Metoprolol Tartrate is a beta-blocker that works by blocking the action of certain natural chemicals in your body, such as adrenaline, on the heart and blood vessels. This effect reduces heart rate, blood pressure, and strain on the heart. Metoprolol Tartrate was first approved by the FDA in 1978.
As it's an immediate-release medication, it needs to be taken more frequently (usually twice daily) than its counterpart metoprolol succinate which is extended-release and can be taken once daily. While both forms are used to treat similar conditions related to cardiovascular health like hypertension or angina pectoris (chest pain), Metoprolol tartrate is often preferred for acute episodes of chest pain or heart attack as it offers quicker relief due to its faster absorption into the bloodstream.
The side-effect profile of metoprolol tartrate may include tiredness or dizziness but does not typically cause weight gain or sexual dysfunction. It can also contribute significantly towards controlling high blood pressure especially when other measures have proven insufficient.
What conditions is Tartrate approved to treat?
Metoprolol Tartrate is a beta-blocker that is approved by the FDA for the treatment of several conditions such as:
- High blood pressure (hypertension)
- Chest pain due to heart disease (angina pectoris)
- Heart attack prevention in patients who have already had one Its rapid onset of action makes it particularly suitable for situations where immediate relief from these symptoms is required.
How does Tartrate help with these illnesses?
Metoprolol Tartrate is a beta-blocker that plays an essential role in managing hypertension, heart failure, and angina by blocking adrenaline's effect on the heart. This reduces the heart rate, lowers blood pressure, and eases the heart's demand for oxygen. As with other beta-blockers, low levels of adrenaline have been implicated in certain cardiovascular conditions. Metoprolol Tartrate works by increasing available receptors for adrenaline binding at the cellular level within the cardiovascular system thereby alleviating some of its symptoms. Its action may also play roles as an anti-arrhythmic agent to prevent abnormal rhythms of the heart. Since it does not significantly affect serotonin levels like SSRI antidepressants (such as Prozac), it can be safely combined with such medications when treating patients who suffer from both depression and certain cardiac conditions or alternatively used alone in patients intolerant to metoprolol succinate.
How effective are both Metoprolol Succinate and Tartrate?
Both metoprolol succinate and metoprolol tartrate are beta-blockers that have established histories of success in treating patients with heart disease, including hypertension, angina pectoris, and heart failure. Metoprolol succinate was approved by the FDA for use in 2001 while metoprolol tartrate was approved much earlier, in 1978. They both act on the same receptors (beta-1 adrenergic receptors) but may be prescribed under different circumstances due to their dosage forms.
The effectiveness of these two drugs has been directly studied; a double-blind clinical trial conducted in 2000 exhibited similar efficacy of both drugs at managing symptoms of hypertension. In this study, there were no significant differences between patients receiving metoprolol succinate vs those receiving metoprolol tartrate on any metrics used to measure blood pressure control or heart rate.
Metoprolol succinate is an extended-release version which only needs to be taken once daily because it slowly releases the medication over time. This can offer better compliance for some patients as they need to remember fewer doses each day compared with immediate-release versions such as Tartrate which usually require twice-daily dosing.
A review article published in 2016 indicated that both formulations seem equally effective at reducing high blood pressure and other conditions related to heart health when administered at equivalent doses. However, data confirming its efficacy as a stand-alone treatment for all indications is less robust than that for combined therapy (with diuretics or ACE inhibitors). Nonetheless, due to its unique pharmacology and delivery mechanism, Metoprolol Succinate may be an optimal treatment choice for certain groups - like elderly individuals who might struggle with multiple doses per day.
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At what dose is Metoprolol Succinate typically prescribed?
Oral dosages of Metoprolol Succinate range from 25-200 mg/day, and it is typically taken once daily due to its extended-release formulation. However, for Metoprolol Tartrate, the standard dosage ranges between 100-450 mg/day divided into two or three doses as it's an immediate-release drug. Both forms are used in treating high blood pressure and heart-related conditions but their frequency of administration differs due to their different pharmacokinetic profiles. The maximum dosage should not exceed 400 mg/day for Metoprolol Tartrate and 200mg/day for Metoprolol Succinate unless under specific medical advice.
At what dose is Tartrate typically prescribed?
Treatment with Metoprolol Tartrate is often initiated at a dosage of 50-100 mg twice daily. The dose can then be increased to up to 200-400 mg/day, divided into two doses and spaced approximately 12 hours apart, depending on the patient's response to treatment. A maximum dose of 450 mg/day divided into two doses may be tested if there is no satisfactory response after several weeks at the lower dosages. This approach allows for fine-tuning of the dosing regimen and ensures that each person receives an individualized treatment plan based on their unique medical history and current health status.
What are the most common side effects for Metoprolol Succinate?
The common side effects of both Metoprolol Succinate and Tartrate include:
- Fatigue, drowsiness or lethargy
- Dizziness or lightheadedness
- Depression or anxiety
- Shortness of breath
- Dry mouth
- Stomach upset, nausea, diarrhea or constipation
- Decreased sex drive, impotence, difficulty having an orgasm
- Insomnia (difficulty sleeping)
- Cold hands and feet
In some people these medications may also lead to more serious side effects such as slow heart rate (bradycardia), extremely low blood pressure (hypotension), heart failure exacerbation, masking symptoms of hypoglycemia in diabetics and exacerbating asthma symptoms. Always consult your doctor if you experience any new symptoms while taking either medication.
Are there any potential serious side effects for Metoprolol Succinate?
Metoprolol succinate and metoprolol tartrate may cause similar side effects, yet some reactions might be more specific to a particular form. These include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Slow heart rate or weak pulse
- Sudden weight gain or feeling short breath
- Lightheadedness like you might pass out
- Cold hands and feet
- Unusual mood changes (depression), confusion or memory problems
- Dry mouth, stomach pain, vomiting
- Symptoms indicating low blood sugar levels - headache, hunger, sweating
In case of severe cardiovascular reactions such as chest pain/pressure that can spread to the jaw/shoulder/arm/back along with sweating and nausea/vomiting.
If any of these symptoms occur while taking either form of metoprolol medication contact your healthcare provider immediately. Also remember that each person's body responds differently to medications so it is important to monitor how you respond when starting any new treatment.
What are the most common side effects for Tartrate?
Potential side effects of Metoprolol Tartrate may include:
- Dry mouth, occasional sore throat or nasal congestion
- Mild ringing in the ears
- Blurred vision or dry eyes
- Nausea, stomach discomfort, decreased appetite but rarely constipation
- Sleep disturbances including insomnia or vivid dreams
- Occasionally feeling nervous or experiencing mild tremors, sweating is also possible
- Slower heartbeat rather than fast one as this medication is a beta-blocker
- Uncommon but potential for confusion and agitation
- Skin rash though not common
-Against its weight controlling properties it doesn’t usually cause weight loss
-Decreased urination due to its blood pressure lowering effect
-Potential for headache and dizziness especially when adjusting doses
-Muscle weakness or minor joint pain are rare side effects.
Are there any potential serious side effects for Tartrate?
While Metoprolol Tartrate is commonly prescribed for managing high blood pressure and chest pain, it does come with potential side effects that should be monitored. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Chest pain or discomfort
- Lightheadedness leading to fainting spells
- Slow or irregular heartbeats
- Mood changes such as confusion or depression
- Shortness of breath even at rest
- Swelling in the feet and lower legs which could indicate fluid retention
If you experience any of these symptoms while taking Metoprolol Tartrate, seek immediate medical attention.
Contraindications for Metoprolol Succinate and Tartrate?
Both metoprolol succinate and tartrate, as with most other heart medications, may cause side effects such as dizziness, lightheadedness, or fainting spells. If you notice these symptoms worsening or experience any serious side effects like shortness of breath, swelling ankles/feet, unusual tiredness or sudden weight gain please seek immediate medical attention.
Neither metoprolol succinate nor tartrate should be taken if you are taking certain drugs that slow down the heart rate (like digoxin) or amiodarone for irregular heartbeat. Always inform your physician about all the medications you take; these drugs can interact dangerously with both forms of metoprolol and may require adjustments to your dosage by a healthcare professional. Remember that abrupt withdrawal from either form of metoprolol is not recommended without doctor's supervision because it might exacerbate angina symptoms or precipitate a heart attack.
How much do Metoprolol Succinate and Tartrate cost?
For the brand name versions of these drugs:
- The price of 100 tablets of Metoprolol Tartrate (50 mg) averages around $80, which works out to about $0.8–$2.4/day depending on your dose.
- The price for 30 capsules of Metoprolol Succinate (50 mg) is approximately $130, working out to roughly $4.3 per day.
Therefore, if you are in a higher dosage range for metoprolol tartrate (i.e., 150 mg/day or higher), then brand-name metoprolol succinate could be less expensive on a daily treatment basis. However, cost shouldn't be the primary factor in determining which drug is right for you.
As for generic versions:
- Generic metoprolol tartrate ranges from about $4 to $10 per month supply depending on the pharmacy and dosage
- Generic metoprolol succinate costs can vary significantly based on pharmacy and dosage but typically fall between about $14 and up to over several hundred dollars per month supply.
Always consult your healthcare provider before making any changes to your medication regimen.
Popularity of Metoprolol Succinate and Tartrate
Metoprolol, either as succinate or tartrate, is a beta-blocker widely used to treat high blood pressure and other cardiovascular conditions.
In 2020, Metoprolol succinate was estimated to have been prescribed to about 7 million people in the US. This version of metoprolol accounted for just over 15% of beta-blocker prescriptions in the country. It's an extended-release form which means it releases medication into your body slowly but works longer. Its increasing prevalence since 2013 can be attributed to its once-daily dosing convenience.
On the other hand, Metoprolol tartrate was prescribed to approximately 3.5 million individuals in the US during that same year. Accounting for around 8% of all beta-blocker prescriptions and needing twice-daily dosing due to its immediate release formulation, this version has maintained a steady prescription rate over the last decade.
Conclusion
Both metoprolol tartrate and metoprolol succinate are beta-blockers, which means they work by blocking the effects of adrenaline on the heart. These medications are used to treat conditions such as hypertension (high blood pressure), angina (chest pain due to heart disease), arrhythmias (irregular heartbeat), and after a myocardial infarction (heart attack).
The main difference between these two forms of metoprolol is how often they need to be taken. Metoprolol tartrate is usually prescribed for administration twice daily, while metoprolol succinate can be administered once daily because it has an extended-release form.
Both versions of this medication are offered in generic form, which allows significant cost savings especially for patients who must pay out of pocket. Both may require an adjustment period meaning that their full effects may not be noticeable right away.
Their side effect profiles are similar with common side effects including fatigue, dizziness, slow heartbeat or hypotension. More serious but rare side effects include shortness of breath or swelling ankles/feet. Patients must closely monitor their symptoms and should seek medical help immediately if any new or worsening symptoms occur.
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Refrences
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