Metoprolol is an effective medication used to treat high blood pressure (hypertension) and chest pain from coronary artery blockages, while also helping decrease heart failure symptoms and avoid having another heart attack.
Additionally, metoprolol helps decrease recurring issues with heart failure patients as well as prevent recurrences after previous attacks.
Patients may be prescribed metoprolol tartrate or succinate, both generic medications covered by Medicare and most insurance plans. While both contain similar salt forms of the medication, patients may have their choice between either version.
The Difference Between Metoprolol Tartrate and Succinate
Mechanism of Action
Metoprolol tartrate and metoprolol succinate are both beta blockers used to treat high blood pressure, chest pain, and heart failure. Their main difference lies in that metoprolol tartrate is an immediate-release tablet while metoprolol succinate is released gradually over time for more consistent effects over the day.
Metoprolol is commonly prescribed to treat cardiovascular conditions like high blood pressure and chronic chest pain. FDA approval also supports its use to improve outcomes and lower mortality for people living with heart failure when taken as a daily dose. Off-label uses include treating supraventricular tachycardia (an abnormally fast heart rate) and thyroid storm (an overproduction of thyroid hormone that leads to dangerous side effects).
Metoprolol works to lower levels of adrenaline, norepinephrine, and dopamine hormones produced in the sympathetic nervous system that cause increased blood pressure, rapid heartbeats, chest pain, as well as blocking their receptors to lower both heartbeat and blood pressure simultaneously. Controlled clinical studies have confirmed metoprolol’s efficacy when combined with diuretics containing thiazides such as Lasix.
Formulations
Metoprolol tartrate and succinate are available both as oral tablets, and an IV formulation used to treat an acute heart attack. Furthermore, this drug comes as both Lopressor (brand-name drug) and generics which typically cost less.
Your doctor may prescribe metoprolol to treat congestive heart failure, a condition in which your heart doesn’t pump enough blood (causing shortness of breath, fatigue and swollen legs – DailyMed 2016). Metoprolol may also help treat high blood pressure but not as effectively as diuretics would.
Metoprolol comes in both immediate-release tablet form and extended release format, with the former dispensing metoprolol over 20 hours while its latter counterpart releases quickly into your body.
Metoprolol may interact with certain antibiotics and antidepressants, increasing the risk of drowsiness. If you take any other medications, be sure to inform your physician. They may also conduct tests to see if you have conditions which interfere with how the drug absorbs into your system such as liver disease or kidney issues that could alter its absorption rate.
Dosing
Metoprolol tartrate and metoprolol succinate both contain the same active ingredient, but have different purposes; metoprolol tartrate is typically prescribed to treat high blood pressure and heart disease while metoprolol succinate is typically used to manage symptoms associated with congestive heart failure.
Both medications have similar side effects; however, each may be absorbed differently by the body, making differences between dosage levels significant for those requiring multiple daily doses of metoprolol.
Metoprolol succinate is different than metoprolol tartrate because it acts gradually over the course of 24 hours (DailyMed). Tartrate acts quickly, quickly affecting body systems before being eliminated (DailyMed).
ER metoprolol also has lower bioavailability than IR metoprolol due to being taken orally through a microcapsule that resists breakdown by stomach acid, leading to much higher first-pass effects and lead to high plasma concentration peaks with potential excessive B1-blockade or loss of selectivity [35].
Metoprolol succinate is commonly prescribed to treat heart failure because it reduces hospital visits and the risk of mortality compared with placebo; however, studies have demonstrated that carvedilol may be even more effective at decreasing hospitalizations and mortality rates among people living with chronic heart failure.
Potential Differences in Effectiveness or Side Effects
Lopressor (IR metoprolol tartrate) and Toprol XL (ER metoprolol succinate) are FDA-approved to treat high blood pressure and chest pain, both belonging to a class of medication known as beta-blockers which work by decreasing heart workload.
There may be slight differences in their effectiveness or potential side effects between them however.
Metoprolol tartrate forms of this medication have an approximate 6- to 12-hour duration of action and should be dosed two or three times a day; by contrast, extended release (ER) metoprolol succinate tablets have approximately 24-hour effects and should only be taken once every 24 hours; their long absorption time is due to controlled-release pellets within their formulation.
Metoprolol carries the FDA’s most serious warning label – known as a black box warning – because of an increased risk of heart attack or stroke in certain groups, such as those living with diabetes, depression or other illnesses.
Furthermore, pregnant or breastfeeding women should avoid using Metoprolol because its effects could pass into breast milk and possibly harm an unborn baby.
Both metoprolol tartrate and succinate are safe to take over long periods and have low rates of side effects; your doctor may begin you off on shorter-acting IR versions before switching you to longer-acting ER versions once your dosage has stabilized.
How Long Does Metoprolol Take to Work: Understanding the Onset of Action
Metoprolol, a beta-blocker commonly used for treating hypertension, angina, and reducing mortality due to myocardial infarction, can have varying onset times depending on the specific formulation. Let’s delve into the details.
Metoprolol Tartrate: Quick-Acting Medication
Metoprolol tartrate is an immediate-release medication known for its short-acting properties. When taken orally, it can start affecting the body within one hour after ingestion. Additionally, the intravenous form of metoprolol tartrate can exhibit its effects within 20 minutes, as per information from Drugs.com.
This medication, marketed as Lopressor, also blocks beta 2 adrenoreceptors, primarily found in bronchial and vascular muscles. Clinical pharmacology studies have demonstrated metoprolol’s ability to reduce heart rate and cardiac output at rest and during exercise.
Metoprolol Succinate: Extended-Release Medication
On the other hand, metoprolol succinate is an extended-release formulation of the medication. When taken in oral immediate-release tablet form, metoprolol succinate can have an onset of action within one hour.
The duration of effect may vary depending on the dosage administered. The extended-release preparation, however, provides a longer duration of effect, lasting approximately 24 hours.
Individual Variations and Medication Guidance
It’s important to note that the onset of action and duration of effect may vary from person to person and depending on the specific medical condition being treated.
To ensure optimal results, it is crucial to follow all directions on your prescription label and carefully read all medication guides or instruction sheets provided. Your doctor may occasionally adjust your dosage, so it’s important to use the medicine exactly as directed.
Consulting Your Healthcare Provider
If you have any concerns about the onset of action or duration of effect of your metoprolol medication, it is advisable to consult with your healthcare provider. They can provide personalized guidance based on your specific needs and medical history.
Understanding the timing of metoprolol’s effects is key to managing your condition effectively. By working closely with your healthcare provider, you can ensure that your treatment plan aligns with your individual requirements.
