What is the Difference between Metoprolol Tartrate and Metoprolol Succinate?

The main difference between metoprolol tartrate (What is metoprolol tartrate?) and metoprolol succinate (What is metoprolol succinate?) is in their formulation. Metoprolol tartrate is the direct-release version of metoprolol whereas metoprolol succinate is the extended-release version. This means that metoprolol succinate is released over time in the body causing a longer-lasting effect.

Metoprolol tartrate may need to be taken several times a day. Metoprolol succinate can be taken once daily because it lasts longer than the tartrate form. Metoprolol succinate can also be used in children aged 6 years and over while metoprolol tartrate can only be used in adults.

What is the main difference between metoprolol tartrate and metoprolol succinate?

Metoprolol Tartrate Metoprolol Succinate
Drug class Beta-blocker Beta-blocker
Brand/generic status Brand and generic versions available Brand and generic versions available
What’s the brand name? Lopressor Toprol XL
What form does the drug take? Tablet oral Oral tablet, extended-release
What is the standard dose? 100 mg to 400 mg/day in divided doses 100 mg once daily
How long is treatment usually? Short-term or long-term use as directed by a doctor Short-term or long-term use as directed by a doctor
Who usually uses the drug? Mature Adults and children 6 years and over

What is Succinate – Definition, Uses

Succinate is the salt form or ester form of succinic acid. Its chemical formula is C 4 H. 4 O 4. A recent study has proven that succinate increases the production of interleukin-1β during inflammation acting as an intermediary. Based on the results of these studies, lipopolysaccharide greatly increased succinate levels in the TCA cycle.

Succinate is produced via glutamine-dependent anaplerosis and the GABA shunt pathway. Succinate dehydrogenase is the main enzyme of the TCA cycle. Inhibition of the enzyme succinate dehydrogenase leads to the accumulation of succinate. Then it inhibits HIF-αprolyl hydroxylases. HIF-1α levels increase due to this process.

Thus, succinate links TCA cycle dysfunction with oncogenesis. This is important for further research in the field of cancer. There is a beta blocker called metoprolol succinate. This is an extended-release medication used to treat high blood pressure.

What is Tartrate – Definition, Usage

Tartrate is a chemical molecule derived from tartaric acid. Its chemical formula is C 4 H. 4 O 6 . Tartaric acid is a chiral molecule. Because of this feature, it is a very famous molecule in the history of stereochemistry. Tartrate is a salt or ester form of tartaric acid. Sodium and potassium tartrate are widely used in the world as food additives. Tartrate was first discovered in 1794.

The condition is treated with metoprolol tartrate and metoprolol succinate

The tartrate and succinate metoprolol are FDA-approved to treat high blood pressure (hypertension) and chest pain (angina pectoris).

Metoprolol tartrate is also FDA-approved as a treatment right after a heart attack (acute myocardial infarction). Taking metoprolol tartrate after a heart attack may help reduce the risk of further cardiovascular events and death, especially in those with coronary artery disease. Treatment usually starts within 3 to 10 days after a heart attack.

In addition to high blood pressure and chest pain, metoprolol succinate is also FDA-approved to treat congestive heart failure. Metoprolol succinate treats class II or III New York Heart Association chronic heart failure. Administered as a daily dose, metoprolol succinate may improve outcomes and decrease the risk of death in heart failure patients.

Off-label uses for metoprolol include supraventricular tachycardia (abnormally fast heart rate) and thyroid storm (a dangerous condition resulting from overproduction of thyroid hormone). Other off-label uses may include treatment for abnormal heart rhythms (arrhythmias) and performance anxiety.

Condition Metoprolol Tartrate Metoprolol Succinate
High blood pressure Can Can
Chronic chest pain Can Can
Acute heart attack Can Off-label
Heart failure Off-label Can
Supraventricular tachycardia Off-label Off-label
Thyroid storm Off-label Off-label
Arrhythmia Off-label Off-label
Performance anxiety Off-label Off-label

Is metoprolol tartrate or metoprolol succinate more effective?

Metoprolol tartrate and metoprolol succinate both have the same effectiveness for treating high blood pressure and chronic chest pain. However, metoprolol tartrate may be more effective as a treatment for acute cardiac arrest whereas metoprolol succinate may be more effective as a treatment for chronic heart failure.

clinical trials have shown that metoprolol tartrate is effective for high blood pressure and preventing adverse outcomes after a heart attack. In contrast, studies including the Merit-HF trial have shown that metoprolol succinate is superior to metoprolol tartrate for chronic heart failure.

Metoprolol succinate can reduce repeat hospital visits and death from heart failure. However, carvedilol, another common beta blocker, may be more effective than metoprolol succinate, according to a trial published in The Lancet.

Because metoprolol tartrate is taken several times throughout the day, body levels of the drug may be inconsistent. This can result in more side effects and less tolerability than the extended-release form of succinate. One analysis found that side effects such as slow heart rate (bradycardia) may be more likely with immediate-release metoprolol tartrate.

Side effects

Since both drugs contain the same active drug, they cause similar side effects. The table below provides examples of the side effects of metoprolol tartrate and metoprolol succinate.

Common side effects Metoprolol tartrate fatigueXXDiasticityXXdepressionXXdiarrheaXX slower than normal heartbeatXXrashXXSome side effects metoprolol tartrate metoprolol succinate slow heart rate aspiration

FDA warning

Both metoprolol tartrate and metoprolol succinate carry a boxing warning, the most serious of the FDA warnings. The FDA warns that any drug can cause severe chest pain or a heart attack if you suddenly stop taking it. This risk is higher in people with heart disease.

If you need to stop taking any medication, your doctor will slowly reduce your dose over one to two weeks.

Drug interactions

The two drugs have similar drug interactions. Be sure to tell your doctor about all prescription and over-the-counter medications, supplements, and herbs you are taking before starting treatment with any new medication.

The following drugs may interact with metoprolol tartrate or metoprolol succinate.

Blood pressure medication:

  • reserpine (Serpasil)
  • hydralazine
  • the antihypertensive drugs guanenetine, betanidine, and alpha-methyldopa

Medicine for heart disease:

  • heart medications such as digoxin (Lanoxin), diltiazem (Cardizem CD, Cardizem LA) and verapamil (Verelan, Verelan PM)
  • heart rhythm medications such as quinidine and propafenone
  • blood thinner, dipyridamole (persantine)

Drugs for mental health treatment:

  • inhibitor monoamine oxidase (MAOIs) seperti selegiline (Atapril), phenelzine (Nardil) dan tranylcypromine (Parnate)
  • antidepresan seperti fluvoxamine (Luvox), fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Pexeva), sertraline (Zoloft), bupropion (Wellbutrin SR, Zyban), clomipramine (Anafranil) dan desipramine (Norpramin)
  • antipsychotics such as chlorpromazine (Thorazine), haloperidol, and thioridazine
  • clonidine (Kapvay), used in attention deficit hyperactivity disorder (ADHD)

other drugs:

  • antiretroviral agents such as ritonavir (Norvir)
  • antihistamines such as diphenhydramine (Benadryl)
  • antimalarial drugs such as hydroxychloroquine (Plaquenil) and quinidine
  • antifungal medications such as terbinafine (Lamisil)
  • Ergot alkaloids are used to treat migraines

Effects on other health conditions

If you have certain health problems, you should tell your doctor about these problems before starting treatment with metoprolol tartrate or metoprolol succinate. If you are already taking any medication, you should also tell your doctor if you are planning surgery.

Both drugs carry warnings for the same health problems. Before taking metoprolol tartrate or metoprolol succinate, discuss the following medical conditions:

  • heart problems such as decreased heart rate, irregular heartbeat, cardiogenic shock and worsening heart failure
  • severe peripheral arterial disease (PAD)
  • allergic to metoprolol or other beta blockers
  • lung or breathing problems
  • diabetes and low blood sugar
  • tumor adrenal
  • thyroid disease
  • liver disease

Talk to your doctor

If your doctor has prescribed metoprolol tartrate or metoprolol succinate, it is important to make sure which drug you are taking. One drug cannot be replaced with another drug.

The two drugs come in different forms, are approved for different uses, and cause slightly different side effects. Work with your doctor to decide which drug is right for you.

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