From the Guidelines
Metoprolol tartrate is generally cheaper than metoprolol succinate, with the price difference attributed to the extended-release technology in the succinate version allowing for once-daily dosing and more consistent blood levels throughout the day. The main difference between metoprolol tartrate and metoprolol succinate lies in their formulation and dosing schedule. Metoprolol tartrate is an immediate-release form that is typically taken twice daily, while metoprolol succinate is an extended-release formulation taken once daily 1.
Key Differences and Considerations
- Metoprolol tartrate and metoprolol succinate contain the same active ingredient (metoprolol) and work by blocking beta-1 receptors in the heart to reduce heart rate and blood pressure.
- The choice between these medications should be based on individual factors including cost considerations, dosing preference, and specific medical needs, as determined by a healthcare provider.
- Both medications are used to treat high blood pressure and heart conditions, but the extended-release formulation of metoprolol succinate may offer better adherence and potentially fewer peak-related side effects for some patients.
Cost and Formulation
- The price difference between metoprolol tartrate and metoprolol succinate is primarily due to the extended-release technology in the succinate version, which allows for more convenient once-daily dosing and provides more consistent blood levels throughout the day 1.
- Generic versions of metoprolol tartrate are often significantly less expensive than the succinate formulation, making it a more cost-effective option for patients who do not require the extended-release benefits of metoprolol succinate.
Clinical Guidelines and Recommendations
- According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults, bisoprolol and metoprolol succinate are preferred in patients with heart failure with reduced ejection fraction (HFrEF) 1.
- However, for patients without specific indications for extended-release formulations or those prioritizing cost-effectiveness, metoprolol tartrate may be a suitable and more affordable alternative, as long as the twice-daily dosing schedule is manageable for the patient.
From the Research
Difference between Metoprolol Tartrate and Metoprolol Succinate
- Metoprolol tartrate and metoprolol succinate are two different salt forms of the beta-blocker metoprolol, used to treat hypertension and heart failure 2, 3.
- Metoprolol tartrate is an immediate-release formulation, while metoprolol succinate is a controlled-release or extended-release formulation, designed to provide a relatively constant metoprolol plasma concentration over a 24-hour period 2, 4.
- A 100-mg metoprolol controlled/extended-release tablet contains 95 mg of metoprolol succinate and is considered to have equivalent activity to 100 mg metoprolol tartrate 2.
Pharmacokinetic and Pharmacodynamic Properties
- The pharmacokinetic and pharmacodynamic properties of metoprolol succinate have been compared with those of metoprolol tartrate, showing that metoprolol succinate has a more consistent beta(1)-blockade throughout the day 4.
- Metoprolol succinate has been shown to have a lower peak plasma concentration and a higher plasma concentration at the end of the dose interval compared to metoprolol tartrate 4.
Efficacy and Tolerability
- Both metoprolol tartrate and metoprolol succinate have been shown to be effective in reducing cardiovascular events and mortality in patients with hypertension and heart failure 3, 5.
- Metoprolol succinate has been shown to be well tolerated, with a similar proportion of patients discontinuing therapy due to adverse events compared to placebo 5.
Cost Comparison
- There is no direct comparison of the costs of metoprolol tartrate and metoprolol succinate in the provided studies.
- However, it can be noted that metoprolol succinate is a more recently developed formulation, and its cost may be higher than that of metoprolol tartrate due to its more complex formulation and manufacturing process 2, 6.