What is the dose of metoprolol succinate (Metoprolol Tartrate is the other form, but succinate is the specified form here)?

From the Guidelines

Metoprolol succinate should be initiated at a dose of 12.5-25 mg once daily for heart failure, with gradual titration to a target dose of 200 mg daily as tolerated, based on the most recent and highest quality evidence 1.

Key Considerations

• The dose of metoprolol succinate may vary depending on the specific condition being treated, such as hypertension or post-myocardial infarction.
• The medication should be taken consistently with or without food, and tablets should be swallowed whole without crushing or chewing.
• Dose adjustments may be necessary for elderly patients or those with liver impairment.
• Metoprolol succinate is an extended-release formulation that should be taken once daily, unlike metoprolol tartrate which requires twice-daily dosing.

Evidence-Based Recommendations

• The European Heart Journal study 1 provides a clear titration scheme for metoprolol succinate, starting at 12.5-25 mg once daily and increasing to a target dose of 200 mg daily as tolerated.
• The Circulation study 1 supports the use of metoprolol succinate in patients with heart failure, demonstrating a significant reduction in mortality.

Important Safety Considerations

• Common side effects of metoprolol succinate include fatigue, dizziness, and bradycardia.
• The medication should not be abruptly discontinued as this can worsen underlying conditions.
• Patients should be monitored closely for signs of adverse effects, and dose adjustments should be made as needed to minimize risks and optimize benefits.

From the Research

Dose of Metoprolol Succinate

The dose of metoprolol succinate is as follows:

• Initiating dose: 12.5 mg once daily 2, 3, 4
• Target dose: 200 mg once daily 3, 5
• Dose titration: The dose should be increased gradually over weeks, with a goal of reaching the target dose or the maximum tolerated dose 2, 3, 5
• Key points to consider:
  • The dose should be individualized based on patient response and tolerance 3, 5
  • The formulation of metoprolol succinate allows for once daily dosing, avoiding peaks and troughs in plasma concentration 4
  • Metoprolol succinate has been shown to be effective in reducing mortality and hospitalization in patients with heart failure, with a consistent treatment effect across various subgroups 5