Metoprolol Administration with Food
Metoprolol can be taken with or without food for both immediate-release (tartrate) and extended-release (succinate) formulations, as food does not significantly affect absorption or bioavailability. 1
Extended-Release Metoprolol Succinate
Food has no clinically significant effect on absorption. Extended-release metoprolol succinate is specifically designed to deliver metoprolol at a near-constant rate for approximately 20 hours, independent of food intake and gastrointestinal pH. 2
Plasma concentrations remain stable regardless of meal timing. Studies demonstrate virtually identical plasma concentration-time profiles whether the medication is taken fasting or with breakfast, lunch, or dinner, with no statistically significant differences in peak concentrations or time to peak. 1
80–90% of the absorbed dose reaches systemic circulation within 10 hours, and this absorption profile is unaffected by concomitant food ingestion. 1
Once-daily dosing produces even plasma concentrations over 24 hours without the marked peaks and troughs seen with immediate-release formulations, maintaining consistent beta-1 blockade. 2
Immediate-Release Metoprolol Tartrate
Food does not alter the fundamental absorption of metoprolol tartrate, though the immediate-release formulation requires twice-daily dosing due to its shorter half-life rather than any food-related considerations. 3
The in vivo release and systemic availability of metoprolol from controlled-release systems are not influenced by food, with metabolite ratios remaining consistent across fasting and fed states. 1
Practical Administration Guidance
Patients may take metoprolol with or without food based on personal preference to optimize adherence, as the pharmacokinetic profile remains stable regardless of meal timing. 1
Consistency in timing (same time each day) is more important than food status for maintaining steady beta-blockade, particularly with the extended-release formulation. 3
The 100 mg metoprolol succinate extended-release tablet contains 95 mg of metoprolol succinate and provides equivalent activity to 100 mg metoprolol tartrate, with the tablet disintegrating into pellets that release drug at a constant rate over approximately 20 hours. 4
Important Distinction from Propranolol
Unlike propranolol, which shows significant food effects (particularly with protein-rich meals increasing bioavailability by up to 250%), metoprolol demonstrates no such interaction. 5
This lack of food effect makes metoprolol more predictable and easier to dose compared to other beta-blockers that require specific timing relative to meals. 1
Special Pediatric Consideration (Propranolol, Not Metoprolol)
- For propranolol in infants (not metoprolol), administration with or after feeding is required to reduce hypoglycemia risk, and doses must be held during diminished oral intake or vomiting. 6 This recommendation does not apply to metoprolol in adults.