Metoprolol Tartrate vs. Metoprolol Succinate ER: Different Uses, Dosing, Cost

Here’s all you need to know about metoprolol and metoprolol ER.

What are metoprolol and metoprolol ER used for?

Metoprolol and metoprolol ER are both beta-blockers, and treat certain heart conditions by blocking the effects of the hormone, epinephrine, which causes the heart to beat slower. However, there are some differences between the two in terms of which conditions they treat.

First off, the two contain different salt forms. Metoprolol contains tartrate, while metoprolol ER contains succinate. These salt forms are approved to treat different conditions. Metoprolol, also referred to as metoprolol tartrate, is used to treat high blood pressure and chest pain, and to prevent heart attacks. Metoprolol ER, also known as metoprolol succinate, is also used to treat chest pain and high blood pressure, but unlike metoprolol, it should not be used to prevent heart attacks.

Secondly, metoprolol and metoprolol ER have different brand-name equivalents:

  • Brand version of metoprolol: Lopressor
  • Brand version of metoprolol ER: Toprol XL

How are metoprolol and metoprolol ER administered?

Forms and strengths

Metoprolol is available in tablet form in the following strengths: 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg.

Metoprolol ER is also available in tablet form but comes in these strengths: 25 mg, 50 mg, 100 mg, and 200 mg.

Dosing

Generally, metoprolol and metoprolol ER have similar dosing instructions. Patients should start on either drug at a low dose and work with their doctor to taper up to the most effective dosage. Similarly, patients should not abruptly discontinue the use of metoprolol and should instead work with their doctor to gradually lower the dose over 1 to 2 weeks.

The main dosing difference between metoprolol and metoprolol ER is how often patients will need to take the medications. Since metoprolol ER is an extended-release medication, its active ingredient is released slowly over time into the body, so patients will typically only need to take the medication once a day. However, those taking the plain form of metoprolol, metoprolol tartrate, will likely need to take two or more doses a day.

Patients must take metoprolol with or immediately following meals. In contrast, according to the manufacturers of metoprolol ER, patients may take the extended-release drug without regards to meals.

What are the most common side effects of metoprolol and metoprolol ER?

The most common side effects associated with metoprolol and metoprolol ER include tiredness, dizziness, cold hands and feet, wheezing, shortness of breath, diarrhea, constipation, slower heart rate, and decreased libido.

How much do metoprolol and metoprolol ER cost?

Both metoprolol and metoprolol ER are generics, which helps with their cost—especially if you have insurance. Both are usually considered “preferred” drugs on insurance formularies, so their price is typically covered. But, if you find that you are paying high out-of-pocket costs, you can get both of these medications for as little as $3 for a 30-day supply with a GoodRx coupon.

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