Metop tartrate to succinate
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Comparison of Metoprolol Tartrate and Metoprolol Succinate
Introduction to Metoprolol Forms
Metoprolol is a beta-blocker commonly used to treat various cardiovascular conditions, including heart failure, myocardial infarction, and angina. It is available in two primary forms: metoprolol tartrate (MT) and metoprolol succinate (MS). While both forms are effective, they have different pharmacokinetic properties and clinical applications.
Hemodynamic Effects in Heart Failure
Studies have shown that both metoprolol tartrate and metoprolol succinate produce similar hemodynamic and clinical effects in patients with congestive heart failure. In a comparative study, patients treated with either form experienced significant improvements in functional, exercise, and hemodynamic parameters over three months1. However, both forms also exhibited parallel adverse hemodynamic effects when the full dose was readministered during chronic therapy, indicating no significant difference in their long-term hemodynamic impact1.
Structural and Behavioral Differences
At the molecular level, metoprolol tartrate and metoprolol succinate exhibit close similarities in their crystal lattices. However, they behave differently under temperature variations. Metoprolol succinate shows a reversible anisotropic lattice expansion/contraction and quickly recrystallizes after melting, whereas metoprolol tartrate expands/contracts isotropically and forms an amorphous solid upon cooling, taking several days to revert to its original crystalline form2. These differences are crucial for pharmaceutical applications, particularly in drug formulation and stability.
Heart Rate Management in Acute Myocardial Infarction
In patients with acute myocardial infarction, both metoprolol tartrate and metoprolol succinate effectively reduce heart rates. However, the degree and trend of heart rate reduction over the first 72 hours post-medication show no significant difference between the two forms4. This suggests that either form can be used effectively for heart rate management in acute settings.
Efficacy in Chronic Obstructive Pulmonary Disease with Heart Failure
For patients with chronic obstructive pulmonary disease (COPD) complicated by chronic heart failure, metoprolol succinate has shown superior efficacy in improving cardiac function compared to metoprolol tartrate. However, both forms have similar safety profiles and do not significantly differ in their impact on lung function or quality of life5.
Clinical and Economic Considerations in Ischemic Heart Disease
In patients with ischemic heart disease, both metoprolol tartrate and metoprolol succinate are effective in preventing cardiac events such as myocardial infarction and angina attacks. Metoprolol succinate has been noted for its direct anti-sclerosis effect, which is not observed with metoprolol tartrate8. Despite this, metoprolol tartrate offers significant pharmacoeconomic advantages due to its lower cost7 8.
Conclusion
Both metoprolol tartrate and metoprolol succinate are effective beta-blockers for managing various cardiovascular conditions. While they exhibit similar clinical efficacy and safety profiles, their structural differences and pharmacoeconomic considerations may influence the choice of treatment. Metoprolol succinate may offer advantages in specific clinical scenarios, such as chronic heart failure and COPD, but metoprolol tartrate remains a cost-effective option for many patients.
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Most relevant research papers on this topic
Hemodynamic comparison of twice daily metoprolol tartrate with once daily metoprolol succinate in congestive heart failure.
Metoprolol tartrate and metoprolol succinate both produce similar hemodynamic and clinical effects in congestive heart failure patients, with once daily metoprolol succinate offering a faster initiation and potentially better treatment outcomes.
RCTSimilar but Different: The Case of Metoprolol Tartrate and Succinate Salts
Metoprolol tartrate and succinate salts show similar molecular structures but different macroscopic behaviors, with tartrate undergoing reversible anisotropic expansion/contraction and succinate showing a slower amorphous solid reversion to crystal form.
Hydroxyapatite/Poly (Butylene Succinate)/Metoprolol Tartrate Composites with Controllable Drug Release and a Porous Structure for Bone Scaffold Application
Hydroxyapatite/poly (butylene succinate)/metoprolol tartrate (HA/PBS/MPT) composites can achieve controllable drug release and porous structures in bone scaffolds, offering a novel method for bone repair material preparation.
In Vitro StudyComparison of effects of metoprolol succinate sustained-release tablets and metoprolol tartrate tablets on heart rates of patients with acute myocardial infarction
Metoprolol succinate sustained-release tablets and metoprolol tartrate tablets both decrease heart rate in acute myocardial infarction patients, but their effects differ in the first 72 hours.
RCTClinical Observation of Two Dosage Forms of Metoprolol in the Treatment of Chronic Obstructive Pulmonary Disease Complicating with Chronic Heart Failure
Metoprolol succinate sustained-release tablet is more effective than Metoprolol tartrate tablet in improving cardiac function in COPD patients with chronic heart failure, but both have similar safety.
RCTMetroprolol Fumarate: Crystal Structure from Powder X-ray Diffraction Data and Comparison with the Tartrate and Succinate Salts
Metroprolol fumarate (MF) salt exhibits anisotropic behavior at room temperature, while tartrate and succinate salts exhibit similar behavior, but MF melts more slowly and takes 3 days to recover its crystalline phase.
Comparative evaluation of the effectiveness of metoprolol succinate and metoprolol tartrate in patients with vasospastic angina
Metoprolol succinate has a significant advantage in reducing clinically significant angina attacks, but no significant difference in cardiovascular events or death between the two drugs.
CLINICAL AND ECONOMICAL ASSESSMENTS OF METOPROLOL TARTRATE/SUCCINATE USAGE IN PATIENTS WITH ISCHEMIC HEART DISEASE
Metoprolol therapy effectively reduces mortality and recurring heart attacks in patients with ischemic heart disease, while being economically reasonable compared to other -blockers.
Literature ReviewMeta-analysis of the effects of carvedilol versus metoprolol on all-cause mortality and hospitalizations in patients with heart failure.
Carvedilol and metoprolol succinate have similar effects in reducing all-cause mortality in patients with heart failure with reduced ejection fraction.
Meta-AnalysisASSA14-07-02 Comparision of metoprolol succinate sustained-release tablets and metoprolol tartrate tablets on cardiac function in patients with chronic congestive heart failure
Metoprolol succinate sustained-release tablets decreased average heart rate in chronic congestive heart failure patients compared to Metoprolol Tartrate tablets, with equal effects on cardiac and renal function.
Observational Study
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