Metoprolol succ vs tartrate
Pro Research Analysisby 
Searched over 200M research papers
Comparison of Metoprolol Succinate vs. Metoprolol Tartrate
Hemodynamic Effects in Congestive Heart Failure
Hemodynamic Benefits and Adverse Effects
Both metoprolol succinate (MS) and metoprolol tartrate (MT) have been shown to produce significant hemodynamic benefits in patients with congestive heart failure. A study comparing the two formulations found that long-term therapy with either drug resulted in similar improvements in functional, exercise, and hemodynamic parameters1. However, upon readministration during chronic therapy, both drugs exhibited parallel adverse hemodynamic effects, such as a decrease in cardiac index and stroke volume index, and an increase in systemic vascular resistance1.
Heart Rate Reduction
In another study, metoprolol succinate sustained-release tablets were found to be more effective in reducing the average heart rate in patients with chronic congestive heart failure compared to metoprolol tartrate tablets2. Despite this difference, both formulations showed no significant differences in other cardiac and renal function parameters, such as left ventricular end-diastolic dimension (LVDd), ejection fraction (EF), blood urea nitrogen (BUN), and creatinine (Crea) levels2.
Structural and Bioavailability Differences
Solid-State Structure and Behavior
The solid-state structures of metoprolol tartrate and metoprolol succinate exhibit notable differences. Metoprolol succinate has a slightly greater cohesive energy and undergoes reversible anisotropic lattice expansion/contraction upon temperature changes. In contrast, metoprolol tartrate expands/contracts isotropically and forms an amorphous solid upon cooling from the melt, which takes several days to revert to its original crystal form3. These differences are significant for pharmaceutical manufacturing and storage.
Bioavailability
A study comparing the bioavailability of metoprolol tartrate administered orally and via a transdermal drug delivery system (TDDS) found that the TDDS form had a threefold improvement in bioavailability over the oral form4. The TDDS maintained therapeutically effective plasma concentrations for up to 48 hours, which could enhance patient compliance by reducing the frequency of administration4.
Extended-Release Formulations
Development and Manufacturing
Research on developing extended-release (ER) matrix tablet formulations for metoprolol tartrate has shown that the choice of polymer and granulation process significantly affects drug release rates. Higher viscosity grades of hydroxypropyl methylcellulose (HPMC) resulted in slower drug release, and fluid-bed granulation was identified as the most satisfactory process for ensuring good flow and tableting performance5. These findings are crucial for regulatory policy development concerning the scale-up and post-approval changes for modified-release dosage forms5.
Conclusion
Both metoprolol succinate and metoprolol tartrate are effective in managing congestive heart failure, with similar hemodynamic benefits and adverse effects. Metoprolol succinate may offer advantages in heart rate reduction and structural stability, while metoprolol tartrate has shown improved bioavailability when administered via TDDS. The development of extended-release formulations for metoprolol tartrate highlights the importance of manufacturing processes in achieving consistent drug release profiles.
Sources and full results
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.
RCTASSA14-07-02 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
Rigorous JournalSimilar 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.
Comparative Bioavailability of Metoprolol Tartrate after Oral and Transdermal Administration in Healthy Male Volunteers
Transdermal drug delivery systems (TDDSs) provide 3-fold improved bioavailability compared to oral therapy, enabling 2-day hypertension management with a single patch, improving patient compliance.
RCTDevelopment of metoprolol tartrate extended-release matrix tablet formulations for regulatory policy consideration.
Metoprolol tartrate extended-release matrix tablet formulations using Methocel K100LV and fluid-bed granulation show satisfactory flow and tableting performance, with fluid-bed granulation being the most suitable process for regulatory policy development.
In Vitro Study
Highly CitedImpact of CYP2D6 polymorphisms on clinical efficacy & tolerability of metoprolol tartrate
CYP2D6 polymorphisms significantly affect heart rate response to metoprolol tartrate, but not blood pressure response or adverse effect rates.
Non-RCTRigorous JournalHighly CitedEvaluation of in vitro release rate and in vivo absorption characteristics of four metoprolol tartrate immediate-release tablet formulations.
Metoprolol tartrate tablets with level 2 type changes show bioequivalence, suggesting in vitro dissolution tests may show bioequivalence for class 1 drugs.
Modeling of the irradiation effect on some physicochemical properties of metoprolol tartrate for safe medical uses
Gamma-irradiation and ionizing radiation affect metoprolol tartrate's physicochemical properties, confirming optimized doses for sterilization and safe medical uses.
Rigorous JournalIdentification of Metoprolol Tartrate-Derived Reactive Metabolites Possibly Correlated with Its Cytotoxicity.
Metoprolol tartrate's cytotoxicity may be linked to its reactive metabolites, which may be produced during its metabolic activation and potentially contribute to liver injury.
In Vitro Study