Metoprolol succinate and tartrate
Pro Research Analysisby 
Searched over 200M research papers
Comparison of Metoprolol Succinate and Metoprolol Tartrate
Introduction to Metoprolol Variants
Metoprolol is a beta-blocker commonly used to treat various cardiovascular conditions, including hypertension, heart failure, and angina. It is available in two primary forms: metoprolol tartrate (MT) and metoprolol succinate (MS). While both forms are effective, they differ in their 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 MT or MS showed significant improvements in functional, exercise, and hemodynamic parameters over three months . Both forms resulted in a decrease in cardiac index and stroke volume index, with no significant difference between the two .
Heart Rate Reduction in Chronic Heart Failure
Metoprolol succinate has been found to be more effective in reducing heart rate in patients with chronic congestive heart failure compared to metoprolol tartrate. In a study involving 182 patients, those treated with MS had a significantly lower average heart rate compared to those treated with MT (64.0 ± 5.4 vs. 69.5 ± 7.6, p < 0.05) Feng-Qi2014Quan-Y2013. However, both forms showed no significant difference in their effects on left ventricular end-diastolic diameter (LVDd), ejection fraction (EF), blood urea nitrogen (BUN), and creatinine (Crea) levels Feng-Qi2014Quan-Y2013.
Efficacy in COPD with Heart Failure
In patients with chronic obstructive pulmonary disease (COPD) complicating chronic heart failure, metoprolol succinate was found to be more effective in improving cardiac function compared to metoprolol tartrate. A study with 88 patients showed that the total effective rate of cardiac function improvement was significantly higher in the MS group compared to the MT group . Both forms, however, had similar safety profiles and no significant difference in lung function improvement .
Pharmacokinetic Properties and Administration
Metoprolol succinate is designed as a controlled-release/extended-release formulation, providing relatively constant plasma concentrations and beta-1 blockade with the convenience of once-daily administration . This formulation disintegrates into individual pellets that release the drug at a constant rate over approximately 20 hours, making it equivalent in activity to metoprolol tartrate .
Clinical Outcomes in Acute Myocardial Infarction
In patients with acute myocardial infarction, both metoprolol succinate and metoprolol tartrate effectively reduced heart rates. However, there was no significant difference in the degree and trend of heart rate reduction between the two groups over the first 72 hours of treatment .
Comparative Effectiveness in Vasospastic Angina
In a study comparing the clinical and economic efficiency of MT and MS in patients with vasospastic angina, MS was found to be more effective in reducing the incidence of clinically significant angina attacks . However, there were no significant differences in the rates of cardiovascular mortality, myocardial infarction, or stroke between the two groups .
Conclusion
Both metoprolol tartrate and metoprolol succinate are effective in treating various cardiovascular conditions, with some differences in their pharmacokinetic properties and specific clinical outcomes. Metoprolol succinate offers the advantage of once-daily dosing and may be more effective in reducing heart rate and angina attacks in certain patient populations. However, both forms have similar safety profiles and overall efficacy in improving cardiac function.
Sources and full results
Most relevant research papers on this topic