Metoprolol succinate dosing frequency

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Metoprolol Succinate Extended-Release Dosing Frequency

Once-Daily Dosing for Metoprolol Succinate Extended-Release

Metoprolol succinate extended-release is specifically designed for once-daily dosing. This formulation releases the drug at a near-constant rate over approximately 20 to 24 hours, providing stable plasma concentrations and consistent β1-blockade throughout the day 1589. The extended-release design helps avoid the peaks and troughs in drug levels that are seen with immediate-release formulations, making once-daily administration effective for maintaining therapeutic effects 1589.

Recommended Dosage and Titration

For hypertension, the usual starting dose is 25 to 100 mg once daily, with the possibility of increasing the dose at weekly or longer intervals to achieve optimal blood pressure control. Doses above 400 mg per day have not been studied 34. For angina pectoris, the initial recommended dose is 100 mg once daily, with gradual increases as needed, but not exceeding 400 mg per day 34. In heart failure, the starting dose is typically 12.5 mg or 25 mg once daily, which can be doubled every two weeks up to a maximum of 200 mg or the highest tolerated dose 34.

Clinical Efficacy and Comparison to Immediate-Release Formulations

Studies show that once-daily metoprolol succinate extended-release provides similar or better 24-hour blood pressure and heart rate control compared to immediate-release metoprolol tartrate given twice daily 12568. The extended-release formulation maintains a more even effect throughout the day, which is especially important for conditions like hypertension and heart failure 12568. In addition, switching from immediate-release to extended-release metoprolol can be done using the same total daily dose, simplifying the transition for patients 34.

Formulation Benefits and Patient Convenience

The controlled-release technology in metoprolol succinate extended-release pellets or tablets ensures that the drug is released steadily, independent of food intake or gastrointestinal pH, further supporting the effectiveness of once-daily dosing 579. This reduces the need for multiple daily doses and improves patient adherence to therapy 579.

Dose Ranges and Tolerability

Metoprolol succinate extended-release is effective and well-tolerated in dose ranges from 12.5 mg to 200 mg once daily, with higher doses providing greater heart rate control when needed 510. Both lower and higher doses have been shown to be safe and effective, with minimal discontinuation due to side effects .

Conclusion

Metoprolol succinate extended-release is intended for once-daily dosing, offering stable drug levels and consistent therapeutic effects for hypertension, angina, and heart failure. The extended-release formulation improves patient convenience and adherence by reducing dosing frequency, while maintaining efficacy and safety across a wide range of doses 12345678+2 MORE.

Sources and full results

Most relevant research papers on this topic

Pharmacokinetic and pharmacodynamic properties of a new controlled-release formulation of metoprolol: A comparison with conventional tablets

The new controlled-release metoprolol formulation maintains a constant degree of -blockade without plasma peaks and troughs, offering potential benefits over conventional tablets.

Non-RCTHighly Cited

2004·

106citations

·A. Sandberg et al.

Comparative Efficacy of Two Different β‐Blockers on 24‐Hour Blood Pressure Control

Metoprolol succinate is more effective in sustaining 24-hour and early morning blood pressure reductions compared to atenolol in hypertensive patients treated with once-daily low-dose hydrochlorothiazide.

RCT

2008·

22citations

·P. Sarafidis et al.

These highlights do not include all the information needed to use METOPROLOL SUCCINATE EXTENDED-RELEASE TABLETS safely and effectively. See full prescribing information for METOPROLOL SUCCINATE EXTENDED-RELEASE TABLETS METOPROLOL SUCCINATE extended-release TABLETS for oral use.Initial U.S. Approval:

METOPROLOL SUCINATE extended-release tablets should be individualized for heart failure, hypertension, and angina pectoris, with initial doses of 25 to 100 mg once daily.

2019·

0citations

FULL PRESCRIBING INFORMATION: CONTENTS* WARNING: ISCHEMIC HEART DISEASE: 1 INDICATIONS AND USAGE 1.1 Hypertension 1.2 Angina Pectoris 1.3 Heart Failure 2 DOSAGE AND ADMINISTRATION 2.1 Hypertension 2.2 Angina

Metoprolol succinate is an individualized oral medication for treating hypertension, angina pectoris, and heart failure, with recommended starting doses of 12.5 mg or 25 mg and gradually increasing to up to 200 mg.

2018·

0citations

Achieving optimal beta1-blockade with metoprolol CR/Zok

Metoprolol CR/Zok provides even beta1-blockade over 24 hours, is well-tolerated, and improves well-being in chronic heart failure patients.

2000·

14citations

·J. Wikstrand

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.

RCT

2000·

48citations

·M. Kukin et al.

Formulation and In vitro Evaluation of Metoprolol Succinate Extended Release Pellets

The resulting formulation F6 (water soluble core and EC 10 cps + HPMC+ Di ethyl phthalate) can reduce Metoprolol succinate dosing frequency to once daily, improving bioavailability and reducing dosage frequency.

In Vitro Study

2013·

4citations

·.. Ch.Kalyani et al.

Pharmacokinetic Considerations of Formulation: Extended-Release Metoprolol Succinate in the Treatment of Heart Failure

Extended-release metoprolol succinate provides consistent and even -blockade over 24 hours, with good tolerability in heart failure patients.

2003·

38citations

·J. Wikstrand et al.

Design of a new multiple-unit controlled-release formulation of metoprolol — Metoprolol CR

The new controlled-release formulation of metoprolol CR provides continuous, smooth, and independent drug delivery throughout the day, independent of pH and physiological variables.

2004·

68citations

·A. Sandberg et al.

Effect of Metoprolol Succinate in Patients with Stable Angina and Elevated Heart Rate Receiving Low-Dose β-Blocker Therapy

The metoprolol succinate dose of 190 mg is superior to the 95 mg dose in terms of heart rate control in Chinese patients with stable angina, low-dose -blocker use, and unsatisfactory heart rate control, both well tolerated.

RCTRigorous Journal

2017·

2citations

·Jie Jiang et al.

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