Metoprolol Succinate vs Tartrate: What’s the Difference?

If you suffer from heart conditions such as high blood pressure (hypertension), chest pain (angina), and heart failure, your doctor may prescribe for you metoprolol.

This active ingredient can be found in two popular medications with similar names – metoprolol succinate and metoprolol tartrate.

You are not alone if you are wondering what the difference is between metoprolol succinate and metoprolol tartrate. These similar medicines treat many similar conditions and can cause similar side effects.

The primary difference between the two medications is how they’re dosed, as well as some possible differences in which medical conditions each one is better for. 

In this article, I will review the main similarities and differences between the two medications, when they should be taken, what side effects they might cause, and when to see a doctor.

Metoprolol Succinate vs. Tartrate

To anyone not familiar with these medications, metoprolol succinate and metoprolol tartrate can appear almost identical.

They both share the same active ingredient, metoprolol, and both are in a class of drugs known as beta-blockers used primarily as blood pressure medicine.

However, they have two slightly different chemical forms, which primarily affect how long they last and, therefore, how often they need to be taken. Your doctor may prescribe beta-blockers to you to treat heart-related conditions.

Beta-blockers work by relaxing your blood vessels and slowing down your heart rate. The active ingredient, metoprolol, is FDA-approved to treat hypertension, angina, heart failure, myocardial infarction, and atrial fibrillation/flutter.

Its off-label uses include the treatment of conditions such as supraventricular tachycardia and thyroid storm. If you have high blood pressure, chest pain due to heart disease, or a heart attack, you may be given metoprolol.

And while both medications are used to treat these conditions, studies suggest that metoprolol tartrate may be more effective at preventing heart attacks, while metoprolol succinate may be better at treating chronic heart failure. 

Cost 

The final cost of the medications will largely depend on whether you have prescription coverage as part of your health insurance plan. If you do, you can expect to pay a lower cost than if it were an out-of-pocket expense. 

Both metoprolol tartrate and metoprolol succinate are available in generic drug form, which is cheaper than brand-name versions. Once you have received your prescription from your healthcare provider, you can pick the medicine up at your local pharmacy. 

Typically, metoprolol tartrate costs about half the price of metoprolol succinate. If you’re paying for the drug without assistance from your health insurance plan, you can expect metoprolol tartrate to cost you anywhere from $4 to $18 for a one-month supply.

Metoprolol succinate may cost you somewhere between $14 and $44 out of pocket for a one-month supply. 

Dosage 

Both metoprolol succinate and metoprolol tartrate come in tablet form by prescription only. Metoprolol succinate is the only one that comes in an extended-release form, meaning that you only take it once daily.

Metoprolol tartrate is only available as an immediate-release tablet and is therefore typically taken twice daily; it can be taken multiple times a day.

While both medications are taken by mouth, in pill form, at home, in some circumstances, and especially in an emergency, your doctor may administer metoprolol to you via an injection into an IV that’s attached to a vein in your arm.

This may be done to treat a heart attack or an arrhythmia and should only be performed in a monitored setting, like an emergency department. 

Drug Interactions  

To avoid negative drug interactions, be sure to review your medical history with your healthcare provider and inform them of any prescription medicines, OTC medicines, or supplements you are currently taking. 

The following medications may cause adverse effects with metoprolol tartrate or metoprolol succinate:

• Medications to treat blood pressure: Betanidine, hydralazine, guanethidine, alpha-methyldopa, and Reserpine (Serpasil)
• Medications to treat heart disease: Digoxin (Lanoxin), diltiazem (Cardizem CD, Cardizem LA), verapamil (Verelan, Verelan PM)
• Heart rhythm drugs: Quinidine and propafenone
• Blood thinners: Dipyridamole (Persantine)
• Monoamine oxidase inhibitors (MAOIs): These include selegiline (Atapril), phenelzine (Nardil), and tranylcypromine (Parnate).
• Antidepressant medications: Fluoxetine (Prozac, Prozac Weekly), Fluvoxamine (Luvox), paroxetine (Paxil, Pexeva), sertraline (Zoloft), bupropion (Wellbutrin SR, Zyban), clomipramine (Anafranil), and desipramine (Norpramin)
• Antipsychotics: These include chlorpromazine (Thorazine), haloperidol, and thioridazine.

Other medications:

• Clonidine (Kapvay), which is used for attention deficit hyperactivity disorder (ADHD)
• Antifungal drugs such as terbinafine (Lamisil)
• Antihistamine drugs such as diphenhydramine (Benadryl)
• Antiretroviral drugs such as ritonavir (Norvir)
• Antimalarial drugs such as hydroxychloroquine (Plaquenil) and quinidine
• Ergot alkaloids, which are used to treat migraines

It is advised that you also avoid alcohol when taking beta-blockers, since alcohol can put you at a higher risk of side effects.

It can interfere with your blood pressure causing it to spike or drop too low. This can disrupt the effectiveness of the medication and cause a serious adverse reaction.  

Side Effects  

Since both drugs contain the same active ingredient in different chemical forms, they tend to cause similar side effects.

Common side effects that can be experienced when taking either medication include:

• Depression
• Dizziness
• Diarrhea
• Rash
• Slower heart rate
• Tiredness

Potential serious side effects include:

• Difficulty breathing or shortness of breath
• Very slow heart rate
• Wheezing

The FDA advises that either drug can cause worse chest pain or a heart attack if the medicine is stopped suddenly.

This warning is issued on the medicine box. While the risk is higher in people with heart disease, you should not stop taking your medication without first consulting with your healthcare provider. More than likely, they will suggest slowly lowering your dosage over one to two weeks.

Consulting With a Medical Provider

When prescribed metoprolol tartrate or metoprolol succinate, always read the label and follow the medical advice given by your doctor or pharmacist. It is important to avoid stopping the medications suddenly.

Beta-blockers can bring on a host of potentially life-threatening side effects and conditions such as thyroid storm when stopped abruptly or mixed with other medications. Before taking the medication, you should carefully review your medical history with your doctor.

Discuss the following medical conditions before taking metoprolol tartrate or metoprolol succinate:

• Allergies to metoprolol or other beta-blockers
• Lung or breathing problems
• Diabetes and low blood sugar levels
• Adrenal gland tumor
• Thyroid disease
• Liver disease
• Heart problems such as decreased heart rate, irregular heart rhythm, cardiogenic shock, and worsening heart failure
• Severe peripheral artery disease (PAD)

Inform your doctor if you have any upcoming surgeries scheduled before or during your medication. They will be able to determine the best course of treatment for you moving forward.

When to See a Medical Provider

Speak with a medical provider if you suffer from common side effects that don’t lessen over time. They can evaluate your dosage and determine if the medicine is right for you.

If you experience any of the following less common and more serious side effects, contact your healthcare provider immediately but continue to take your medication as prescribed:

• Difficulty breathing or shortness of breath
• Very slow heart rate
• Wheezing

How K Health Can Help

K Health offers affordable and convenient access to highly qualified doctors to treat and manage high blood pressure, as long as you are not having a hypertensive crisis.

You can meet with your K Health doctor from the comfort of your own home via the K Health app, all while knowing that you’re getting individualized and expert care.