Metoprolol-succinate-ER Patient Tips
Medically reviewed on Nov 14, 2017 by C. Fookes, BPharm.
How it works
- Metoprolol succinate is a heart medication works by blocking the effects of epinephrine on beta-1 receptors within the heart tissue, causing the heart to pump more slowly and with less force. At high doses, metoprolol succinate also blocks beta-2 receptors within the lungs and breathing tubes (which may affect breathing).
- Metoprolol is available as two different salts: metoprolol tartrate and metoprolol succinate. These two salts are not interchangeable because they have different dosages, durations of action, and indications for use.
- Metoprolol succinate belongs to the class of drugs known as beta-blockers.
- Lowers blood pressure and relieves symptoms of angina in people with heart disease.
- Available as an extended-release (ER) tablet which is usually dosed once a day. Slow-release forms may be beneficial in people with certain types of heart failure.
- Classified as a "selective" beta-blocker meaning it is less likely than nonselective beta-blockers to affect breathing and insulin response.
- Generic metoprolol tartrate is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Heart rate slowing, depression, diarrhea, skin rash and shortness of breath. Side effects are similar for both metoprolol tartrate and metoprolol succinate because they both contain the same active drug, metoprolol.
- Dry eyes; blurred vision; dizziness, particularly when rising from a sitting to standing position; fatigue; nightmares, slow heartbeat, and sweating are common.
- Less common side effects include facial and limb swelling, headache, visual disturbances, and tingling of the hands or feet.
- Avoid abrupt discontinuation; stopping metoprolol (both tartrate and succinate) suddenly can exacerbate angina and may increase the risk of a heart attack. Reduce dosage gradually over a few weeks as instructed by your doctor.
- May interfere slightly with laboratory cholesterol results.
- 8% of the Caucasian population and approximately 2% of other populations have a reduced ability to metabolize metoprolol; dosage may need reducing.
- May not be suitable for some people including those with heart block greater than 1st degree, pheochromocytoma, poor circulation, sick sinus syndrome, a thyroid disorder, overt or decompensated heart failure, or under the age of 18.
- Should be used with caution in people with pre-existing respiratory disease.
- Should not be used to prevent heart attacks.
- May decrease symptoms of hypoglycemia (such as fast heart rate, palpitations, tremor, feelings of anxiety) and potentiate the hypoglycemic effects of insulin.
- May also mask signs of hyperthyroidism (such as fast heart rate). May precipitate a thyroid storm if abruptly stopped.
- May interact with some other medications including antidepressants, antipsychotics, ergot alkaloids, or some other blood pressure medications.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- Take tablets at the same time each day.
- Can be taken once daily.
- Metoprolol succinate tablets can be taken with or without food.
- Extended-release tablets may be scored or divided; however, do not crush or chew, swallow whole.
- Report any shortness of breath or facial swelling immediately to your doctor.
- Also, talk to your doctor if you develop a very slow heartbeat or cold feeling in your hands or feet.
- If you are diabetic, talk to your doctor about the possibility that metoprolol may reduce symptoms of hypoglycemia.
- Talk to you doctor if you are having any side effects that are interfering with your quality of life. Do not stop taking metoprolol suddenly.
- Do not substitute metoprolol succinate with metoprolol tartrate.
- Always check that your prescription is correct. There have been a number of dosing errors involving metoprolol tablets.
- Your doctor will need to regularly monitor your blood pressure and possibly other markers. Keep your appointments.
- Metoprolol may impair your thinking or reaction time and affect your ability to drive. Drinking alcohol may enhance these effects. Do not drive if you think your driving ability is being compromised by metoprolol.
Response and Effectiveness
- With oral metoprolol succinate extended-release (ER) tablets, peak concentrations are reached in about seven hours following a single dose. With regular dosing; however, concentrations of metoprolol remain steady and do not fluctuate much. Usually dosed once daily.
- The blood pressure lowering effects of metoprolol succinate ER tablets persist for about 24 hours following a single dose.
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- Drug class: cardioselective beta blockers
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- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metoprolol-succinate-ER only for the indication prescribed.
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