MetoprololMetoprolol Succinate/Tartrate

About Metoprolol

Metoprolol blocks beta-1 receptors, mainly in the heart, slowing the heart rate and lowering blood pressure. Metoprolol tartrate is labeled for high blood pressure in adults, angina, and lowering the risk of cardiovascular death in stable people with a definite or suspected heart attack; for blood pressure or angina it usually starts at 100 mg a day, and after a heart attack it is usually continued at 100 mg twice a day for at least three months. Metoprolol succinate is labeled for high blood pressure (with dosing from age 6), angina, and heart failure, where it lowers the risk of cardiovascular death and hospital admission for heart failure. Adults with high blood pressure usually start at 25 to 100 mg once a day; heart failure starts at 25 mg, or 12.5 mg when it is more severe, and the dose is doubled every two weeks as tolerated, up to 200 mg.

The current Lopressor, Toprol-XL and Kapspargo labels have no boxed warning, but their first warning is about stopping: angina has worsened, and some people have had a heart attack, after beta blockers were stopped abruptly, so metoprolol is tapered over one to two weeks, even when taken only for blood pressure. It must not be taken with a severely slow heartbeat, second- or third-degree heart block, cardiogenic shock, decompensated heart failure, or sick sinus syndrome without a permanent pacemaker, and the tartrate labels add a systolic blood pressure below 100. Heart failure can worsen while the dose is raised, people with bronchospastic lung disease generally should not take beta blockers, and it can hide the signs of low blood sugar and make it more severe or prolonged, especially in diabetes, in children, and during fasting or vomiting. Tiredness, dizziness, depression, shortness of breath, a slow heartbeat, diarrhea, itching and rash are among the most common side effects.

The two salts are not rated equivalent, so a prescription for one cannot be filled with the other; when a prescriber switches someone from immediate-release metoprolol to succinate, the label uses the same total daily dose, once a day. Succinate tablets are scored and can be divided but not crushed or chewed, and Kapspargo capsules can be opened onto soft food or given through a nasogastric tube. Lopressor oral solution, with the same uses as the tablets, and a Lopressor 12.5 mg tablet labeled only for heart attacks were approved in 2025. Newborns whose mothers took metoprolol may have low blood pressure, low blood sugar, a slow heartbeat or slowed breathing, and metoprolol is present in breast milk.

Taking Metoprolol

How to take it

Tartrate with or right after meals, measuring the solution only with the syringe and adapter that come with it. Succinate once a day, preferably with or right after a meal; Kapspargo capsules are swallowed whole or opened onto applesauce, pudding or yogurt that is eaten within 60 minutes.

If you miss a dose

Skip the missed dose and take the next one at the usual time. Do not take a double dose.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture (not in a bathroom) and out of reach of children; use the oral solution within 30 days of opening.

Interactions to know about

Quinidine, fluoxetine, paroxetine and propafenone can double metoprolol levels. Digoxin, clonidine, diltiazem and verapamil add to slowing of the heart (if clonidine is being stopped, metoprolol is stopped several days before), and alcohol is avoided with Kapspargo capsules.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Metoprolol differs from pharmacy to pharmacy

Generic tartrate and succinate tablets each have many makers, but each pharmacy sets its own cash price, including its dispensing fee, so quotes for the same tablet can differ. A prescription that names Lopressor or Toprol-XL and blocks substitution is priced as a brand, as are Kapspargo Sprinkle, the oral solution and the 12.5 mg tablet, which have no generic.

Ways to pay less for Metoprolol without insurance

• Ask for generic substitution, make sure the prescription does not block it, and check that the label shows the salt prescribed.
• Ask whether your metoprolol is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once your dose is stable, ask for a ninety-day supply, and refill early enough never to run out.
• If Kapspargo Sprinkle or the oral solution is prescribed for someone who can swallow tablets, ask the prescriber whether generic tablets would suit.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Metoprolol

1. 1.Is my prescription for tartrate or succinate, and is that what is in my bottle?
2. 2.Can my tablet be split, and should I take it with meals?
3. 3.What pulse rate or symptoms mean I should call my prescriber?
4. 4.Do my antidepressant, heart rhythm medicine or clonidine interact with it?

Related medications