Is a Toprol XL generic available?

In this article:

• Generic vs. brand-name Toprol XL
• Generic Toprol XL cost
• Is Toprol XL covered by insurance?
• How to get coverage
• Alternatives
• Expert takeaway

In this article

• Generic vs. brand-name Toprol XL
• Generic Toprol XL cost
• Is Toprol XL covered by insurance?
• How to get coverage
• Alternatives
• Expert takeaway

Nearly half of all U.S. adults have high blood pressure, according to the CDC, and only one out of every four has it under control. That makes controlling hypertension with drugs like Toprol XL extremely important. As a beta blocker, it treats not only hypertension, but also angina pectoris (chest pain) and chronic heart failure, making it a versatile option in every cardiologist’s arsenal. Cost-conscious patients may want to save money by using a generic version, and fortunately, they have that option. 

What are the differences between generic and brand-name Toprol XL?

Both drugs contain the same active ingredient (metoprolol) in the same strengths, dosage options, and routes of administration. Those are the FDA requirements for approving any generic drug.

“For blood pressure control, I use metoprolol and Toprol XL interchangeably, since both are the same drug. Duration of effect is not a factor, so the best choice is generally the cheapest,” says Dr. Morton Tavel, MD, FACC, clinical professor emeritus (cardiology) at the Indiana University School of Medicine. That means “the generic is generally the best choice.”

The biggest difference is that Toprol XL is an extended-release version, while generic metoprolol is available in both extended-release and immediate-release versions. According to Dr. Padma Shenoy, MD, cardiologist with Manhattan Cardiology and contributor to LabFinder. “The main difference between the two medications is the polymer that facilitates the slow release of the drug.”

The extended-release version is called metoprolol succinate, a once-daily medication commonly prescribed for long-term treatment of hypertension, angina, and chronic heart failure, as it provides more consistent beta receptor blocking over time. Metoprolol tartrate, on the other hand, is typically taken multiple times a day, usually for conditions that require rapid adjustments in heart rate and blood pressure, such as a heart attack. Some recent research, however, has shown that succinate can also be a viable option in some cases of heart attack.

Other differences between brand-name and generic versions may include inactive ingredients like dyes and fillers. These typically don’t affect the body, but “in rare cases, individual patients may notice a change in blood pressure or heart rate if the generic manufacturer has changed the slow-release polymer in the medication,” Dr. Shenoy says. “These changes are extremely subtle, but the development of new symptoms may be a reason to transition to the brand-name Toprol XL.”

How much does generic Toprol XL cost?

Cost is the most significant difference between most brand-name and generic drugs—and Toprol XL is no different. The average price for generic metoprolol succinate is around $103 for 90, 25mg extended-release tablets, while the same amount of Toprol XL costs $161 on average.

If your healthcare provider prescribes metoprolol tartrate instead, it can be slightly more expensive. The generic version costs an average of $198 for 60, 25mg tablets, while the branded version (Lopressor) is often around $192.

Is Toprol XL covered by insurance?

Some insurance plans cover brand-name Toprol XL, but others may prefer that you get the generic version instead, since it’s usually less expensive. The only way to know for sure is to review your insurance plan’s formulary to see which medication is listed as preferred.

Medicare Part D plans are similar. Some may cover Toprol XL, while others might only cover metoprolol. For example, in 2023, Medicare Part D plans paid only around $6 million nationwide in name-brand Toprol XL coverage, even though each prescription costs more, but they paid out more than $587 million worth of generic metoprolol, according to the Centers for Medicare & Medicaid Services.

How do you get Toprol XL covered by insurance?

If you have an insurance plan that covers Toprol XL, using that coverage is as simple as presenting your insurance card at the pharmacy. But if your plan only covers generic metoprolol and you want the brand name instead, it could be more complicated.

In this case, you might need to ask your prescriber to complete a prior authorization form first. This is a process insurance companies use to decide whether a particular drug is medically necessary. This may require documentation of specific symptoms, confirmation of serious side effects caused by generic metoprolol, or drug interactions, or paperwork showing that you’ve tried other medications first (step therapy) and were intolerant of them or they did not work.

Additionally, if your insurance company denies coverage for Toprol XL even after a prior authorization, you can appeal that decision. The specifics of this process depend on the insurance company, so you’ll have to check with them to find out how to file.

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Generic alternatives to Toprol XL

Beta blockers are a well-established drug class, and there are several generic options for anyone who has heart problems or cardiovascular conditions and needs lower blood pressure. For example, Dr. Tavel says, “For better blood pressure control, I resorted to ACE receptor blockers such as candesartan.” Some of Toprol XL’s other common generic alternatives include:

• Other beta blockers: atenolol, carvedilol, nebivolol, nadolol, and propranolol.
• Angiotensin-converting enzyme (ACE) inhibitors: lisinopril or lotensin.
• Angiotensin II receptor blockers (ARBs): valsartan or losartan.
• Calcium channel blocking agents: amlodipine and diltiazem.
• Centrally acting alpha-agonist hypotensive agents: clonidine.

Beta blockers like metoprolol have many uses, including ones not specifically approved by the FDA. Some healthcare providers may prescribe metoprolol for anxiety, hyperthyroidism, irregular heartbeats, or migraine prevention. Because these conditions aren’t approved uses, some insurance plans might not cover metoprolol for them.

If you’re considering switching from Toprol XL or metoprolol to another drug, first get medical advice from a healthcare professional to see if the change is appropriate for your condition. If so, they will likely taper you off the drug, since sudden cessation of beta blocker use may cause withdrawal-like symptoms.

“The transition should be done under the supervision of a physician as stopping these medications can cause rebound hypertension and tachycardia,” Dr. Shenoy says. This tapering typically lasts one or more weeks, depending on your dose of metoprolol, condition, and side effects. After you’ve stopped taking metoprolol completely, you can begin your new medication.

Expert takeaway 

“Toprol XL and generic metoprolol succinate are therapeutically equivalent extended-release formulations of metoprolol. They share the same active ingredient, mechanism of action, available strengths, and dosing schedule,” says Leslie Greenberg, MD, associate professor of family and community medicine at the University of Nevada, Reno Family Medicine Residency Program. “Differences between the two medications are generally limited to inactive ingredients (like coatings, colorants, and fillers).”