Metoprolol tartrate vs. succinate: Differences and similarities

In this article:

• Key differences
• Conditions treated
• Which is more effective?
• Coverage and cost comparison
• Side effects
• Drug interactions
• Warnings

In this article

• Key differences
• Conditions treated
• Which is more effective?
• Coverage and cost comparison
• Side effects
• Drug interactions
• Warnings

People who have experienced a heart attack or live with high blood pressure may be prescribed Lopressor (metoprolol tartrate) or Toprol XL (metoprolol succinate) by their healthcare provider. Both belong to a class of drugs known as beta blockers and work by blocking hormones like epinephrine that activate the body’s “fight-or-flight” response. Althoiugh they both help reduce stress on the heart and relax blood vessels to prevent heart complications, they differ in how they’re absorbed and how long they last in the body.

What are the main differences between metoprolol tartrate and succinate?

The main difference between metoprolol tartrate and metoprolol succinate is in their formulations. Metoprolol tartrate is the immediate-release version of metoprolol, while metoprolol succinate is the extended-release version. This means that metoprolol succinate is released over time in the body, leading to longer-acting effects. 

Metoprolol tartrate may need to be taken multiple times per day. Metoprolol succinate can be taken once daily since it lasts longer than the tartrate form. Metoprolol succinate can also be used in children ages 6 years and older, whereas metoprolol tartrate can only be used in adults. 

Compare key differences between metoprolol tartrate and succinate
Differences	Metoprolol tartrate	Metoprolol succinate
Drug class	Beta blocker	Beta blocker
Brand/generic status	Brand and generic version available	Brand and generic version available
What is the brand name?	Lopressor	Toprol XL
What form(s) does the drug come in?	Oral tablet	Oral tablet, extended-release
What is the standard dosage?	100 to 450 mg daily in 2 to 3 divided doses Dosage depends on the condition being treated	25 to 100 mg once daily Dosage depends on the condition being treated
How long is the typical treatment?	Short-term or long-term use as directed by a physician	Short-term or long-term use as directed by a physician
Who typically uses the medication?	Adults	Adults and children 6 years and older

 

Conditions treated by metoprolol tartrate and metoprolol succinate

The tartrate and succinate forms of metoprolol are FDA-approved to treat high blood pressure (hypertension) and chest pain (angina pectoris). 

Metoprolol tartrate is also approved as treatment right after a heart attack (acute myocardial infarction). Taking metoprolol tartrate after a heart attack may help reduce the risk of further cardiovascular events and death, especially in those with coronary artery disease. 

In addition to high blood pressure and chest pain, metoprolol succinate is also approved to treat heart failure. More specifically, metoprolol succinate treats chronic heart failure that is New York Heart Association class II or III. Taking it daily may help reduce hospital visits and decrease the risk of death in heart failure patients. 

Off-label uses for metoprolol include the treatment of abnormally fast heart rhythms (tachycardia) and thyroid storm (a dangerous condition caused by the overproduction of thyroid hormone). Metoprolol may also be used off-label to treat essential tremors and prevent migraines.

Compare metoprolol tartrate vs. succinate conditions treated
Condition	Metoprolol tartrate	Metoprolol succinate
High blood pressure	Yes	Yes
Chronic chest pain	Yes	Yes
Acute heart attack	Yes	No
Heart failure	No	Yes
Tachycardia	Off-label	Off-label
Thyroid storm	Off-label	Off-label
Essential tremors	Off-label	Off-label
Migraine prevention	Off-label	Off-label

 

Is metoprolol tartrate or metoprolol succinate more effective?

Metoprolol tartrate and metoprolol succinate are both similar in effectiveness for treating high blood pressure and chronic chest pain. However, the preferred option will depend on the condition being treated. For acute heart attacks, metoprolol tartrate is the preferred option. For chronic heart failure, metoprolol succinate is the approved option.

In a large international study known as the MERIT-HF trial, researchers found that metoprolol succinate greatly improved survival in people with heart failure. Patients taking it were less likely to be hospitalized for worsening symptoms than those taking a placebo. Another study compared several beta blockers and found that metoprolol succinate was more effective than metoprolol tartrate for chronic heart failure.

Because metoprolol tartrate is taken multiple times throughout the day, drug levels in the body may not be as consistent. This could result in more side effects than those with the extended-release formulation. One analysis found that a slow heartbeat (bradycardia) may be more likely to occur with immediate-release metoprolol tartrate. 

There are limited studies that directly compare metoprolol tartrate and metoprolol succinate. It’s important to consult a healthcare provider for the best treatment option.

Coverage and cost comparison of metoprolol tartrate vs. succinate

Metoprolol tartrate is a generic drug that is usually covered by Medicare and other insurance plans. Without insurance, the average cash price for generic metoprolol tartrate is around $197. SingleCare coupons for metoprolol tartrate can be used at participating pharmacies to reduce the cost of this drug to as low as $4. 

Metoprolol succinate is also a generic medication covered by most Medicare and insurance plans. Generic metoprolol succinate is more likely to be covered than brand-name Toprol XL. The average retail price for generic metoprolol succinate is around $107. A SingleCare coupon for metoprolol succinate could reduce that cost to around $9.

Compare metoprolol tartrate vs. succinate cost and coverage
Cost and coverage factors	Metoprolol tartrate	Metoprolol succinate
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare?	Yes	Yes
Quantity	60, 25 mg tablets	90, 25 mg tablets
SingleCare cost	$4 at Kroger	$9 at Kroger

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of Nov. 11, 2025. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.

Common side effects of metoprolol tartrate vs. metoprolol succinate

Metoprolol tartrate and metoprolol succinate can cause similar side effects. The most common side effects of metoprolol include:

• Fatigue or tiredness
• Dizziness
• Depression
• Bradycardia
• Shortness of breath (dyspnea)
• Low blood pressure (hypotension)
• Diarrhea
• Itching
• Rash

Serious side effects may include allergic reactions, worsening heart failure, and worsened symptoms of poor blood flow through the arteries (arterial insufficiency). It’s important to consult a healthcare provider if serious side effects develop.

Compare side effects of metoprolol tartrate vs. succinate
Side effect	Metoprolol tartrate frequency	Metoprolol succinate frequency
Fatigue	10%	>2%
Dizziness	10%	>2%
Rash	5%	>2%
Depression	5%	>2%
Diarrhea	5%	>2%
Shortness of breath	3%	>2%
Slow heartbeat	3%	>2%
Dry mouth	1%	N/A
Nausea	1%	N/A
Heartburn	1%	N/A
Constipation	1%	N/A
Fatigue	10%	>2%

This may not be a complete list. Consult your healthcare provider or pharmacist for possible side effects.

Source: DailyMed (metoprolol tartrate), DailyMed (metoprolol succinate) 

Drug interactions of metoprolol tartrate vs. metoprolol succinate

Metoprolol tartrate and metoprolol succinate can interact with many of the same medications. Because they contain the same active ingredient, their potential interactions are nearly identical. For example, many prescription drugs can increase metoprolol’s effects, potentially causing more side effects.

Taking catecholamine-depleting drugs like monoamine oxidase inhibitors with metoprolol may increase metoprol’s side effects. This drug interaction could increase the risk of low blood pressure and slow heartbeat, which could lead to dizziness and fainting. 

Metoprolol is broken down mainly by an enzyme called CYP2D6. Medications that block this enzyme, known as CYP2D6 inhibitors, can increase metoprolol levels in the body, potentially causing side effects such as fatigue, dizziness, and slow heart rate.

Lanoxin (digoxin) and certain drugs called calcium channel blockers may slow the heartbeat when used together with metoprolol. In addition, stopping Catapres (clonidine) suddenly while taking metoprolol can cause a sharp increase in blood pressure (rebound hypertension).

People taking metoprolol may also be less responsive to epinephrine (adrenaline) during an allergic reaction. Anyone with a history of severe allergies should let their healthcare provider know before starting metoprolol.

Compare metoprolol tartrate vs. succinate drug interactions
Drug	Drug class	Metoprolol tartrate	Metoprolol succinate
Azilect (rasagiline) Emsam (selegiline) Marplan (isocarboxazid)	Monoamine oxidase inhibitors	Yes	Yes
Prozac (fluoxetine) Paxil (paroxetine) Zoloft (sertraline) Zyban (bupropion) Lamisil (terbinafine) Plaquenil (hydroxychloroquine) Quinidex (quinidine) Rythmol (propafenone)	CYP2D6 inhibitor	Yes	Yes
Lanoxin (digoxin)	Cardiac glycoside	Yes	Yes
Cardizem (diltiazem) Calan (verapamil)	Calcium channel blocker	Yes	Yes
Catapres (clonidine)	Alpha-adrenergic agent	Yes	Yes

This may not be a complete list of all possible drug interactions. Consult a healthcare provider about all the medications you may be taking. 

Warnings of metoprolol tartrate and metoprolol succinate

Both metoprolol tartrate and metoprolol succinate should not be discontinued abruptly. If treatment with metoprolol is stopped abruptly, some people may experience a higher risk of heart attack, abnormal heart rhythm, and chest pain, especially those with existing heart conditions. 

Beta blockers like metoprolol should not be used in anyone with the following conditions:

• Severe bradycardia
• Heart block greater than first degree (without a pacemaker)
• Cardiogenic shock
• Decompensated heart failure
• Sick sinus syndrome without a pacemaker
• Hypersensitivity to any ingredients in these drugs

Metoprolol can sometimes worsen heart failure symptoms when the dose is being increased. It may also slow the heart rate too much, especially when taken with other heart medicines.

People with asthma or COPD should use metoprolol with caution, as it can sometimes worsen breathing problems. Those with diabetes should check their blood sugar regularly because beta blockers can hide symptoms of low blood sugar, like a fast heartbeat. In addition, metoprolol can mask signs of an overactive thyroid, such as a rapid heartbeat, and stopping it suddenly could trigger serious thyroid problems.

Tell a healthcare provider about all medical conditions and other medications you’re taking before starting metoprolol.