What is Metoprolol Succinate ER: Uses, Warnings & Interactions

Medically reviewed by Kristi C. TorresPharm.D.
Licensed Pharmacist
Updated May 14, 2025  •  Published Dec 30, 2020
Datos Verificados

Metoprolol succinate is the long-acting form of metoprolol, a medicine commonly prescribed to treat high blood pressure and heart problems. The main difference is that metoprolol succinate only requires one dose per day versus several times a day for metoprolol tartrate. Metoprolol belongs to a class of medications called cardioselective beta blockers. These drugs work by reducing the amount of work the heart does, helping spare the heart and reduce blood pressure. Extended-release metoprolol is typically taken by mouth once per day, preferably at the same time every day.

Metoprolol Succinate ER overview

BRAND NAMES:

  • Toprol XL, Kapspargo Sprinkle

Generic Names:

  • Metoprolol succinate ER

Uses:

  • Treats high blood pressure, angina (chest pain), heart attacks, heart failure, and abnormal heart rhythms.

Therapeutic Classes:

  • Beta blocker, cardioselective beta blocker, antianginal, antiarrhythmic, antihypertensive

Forms:

  • Extended-release tablet, extended-release capsule

How it’s taken:

  • By mouth

What is Metoprolol Succinate ER used for?

Metoprolol succinate ER is FDA-approved to lower blood pressure in people with high blood pressure; decrease chest pain attacks, and increase exercise tolerance in people with angina. Metoprolol succinate is also used in the treatment of acute myocardial infarction (heart attack)and to reduce the risk of death or hospitalization in those with heart failure. Healthcare providers sometimes prescribe it off-label to treat heart rhythm problems (atrial fibrillation), prevent migraine headaches, or for other health problems.

Key takeaways

  • Metoprolol succinate ER is the extended-release formulation of metoprolol, a cardioselective beta receptor blocking medication.

  • Due to the extended release formulation, this form of metoprolol is typically only dosed once per day as compared to the immediate-release metoprolol formulation.

  • Metoprolol succinate ER should be taken with or right after a meal at approximately the same time every day. 

  • The appropriate dosage for an individual depends on their diagnosis. Metoprolol succinate ER is dosed individually for different conditions.

  • This medication has several potential drug interactions with other prescription medications, over the counter medications, or vitamins and herbal products. Make sure your health care team knows about all products you are taking.

What form(s) does Metoprolol Succinate ER come in

  • Extended-release tablet

    • 25 mg

    • 50 mg

    • 100 mg

    • 200 mg

  • Extended-release capsule

    • 25 mg

    • 50 mg

    • 100 mg

    • 200 mg

What are common Metoprolol Succinate ER doses?

  • For hypertension:

    • In adults: 25–100 mg taken once per day

    • In children 6 years and older: 1–2 mg/kg taken once per day

  • For angina in adults: 100–400 mg taken once per day

  • For heart failure in adults: Doses will vary based on how well the patient can tolerate the drug—the maximum dose is 200 mg per day.

Common Metoprolol Succinate ER prescriptions

  • Metoprolol Succinate ER
    30 tablets extended release 24 hour bottle

  • Metoprolol Succinate ER
    100mg tablet extended release 24 hour

  • Metoprolol Succinate ER
    200mg tablet extended release 24 hour

  • Metoprolol Succinate ER
    25mg tablet extended release 24 hour

  • Metoprolol Succinate ER
    50mg tablet extended release 24 hour

How to take Metoprolol Succinate ER

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.

  • Take this medicine with a meal or right after a meal. Take this medicine the same way every day, at the same time every day.

  • How to take metoprolol succinate ER tablets:

    • Swallow the extended-release metoprolol oral tablets whole with a glass of water. Do not crush or chew the tablet.

    • The oral tablet is scored to allow it to be cut into two doses. If the doctor asks you to take half a tablet, ask for a demonstration on how to break the tablets correctly.

  • How to take metoprolol succinate ER capsules:

    • Swallow the extended-release capsule whole. 

    • Do not crush, break, or chew it. 

    • If you cannot swallow the extended-release capsule, open it and sprinkle the contents over a small amount (teaspoonful) of soft food such as applesauce, pudding, or yogurt. Swallow the mixture within 60 minutes. Do not store for later use.

    • If the capsule needs to be given through a nasogastric tube, mix the contents of the opened capsule with water into a syringe. Gently shake the mixture for about 10 seconds, then flush it through the tube. Rinse the tube with water until all of the medicine is washed out.

  • Store metoprolol succinate ER tablets or capsules at room temperature. 

What to do if you miss a dose of Metoprolol Succinate ER

  • Doses are taken once per day.

  • If a dose is missed, skip the missed dose if it is almost time for the next dose. Take the next dose when it’s scheduled.

  • Do not take extra medicine to make up for a missed dose.

Metoprolol Succinate ER contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to metoprolol or allergic reactions to any of its ingredients. Seek immediate medical attention if you develop a rash, hives, or swelling of the tongue or lips, as these can be signs of an allergic reaction.

  • This medicine should never be used by someone diagnosed with any of the following heart problems:

    • A very slow heart rate (severe bradycardia)

    • Symptomatic heart failure (decompensated heart failure)

    • Moderate or severe heart block

    • A heart rhythm problem called sick sinus syndrome (unless a permanent pacemaker is in place)

Metoprolol Succinate ER warnings

  • Tell any doctor, pharmacist, or other health care provider who treats you that you are using this medicine.

  • It is important to take this medication according to the prescribed dosage instructions provided by your doctor on the prescription label.

  • Your doctor may need to do lab tests regularly to check on the effects of this medicine and make sure the dose is correct. Keep all appointments.

  • Tell your doctor if you are pregnant or breastfeeding.

  • Tell your doctor if you have:

    • Heart disease or heart failure

    • Heart rhythm abnormalities

    • Slow heart rate

    • Problems with the blood vessels in the legs, arms, hands, and feet

    • Kidney disease

    • Liver disease

    • Lung diseases such as asthma, emphysema, or bronchitis

    • Diabetes

    • Thyroid problems

    • Adrenal gland cancer 

  • This medicine may worsen the symptoms of heart failure. Your prescriber may ask that you check your body weight regularly to catch early signs that it is worsening.

  • This medicine could lower your blood pressure too much, especially when you first use it or if you are dehydrated. Stand or sit up slowly if you feel lightheaded or dizzy.

  • Metoprolol may cause low blood sugar (hypoglycemia) in people who are not eating regular meals or vomiting.

  • Higher doses of metoprolol should be avoided right before major surgery.

  • This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine and its possible adverse effects affect you.

  • Medication is only one aspect of treating heart disease. Lifestyle changes, regular exercise, and a heart healthy diet play a crucial role in preventing heart disease and lowering your risk of heart conditions.

Metoprolol Succinate ER interactions

  • To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and dietary supplements you use before taking metoprolol.

  • Tell other healthcare providers you are using this medicine before they prescribe new medications. You should not take immediate-release metoprolol in combination with the long-acting form of metoprolol.

  • Some medicines can affect how metoprolol works or increase the risk or severity of side effects. Alternatively, metoprolol can affect how other medicines work. Tell your doctor if you are taking:

    • Heart rhythm medications, particularly digoxin, propafenone, and quinidine

    • Calcium channel blockers (a class of blood pressure treatment medications)

    • Other drugs that act upon beta receptors of the heart

    • Migraine treatments called ergot drugs

    • HIV/AIDS drugs

    • Drugs that treat depression, psychosis, or similar mental illnesses

    • MAO inhibitors (MAOIs)

    • The blood pressure drugs clonidine or reserpine

  • Do not drink alcohol if you are taking metoprolol extended-release capsules. This may cause the capsule to quickly release its contents, increasing the risk and severity of side effects.

Find more detailed information about metoprolol interactions to avoid here.

Metoprolol Succinate ER side effects

Serious side effects

Seek medical advice from your prescriber if you notice any signs or symptoms of a possible serious side effect including:

  • Slow heartbeat

  • Worsening chest pain

  • Swelling in your hands, ankles, or feet

  • Fluid retention that causes weight gain

  • Trouble breathing

  • Lightheadedness, dizziness, or fainting

  • Trouble breathing, shortness of breath, asthma-like symptoms

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing (Seek medical help immediately if these occur)

Less serious common side effects

  • Low blood pressure

  • Drowsiness

  • Dizziness

  • Fatigue

Find more detailed information about metoprolol side effects here.

Medically reviewed by Kristi C. TorresPharm.D.
Licensed Pharmacist

Kristi C. Torres, Pharm.D., is a 2005 graduate of The University of Texas at Austin. Her professional background includes academic teaching roles, district-level management for a nationwide pharmacy chain, and clinic-based pharmacy management. Dr. Torres has a wide range of experience in pharmacy operations and has traveled to many states to open and convert clinic-based pharmacies for one of the largest healthcare systems in the nation.

Currently, she works for Tarrytown Expocare Pharmacy in Austin, Texas, serving the intellectual and developmental disability community. There, she leads the order entry team, overseeing orders from across the country.

Dr. Torres began working in pharmacy at the age of 16 in a small East Texas town. She currently resides in Round Rock, Texas, with her daughter and a Shih-Tzu puppy.

...