How Long Does Metoprolol Stay in Your System?

A pharmacist weighs in on how long this beta-blocker lasts

Medically reviewed by Lindsay Cook, PharmD

Metoprolol is a generic prescription medication approved by the Food and Drug Administration (FDA) to treat the following:

• High blood pressure (hypertension)

• Other cardiovascular conditions

Metoprolol belongs to a drug class known as beta-blockers. Brand-name versions of metoprolol include the following:

• Lopressor

• Toprol XL

• Kaspargo Sprinkle
  

This article will cover metoprolol's potential side effects and ways to take it safely.

How Long Does Metoprolol Stay In Your System?

There are two types of metoprolol: metoprolol tartrate and metoprolol succinate.

The main difference between the two medications is how long they stay in your system.

Metoprolol has a half-life (when half of the drug is eliminated from the body) of three to seven hours.

Lopressor (metoprolol tartrate), an immediate-release product, disperses quickly throughout the body after administration. The body removes 50% of the full dose of metoprolol tartrate over three to seven hours.

However, the extended-release versions of metoprolol succinate (brand names Toprol XL and Kaspargo Sprinkle) release a steady amount of the medications over 24 hours.

Due to how long they last in the body, metoprolol tartrate and metoprolol succinate typically have different dosing schedules, as follows:

• Metoprolol tartrate requires two doses per day.

• Metoprolol succinate only requires one dose due to longer drug exposure.

How Quickly Will Metoprolol Work?

Typically, metoprolol begins working soon after you take the medication, regardless of the form.

• However, most healthcare providers will start you on a low dose of the medication and then gradually increase it either toward a target dose or to reach a blood pressure goal over several weeks' time.

For this reason, it may take a few weeks to receive the full effects of metoprolol.

Exactly how long metoprolol's effects last depends on the form you take.

Metoprolol succinate works for around 24 hours, while metoprolol tartrate works for around 12 hours.

What Is Metoprolol?

The FDA approved metoprolol, a beta-blocker, for the following:

1. Lowering blood pressure in those with hypertension

2. Addressing chest pain (angina pectoris)

3. Decreasing heart-related hospitalization and death in heart failure (metoprolol succinate only)

4. Treating and preventing heart attacks (metoprolol tartrate only)

Healthcare providers may prescribe metoprolol off-label (for reasons other than those approved by the FDA) for conditions such as:

• Migraine prevention

• Supraventricular tachycardia (abnormal heart rhythm)

FDA approval for metoprolol tartrate is limited to adults. However, metoprolol succinate is approved for adults and children age 6 and older with high blood pressure.

Available in three brand names—Lopressor, Toprol XL, and Kaspargo Sprinkle—metoprolol comes in tablet and capsule forms, the latter of which can be opened and sprinkled over soft foods for people who have trouble swallowing.

Additionally, metoprolol tartrate is a key component in Lopressor HCT, a combination drug for high blood pressure that includes hydrochlorothiazide, though this article concentrates on its oral forms.

How Does Metoprolol Work?

Metoprolol is a selective beta-1 receptor blocker. Meaning it works primarily in the heart. Metoprolol has little impact on other beta receptors located in other parts of your body.

Metoprolol tartrate and metoprolol succinate work the same way in that they are both selective for mainly blocking the beta-1 receptor.

Other beta-blockers, like Coreg (carvedilol) and Inderal (propranolol), block beta receptors throughout your body.

Metoprolol binds to beta-1 receptors in the heart, blocking adrenaline from activating the receptors. This results in the following:

• Reduced heart rate

• Decreased blood pressure

• Less stress on the heart
  

Types of Metoprolol

Metoprolol is available in two types: tartrate and succinate. The FDA approved both types for the following:

• High blood pressure

• Chest pain

The FDA also approved:

• Metoprolol tartrate for managing heart attacks

• Metoprolol succinate for treating heart failure

The two types differ in how long they work:

• Metoprolol tartrate is immediate-release and lasts about half a day.

• Metoprolol succinate is extended-release and works for 24 hours.

They also vary in how frequently they're taken:

• Metoprolol tartrate is taken twice daily.

• Metoprolol succinate is typically taken once daily.

Dosing Guidelines

The recommended dosage for metoprolol varies depending on the following:

• The specific condition being treated

• Condition severity

• Form of metoprolol (immediate- vs. extended-release) prescribed

• Age of the individual

The table below is not meant to be a complete dosage guide for metoprolol.

However, it shows the typical starting and maintenance dosage of metoprolol tartrate for adults (18 years and older) with hypertension or angina.

The FDA has approved the following dosages of metoprolol succinate (Toprol XL and Kaspargo Sprinkle) in adults:

Metoprolol is not approved for children less than 6. For children ages 6 to 17 years old with high blood pressure, the FDA approves metoprolol succinate at the following doses based on body weight in kilograms (kg):

Your healthcare provider may prescribe metoprolol for different uses or dosages shown here.

Consult your healthcare provider for personalized dosage recommendations.

Safe Consumption Guidelines

Metoprolol should be taken with food as directed by your prescribing healthcare provider.

In case of a missed dose, avoid doubling up. Instead, skip the missed dose and continue with your regular dosing schedule.

While metoprolol tartrate tablets can be crushed and both tablets can be split, metoprolol succinate tablets should not be crushed.

Healthcare providers often prescribe metoprolol for the long term, as it remains safe and effective. Some individuals may require lifelong use.

Interactions

Other medications may interact with metoprolol, resulting in the following:

• Reduced effectiveness

• Potentially dangerous side effects

Discussing everything you take with your healthcare provider and pharmacist is essential.

Some examples of medications that interact with metoprolol include the following:

• Monoamine oxidase inhibitors (MAOIs), such as Marplan (isocarboxazid) and Emsam (selegiline): When taken with a beta-blocker like metoprolol, MAOIs may result in severe side effects such as vertigo, fainting, or severely low blood pressure.

• Certain medications that block the breakdown of metoprolol: Medications like Paxil (paroxetine) and Cardioquin (quinidine) can slow the body’s drug clearance, increasing the amount of metoprolol.

• Other medications that affect the heart rate: A few examples are Lanoxin (digoxin) and Calan (verapamil). In combination with metoprolol, these medications may result in dangerously low heart rates.

• Nasal decongestants like Sudafed (pseudoephedrine): Sudafed can increase blood pressure and make metoprolol less effective.
  

Side Effects and Precautions

Most people tolerate metoprolol well, but some of the more common but mild side effects may include:

• Tiredness

• Shortness of breath

• Low heart rate

• Low blood pressure

• Diarrhea

• Itching or rash

In some cases, metoprolol results in more severe side effects. These include:

• Worsening heart failure

• Hypoglycemia (low blood sugar)

• Dangerously low heart rate

• Worsening symptoms of vascular disease caused by reduced circulation
  

What Is High Blood Pressure?

High blood pressure is one of the most common conditions in the United States.

According to the Centers for Disease Control and Prevention (CDC), nearly half of all adults in the United States have high blood pressure.

High blood pressure increases the risk of:

• Heart disease

• Stroke

This highlights the importance of keeping blood pressure under control with a healthy lifestyle and the use of blood pressure medications.

Understanding Beta-Blockers

Beta-blockers such as metoprolol are an older class of medications that were once the first choice for conditions like the following:

• High blood pressure

• Certain types of heart arrhythmia

• Angina

• Reducing heart attack risk

• Heart failure

• Migraines
  

However, they are now typically prescribed as a second-line treatment due to better alternatives like the following:

• Thiazide diuretics

• Calcium channel blockers

• ACE inhibitors

• Angiotensin-receptor blockers (ARBs)

Beta-blockers work by blocking adrenaline effects on beta receptors:

• Some types work on beta-1 receptors for high blood pressure.

• Nonselective types work on both beta-1 and beta-2 receptors for anxiety and migraine prevention.

In addition to metoprolol, commonly prescribed beta-blockers include the following:

• Coreg (carvedilol)

• Inderal (propranolol)

• Normodyne (labetalol)

• Tenormin (atenolol)

• Zebeta (bisoprolol)

Alternative Treatment Options

Nondrug options for lowering high blood pressure include eliminating common risk factors.

The most common risk factors for high blood pressure include:

• Obesity

• High sodium diet

• Sedentary lifestyle

• Unchecked stress

• Smoking

Accordingly, the American Heart Association recommends the following as important lifestyle changes for lowering high blood pressure:

• Low-sodium diets

• Increasing exercise

Implementing these recommendations also promotes healthy weight loss, which further helps reduce the risk of high blood pressure and its complications.

Summary

Metoprolol has two types: metoprolol tartrate (immediate-release) and metoprolol succinate (extended-release).

The effects of metoprolol tartrate last for about 12 hours. On the other hand, metoprolol succinate lasts an entire 24-hour period.

In addition to treating hypertension, healthcare professionals prescribe metoprolol to treat the following:

• Chest pain

• Heart failure

• Preventing heart attacks

High blood pressure is associated with a number of risk factors:

• Age

• Smoking

• Obesity

• High sodium intake

In most cases, hypertension is not life-threatening. However, it can contribute to an increased risk of heart disease and stroke.

Beta-blockers like metoprolol represent one type of medication used to treat high blood pressure. This drug class generally works by blocking the effects of adrenaline on the heart.

Frequently Asked Questions

How can I safely store metoprolol?

Metoprolol should be stored at room temperature. Keep metoprolol secure and out of the sight and reach of pets and children.

Are there any studies that reviewed the efficacy of metoprolol? What were the results?

Many studies have investigated the effectiveness of metoprolol for high blood pressure. In one study, researchers found that metoprolol significantly reduced the risk of cardiac events such as heart attack and stroke when used to lower blood pressure. However, studies have shown the most benefit of beta-blocker use, including metoprolol, in individuals with both high blood pressure and heart failure.

Read the original article on Verywell Health.