Comparative Pharmacology
Head-to-head clinical analysis: COREG CR versus METOPROLOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COREG CR versus METOPROLOL.
COREG CR vs Metoprolol
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nonselective beta-1, beta-2, and alpha-1 adrenergic receptor antagonist; no intrinsic sympathomimetic activity; reduces myocardial oxygen demand, decreases peripheral vascular resistance, and suppresses renin-angiotensin-aldosterone system.
Selective beta-1 adrenergic receptor antagonist; competitively blocks beta-1 receptors in the heart, decreasing heart rate, contractility, and cardiac output; reduces renin release from kidneys.
Initial dose 20 mg orally once daily for patients with heart failure; may increase at 2-week intervals to a target dose of 80 mg once daily.
Metoprolol tartrate: Initial 50 mg PO BID or 100 mg PO daily; maintenance 100-450 mg/day in divided doses. Metoprolol succinate (extended-release): Initial 25-100 mg PO once daily; maintenance 100-400 mg once daily.
None Documented
None Documented
Clinical Note
moderateMetoprolol + Digoxin
"Metoprolol may increase the bradycardic activities of Digoxin."
Clinical Note
moderateMetoprolol + Digitoxin
"Metoprolol may increase the bradycardic activities of Digitoxin."
Clinical Note
moderateMetoprolol + Deslanoside
"Metoprolol may increase the bradycardic activities of Deslanoside."
Clinical Note
moderateMetoprolol + Acetyldigitoxin
"Metoprolol may increase the bradycardic activities of Acetyldigitoxin."
Terminal elimination half-life is 7-10 hours; due to controlled-release formulation, effective half-life is prolonged to support once-daily dosing
3–7 hours for metoprolol; prolonged in poor CYP2D6 metabolizers (up to 8–16 hours). Clinical context: dosing interval typically twice daily (immediate-release) or once daily (extended-release).
Renal (16% unchanged, 60% as glucuronide conjugates), biliary/fecal (20%)
Primarily hepatic metabolism (CYP2D6) producing inactive metabolites; renal excretion accounts for <5% unchanged. Fecal elimination minimal.
Category C
Category C
Beta-Blocker
Beta-Blocker