Comparative Pharmacology
Head-to-head clinical analysis: COREG CR versus METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COREG CR versus METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE.
COREG CR vs METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE
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.
Metoprolol is a cardioselective beta-1 adrenergic receptor antagonist that reduces heart rate, myocardial contractility, and blood pressure. Hydrochlorothiazide is a thiazide diuretic that inhibits the sodium-chloride symporter in the distal convoluted tubule, increasing excretion of sodium and water, thereby reducing plasma volume and blood pressure.
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.
Oral: 50-100 mg metoprolol tartrate/12.5-25 mg hydrochlorothiazide once or twice daily; maximum 200 mg metoprolol/50 mg hydrochlorothiazide per day.
None Documented
None Documented
Terminal elimination half-life is 7-10 hours; due to controlled-release formulation, effective half-life is prolonged to support once-daily dosing
Metoprolol: 3–7 h (terminal), clinical context: may require twice-daily dosing; prolonged in hepatic impairment. Hydrochlorothiazide: 6–15 h (terminal), clinical context: supports once-daily dosing; prolonged in renal impairment.
Renal (16% unchanged, 60% as glucuronide conjugates), biliary/fecal (20%)
Metoprolol: <5% renal (unchanged), >95% hepatic metabolism, metabolites excreted renally. Hydrochlorothiazide: >95% renal (unchanged).
Category C
Category C
Beta-Blocker
Beta-Blocker