Comparative Pharmacology
Head-to-head clinical analysis: COREG versus METOPROLOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COREG versus METOPROLOL.
COREG vs Metoprolol
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Carvedilol is a nonselective beta-blocker with alpha1-blocking activity. It competitively blocks beta1, beta2, and alpha1 adrenergic receptors, leading to decreased cardiac output, reduced sympathetic tone, and vasodilation. It also has antioxidant and anti-proliferative properties.
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.
Heart failure: Start 3.125 mg orally twice daily; titrate up to target 25 mg twice daily as tolerated. Hypertension: Start 6.25 mg orally twice daily; increase to max 50 mg twice daily. Post-MI LV dysfunction: Start 3.125-6.25 mg orally twice daily; titrate to target 25 mg twice 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 in most patients, but may be prolonged in severe hepatic impairment (up to 14-18 hours). The half-life is not significantly altered in renal impairment.
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 excretion of unchanged drug and metabolites accounts for approximately 16% of the dose; fecal excretion accounts for about 84% (mainly as metabolites). Less than 2% is excreted unchanged in urine.
Primarily hepatic metabolism (CYP2D6) producing inactive metabolites; renal excretion accounts for <5% unchanged. Fecal elimination minimal.
Category C
Category C
Beta-Blocker
Beta-Blocker