Is Metoprolol And Metoprolol Succinate Same?

Posted on Tue, 9 Feb 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 9 Feb 2016 Answered on

Wed, 30 Mar 2016 Last reviewed on

Question : Hi, I have been taking 25 mg of metoprolol er for about 8 years for a racing heartbeat that would wake me up at night. Recently I noticed I am getting metoprolol succinate er (which is apparently the same thing). Also I was diagnosed with obstructive sleep apnea and began use of a CPAP machine in April 2015. During the summer of 2015 and intermittently ever since, I find myself dizzy. I am not nauseous, just dizzy and weak, and feel like I can't really do anything. It passes fairly quickly. I have a wrist bp device - I tried using it when I get this dizzy feeling, and it consistently records 95/70. When I feel good it is usally 110 or 115/70. I tried not taking the Toprol after I had the CPAP machine (on the advice of a cardiac doctor), but I still did have racing heartbeat, so I now take it again. I guess this is a pretty long question - is succinate er different than just the metoprolol er? Is this a bp problem? Or a medication problem? I also take 25 mg of hydrochlorathiazide for hi blood pressure, but it seems it really isn't that high anymore since I got the CPAP machine.

Answered by Dr. Priyank Mody (1 hour later)

Brief Answer:
metoprolol er 25 and hydrochlorthiazide 12.5 mg should be the regime I sugg

Detailed Answer:
Hello ,
I am Dr. Mody and I would be addressing your concern. .
1) Metoprolol ER and metoprolol succinate ER is the same medication, the latter is just in compound form
2) Sleep apnea per say can cause hypertension, so when you treated sleep apnea with CPAP , to some extent your hypertension would also be treated , making your requirement of anti hypertensive less than before .
3) The cause of your dizziness can be either your decreased blood pressure or spells of racing heart.
By either means you should maintain your blood pressure always above 115 / 70 for optimum circulation .
If you had suddenly stopped toprol than it may cause withdrawal which may cause racing of your heart and shooting up of your blood pressure ( if any ).
Now , after going through all the details you have provided .
I would suggest.
Decrease the dose of thiazide to half 12.5 , that would be more than enough for you at this point and also it with decrease the side effect profile of the drug.
You should take metoprolol er 25 as it will prevent racing of your heart , will manage your blood pressure and at the same time protect your heart .
( Your doctor was justified in trying to taper of metoprolol as racing of heart can also be because of sleep apnea, and after CPAP he can give a trial , however a recurrence preclude we restart the medication to prevent any future episode as than can be a reason for clot formation in the heart and stroke which we should prevent by all means )
Hoping I could resolve your doubts .
Feel free to ask if any clarification needed.
Regards Dr Priyank Mody

Above answer was peer-reviewed by : Dr. Prasad