Overview

Metoprolol is a selective beta-1 blocker commonly employed as the succinate and tartrate derivatives depending if the formulation is designed to be of immediate release or extended release. The possibility of the generation of these formulations comes from the lower systemic bioavailability of the succinate derivative. To this date, it is one of the preferred beta-blockers in general clinical guidelines and it is widely prescribed in the Netherlands, New Zealand, and the US. Metoprolol was developed since 1969 by US Pharmaceutical Holdings I and FDA approved in 1978.

Indication

Metoprolol is indicated for the treatment of angina, heart failure, myocardial infarction, atrial fibrillation, atrial flutter and hypertension. Some off-label uses of metoprolol include supraventricular tachycardia and thyroid storm. All the indications of metoprolol are part of cardiovascular diseases. These conditions correspond to a number of diseases that involve the function of the heart and blood vessels. The underlying causes of these conditions are variable and can be due to genetic disposition, lifestyle decisions such as smoking, obesity, diet, and lack of exercise, and comorbidity with other conditions such as diabetes. The cardiovascular diseases are the leading cause of death on a global scale.

Associated Conditions

Angina Pectoris
Atrial Fibrillation
Hypertension
Migraine
Myocardial Infarction
Supraventricular Tachycardia (SVT)
Thyroid Crisis
Chronic heart failure with reduced ejection fraction (NYHA Class II)
Chronic heart failure with reduced ejection fraction (NYHA Class III)

Research Report

Published: Jul 24, 2025

Comprehensive Monograph: Metoprolol (DB00264)

Executive Summary

Metoprolol is a cornerstone therapeutic agent in cardiovascular medicine, classified as a beta-1 selective adrenoceptor antagonist.[1] Its primary mechanism of action involves the competitive blockade of beta-1 adrenergic receptors, which are predominantly located in cardiac tissue. This action results in a reduction of heart rate, myocardial contractility, and cardiac output, leading to a decrease in blood pressure and myocardial oxygen demand.[3]

The U.S. Food and Drug Administration (FDA) has approved metoprolol for a range of critical cardiovascular indications, including the management of hypertension, the long-term treatment of angina pectoris, the improvement of survival following an acute myocardial infarction (MI), and as an essential component in the management of stable, symptomatic heart failure.[5] Its clinical utility extends to several off-label uses, such as the control of arrhythmias, migraine prophylaxis, and symptomatic management of thyrotoxicosis.[8]

Continue reading the full research report

Clinical Trials

Title	Posted	Study ID	Phase	Status	Sponsor
Metoprolol and Trimetazidine for Coronary Heart Disease With Angina	2025/07/20	NCT07074834	Not Applicable	Completed	Shiyan City Renmin Hospital
Early Beta Blocker Administration in STEMI Patients With SCAI B Status	2025/05/13	NCT06967194	Not Applicable	Recruiting	Tel-Aviv Sourasky Medical Center
Comparative Effectiveness of Carvedilol Versus Metoprolol Succinate in Heart Failure Patients With an Implantable Cardioverter Defibrillator	2025/05/09	NCT06964464	Phase 4	Recruiting	University of Rochester
Effect of Beta-blockers on Coronary Flow and Resistance in Patients With ANOCA	2025/03/07	NCT06864234	Phase 4	Recruiting	VZW Cardiovascular Research Center Aalst
To Investigate the Effect of Retatrutide (LY3437943) on Metoprolol Pharmacokinetics in Healthy Participants	2025/02/05	NCT06808802	Phase 1	Completed	Eli Lilly and Company
An Open-label, DDI Study to Investigate the Effects of Amlitelimab on the PK of Selected Cytochrome P450 Substrates	2024/11/13	NCT06686628	Phase 1	Active, not recruiting	Sanofi
Intravenous Metoprolol in Septic Shock	2024/09/19	NCT06592547	Phase 2	Completed	Alexandria University
Aging, Beta Blockers, and Thermoregulatory Responses	2024/09/03	NCT06582680	Phase 4	Recruiting	University of Texas Southwestern Medical Center
Beta-1 Adrenergic Inhibition to Reduce Cardiac Injury and Inflammation After Subarachnoid Hemorrhage (BADCATS)	2024/08/23	NCT06569212	Phase 4	Recruiting	Madeleine Puissant
Detoxification From the Lipid Tract	2024/04/10	NCT06357104	Phase 4	Completed	Pachankis, Yang I., M.D.

FDA Drug Approvals

Approved Product	Manufacturer	NDC Code	Route	Strength	Effective Date
Metoprolol succinate	RedPharm Drug, Inc.	67296-1720	ORAL	50 mg in 1 1	1/14/2021
Metoprolol Succinate	Wockhardt USA LLC.	64679-734	ORAL	25 mg in 1 1	11/26/2019
Metoprolol Tartrate	Aphena Pharma Solutions - Tennessee, LLC	67544-911	ORAL	50 mg in 1 1	4/3/2014
TOPROL XL	Aralez Pharmaceuticals US Inc.	70347-025	ORAL	25 mg in 1 1	11/30/2022
Metoprolol Tartrate	REMEDYREPACK INC.	70518-3606	ORAL	50 mg in 1 1	3/26/2024
METOPROLOL SUCCINATE	Camber Pharmaceuticals, Inc.	31722-590	ORAL	50 mg in 1 1	3/12/2024
Metoprolol Succinate	Bryant Ranch Prepack	63629-8865	ORAL	100 mg in 1 1	2/24/2022
Metoprolol Tartrate	Medical Purchasing Solutions, LLC	71872-7225	INTRAVENOUS	5 mg in 5 mL	5/4/2023
Metoprolol Tartrate	Aphena Pharma Solutions - Tennessee, LLC	43353-944	ORAL	100 mg in 1 1	6/18/2014
Metoprolol succinate	Northstar Rx LLC	72603-143	ORAL	50 mg in 1 1	6/20/2023

EMA Drug Approvals

Approved Product	Authorization Holder	Status	Issued Date
No EMA approvals found for this drug.

HSA Drug Approvals

Approved Product	Manufacturer	Approval Number	Dosage Form	Strength	Approval Date
APO-METOPROLOL TABLET 100 mg	APOTEX INC	SIN00440P	TABLET	100 mg	4/27/1988
DENEX TABLET 100 mg	MEDOCHEMIE LTD	SIN01331P	TABLET	100 mg	5/19/1988
APO-METOPROLOL TABLET 50 mg	APOTEX INC	SIN00445P	TABLET	50 mg	4/27/1988

NMPA Drug Approvals

Approved Product	Company	Approval Number	Drug Type	Dosage Form	Approval Date
No NMPA approvals found for this drug.

PPB Drug Approvals

Approved Product	Registration No.	Company	Licence No.	Strength	Registration Date
BETALOC ZOK TAB 25MG	N/A	ASTRAZENECA HONG KONG LIMITED	N/A	N/A	6/10/2002
BETALOC ZOK TAB 200MG	N/A	ASTRAZENECA HONG KONG LIMITED	N/A	N/A	9/6/1988
CZSY-METLOL TABLETS 50MG	N/A	REGAL MEDICAL HEALTHCARE LIMITED	N/A	N/A	1/9/2017

TGA Drug Approvals

Approved Product	ARTG ID	Sponsor	Registration Type	Status	Registration Date
ARX-METOPROLOL 50 Metoprolol tartrate 50mg tablet blister pack	75835	Arrotex Pharmaceuticals Pty Ltd	Medicine	A	8/28/2000
METOPROLOL-WGR metoprolol tartrate 50mg tablet blister pack	234003	GM Pharma International Pty Ltd	Medicine	A	9/23/2015
NOUMED METOPROLOL metoprolol tartrate 50mg tablet blister pack	298212	Avallon Pharmaceuticals Pty Ltd	Medicine	A	2/26/2018
METROL 100 metoprolol tartrate 100 mg tablet blister pack	234002	Arrotex Pharmaceuticals Pty Ltd	Medicine	A	9/23/2015
ETOCAR metoprolol tartrate 50 mg film-coated tablet blister pack	222125	Ipca Pharma (Australia) Pty Ltd	Medicine	A	3/25/2015
MYOTAR metoprolol tartrate 100 mg film-coated tablet blister pack	222122	Ipca Pharma (Australia) Pty Ltd	Medicine	A	3/25/2015
TOPRELOC-XL metoprolol succinate 23.75 mg modified release tablet blister pack	356239	Pharmacor Pty Ltd	Medicine	A	3/4/2022
Metoprolol tartrate 100 mg tablet bulk	371588	Alphapharm Pty Ltd	Medicine	A	7/23/2021
Metoprolol tartrate 50 mg tablet bulk	371587	Alphapharm Pty Ltd	Medicine	A	7/23/2021
IPCA-METOPROLOL metoprolol tartrate 50mg tablet blister pack	192780	Ipca Pharma (Australia) Pty Ltd	Medicine	A	1/8/2013

Health Canada Drug Approvals

Approved Product	Company	DIN	Dosage Form	Strength	Market Date
LOPRESOR SR 200 MG	novartis pharmaceuticals canada inc	00534560	Tablet (Extended-Release) - Oral	200 MG	12/31/1983
JAMP-METOPROLOL-L	Jamp Pharma Corporation	02356821	Tablet - Oral	50 MG	10/21/2010
PENTA-METOPROLOL TABLETS	pentapharm ltd.	02232547	Tablet - Oral	100 MG	N/A
APO-METOPROLOL	Apotex Inc	00618640	Tablet - Oral	100 MG	12/31/1984
CO METOPROLOL-L TABLETS 100MG	Cobalt Pharmaceuticals Company	02244643	Tablet - Oral	100 MG	N/A
PMS-METOPROLOL-L	Pharmascience Inc	02230804	Tablet - Oral	100 MG	4/16/1998
PMS-METOPROLOL-L	Pharmascience Inc	02230803	Tablet - Oral	50 MG	4/16/1998
NU-METOPROLOL SR	nu-pharm inc	02337371	Tablet (Extended-Release) - Oral	100 MG	N/A
AG-METOPROLOL-L	angita pharma inc.	02481308	Tablet - Oral	25 MG	12/27/2018
NU-METOPROLOL (TYPE L)	nu-pharm inc	02337363	Tablet - Oral	100 MG	N/A

CIMA AEMPS Drug Approvals

Approved Product	Company	Registration Number	Pharmaceutical Form	Prescription Type	Status
No CIMA AEMPS (Spain) approvals found for this drug.

Philippines FDA Drug Approvals

Approved Product	Company	License Number	Dosage Form	Strength	Approval Date
No Philippines FDA approvals found for this drug.

Saudi SFDA Drug Approvals

Approved Product	Company	License Number	Dosage Form	Strength	Approval Date
No Saudi SFDA approvals found for this drug.

Malaysia NPRA Drug Approvals

Approved Product	Company	Registration Number	Dosage Form	Strength	Approval Date
No Malaysia NPRA approvals found for this drug.

UK EMC Drug Information

Medicine Name	MA Holder	MA Number	Pharmaceutical Form	Active Ingredient	Authorization Date
No UK EMC drug information found for this drug.

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