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    OBJECTIVESTo compare the hemodynamic effects of twice daily metoprolol tartrate (MT) and once daily metoprolol succinate (MS) in congestive heart failure patients. BACKGROUNDAdverse hemodynamic effects with MT demonstrated during initiation persist with drug readministration during chronic therapy. METHODSPatients were randomly assigned to 6.25 mg MT or 25 mg MS orally and the dose was gradually increased to a target of 50 mg twice a day or 100 mg once a day, respectively. Hemodynamic measurements were obtained at baseline and after three months of therapy—both before and after drug readministration. RESULTSLong term metoprolol therapy produced significant functional, exercise and hemodynamic benefits with no difference in response between either metoprolol preparation in the 27 patients (MT [14], MS [13]). When full dose metoprolol was readministered during chronic therapy, there were parallel adverse hemodynamic effects in both drug groups. Cardiac index decreased by 0.6 liters/min/m Mortality benefits with both beta-1 selective and beta nonselective adrenergic blockers in congestive heart failure have now been shown in three recent survival trials (1–3). Immediate- vs extended-release metoprolol in heart failure MDedge. viagra best price Toprol XL Metoprolol Succinate Side Effects, Interactions, Warning. Hemodynamic comparison of twice daily metoprolol tartrate. - JACC
     
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