Comparative Study of Metoprolol Succinate and Metoprolol Tartrate: Therapeutic Efficacy and Safety through Oral and Nasogastric Tube Administration

ABSTRACT
Background: Metoprolol, a selective β1-adrenergic receptor blocker, is widely prescribed in cardiovascular conditions
including hypertension, heart failure, and arrhythmia. The route and formulation significantly influence therapeutic outcomes.
This study aims to compare the efficacy and safety of Metoprolol Succinate (extended-release) and Metoprolol Tartrate
(immediate-release) administered via oral and nasogastric (NG) routes in hospitalized patients requiring β-blocker therapy.
Methods: A prospective, comparative interventional study was conducted for six months at ESI Hospital, Ayanavaram,
Chennai, including 108 patients aged 25–75 years diagnosed with cardiovascular diseases. Participants were categorized into
four groups (n=27 each): Oral Succinate, Oral Tartrate, NG Succinate, and NG Tartrate. Baseline parameters such as systolic
blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded. Therapeutic efficacy, safety (adverse
drug reactions, ADRs), and biochemical parameters were assessed. Statistical analysis was conducted using SPSS v27.0 with
ANOVA and paired t-tests; p<0.05 was considered significant.
Results: Oral Metoprolol Succinate exhibited the highest efficacy (77.8%), followed by Oral Tartrate (64.7%), NG Tartrate
(55.6%), and NG Succinate (40.7%). Significant reductions in SBP and HR were observed across all groups (p<0.05), with the
greatest decline in the Oral Succinate group (SBP 148.6±11.4 to 124.2±9.8 mmHg; HR 92.7±6.2 to 73.3±5.8 bpm). ADRs were
mild, with fatigue and dizziness being most common. No severe ADRs or biochemical abnormalities were noted.
Conclusion: Oral Metoprolol Succinate demonstrated superior therapeutic efficacy and safety compared to other groups,
attributed to its stable plasma concentration and extended-release profile. NG Tartrate remains a suitable alternative when oral
administration is not feasible. This study emphasizes the importance of formulation and administration route in optimizing
cardiovascular pharmacotherapy.
KEYWORDS: Metoprolol succinate, Metoprolol tartrate, Oral vs nasogastric, β-blockers, Hypertension, Cardiovascular
efficacy.