metoprolol succinate / Generic mfg. - LARVOL DELTA

Beta-Blockers for the Treatment of Arrhythmias: Which Drug for Which Arrhythmia? A State-of-the-Art Narrative Review. (PubMed, Am J Cardiovasc Drugs) - "In adrenergically mediated inherited syndromes, namely catecholaminergic polymorphic ventricular tachycardia and long QT syndrome, nonselective agents and especially nadolol are clearly superior to beta1-selective agents, and the same principle appears to extend to ventricular electrical storm, in which propranolol has outperformed metoprolol in a randomized comparison. In acute care, pharmacokinetics dominate, and the ultra-short-acting agents esmolol and landiolol permit a degree of titration that longer-acting drugs cannot match. In patients with heart failure and reduced ejection fraction, carvedilol, metoprolol succinate, and bisoprolol should be preferred irrespective of arrhythmia subtype because of their established mortality benefit. Conversely, beta1-selective agents, including the highly selective agent nebivolol, improve tolerability in bronchospastic disease, although this reflects respiratory tolerability rather than any demonstrated antiarrhythmic..."

Journal • Review • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Genetic Disorders • Heart Failure • Ventricular Tachycardia

Premedication With Atenolol Versus Metoprolol for Controlled Hypotensive Anesthesia During Nasal Surgeries (clinicaltrials.gov) - P4 | N=60 | Recruiting | Sponsor: Damanhour Teaching Hospital | Trial completion date: Jan 2026 ➔ Jan 2027 | Trial primary completion date: Jan 2026 ➔ Jan 2027

Trial completion date • Trial primary completion date • Anesthesia • Hypotension • Otorhinolaryngology

Are beta-blockers safe early after heart transplantation? (TTS 2026) - "This includes excess bradycardia and hypotension, especially if previous amiodarone was given prior to HTx. This study confirms that BB therapy used early after heart transplant must be used with caution, as exaggerated responses are experienced."

Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Transplantation

CONTROL-IHD Study: 24-h BP Control with Metoprolol-Telmisartan FDC in Hypertension and Stable Ischemic Disease. (PubMed, Adv Ther) - "Metosartan® demonstrated effective and sustained 24-h BP reduction and good tolerability in Indian patients with hypertension and stable IHD. The reductions observed during the early post-application and late dosing-interval periods suggest sustained BP lowering over 24 h."

Journal • Cardiovascular • Coronary Artery Disease • Heart Failure • Hypertension

Mechanistic Clinical Trial Comparing the Pharmacokinetics/Pharmacodynamics of Metoprolol in Heart Failure With Reduced Ejection Fraction Patients With Low vs. High Polygenic Score (clinicaltrials.gov) - P4 | N=100 | Recruiting | Sponsor: University of Michigan | Initiation date: Jul 2026 ➔ Oct 2026

Trial initiation date • Cardiovascular • Congestive Heart Failure • Heart Failure

Beta‑blocker tapering and symptom improvement in dysautonomic dysfunction patients (ESC 2026) - "Cardioselective beta‑blockers were commonly used (metoprolol succinate 33 %, metoprolol tartrate 29 %, bisoprolol 28 %, carvedilol 11 %). Symptom improvements were observed across the full spectrum of dose reduction; this highlights the synergistic value of combining beta‑blocker tapering with multimodal rehabilitation. Prospective controlled studies are warranted to confirm these observations and to optimise pharmacological strategies in dysautonomic dysfunction management."

Clinical • Cardiovascular

Long-term effect of beta-blockers after myocardial infarction with preserved left ventricular ejection fraction in a per protocol analysis of the REDUCE-AMI trial (ESC 2026) - "All dispensation data relating to the beta-blockers metoprolol succinate and bisoprolol (the treatment strategies defined in the trial protocol) were manually extracted. The study population was composed of 4,786 individuals. The median follow up was 30 months in the beta-blocker group and 38 months in the no beta-blocker group. Adherence was 71.8% in the beta-blocker group, and 89.7% in the no beta-blocker group."

Clinical • Cardiovascular • Myocardial Infarction

Efficacy of Aficamten vs Metoprolol According to Pretrial Beta-Blocker Treatment in Obstructive Hypertrophic Cardiomyopathy: Insights From MAPLE-HCM. (PubMed, JACC Heart Fail) - P3 | "Aficamten was superior to metoprolol regardless of BB use at screening or prior SOC medications. This supports the primary study results and suggests no confounding by BB resistance. Consequently, aficamten can be considered an early treatment option independent of prior SOC history. (Phase 3 Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Metoprolol Succinate in Adults With Symptomatic oHCM [MAPLE-HCM; NCT05767346)."

Journal • Cardiomyopathy • Cardiovascular • Hypertrophic Cardiomyopathy • Obstructive Hypertrophic Cardiomyopathy

Swallowing-Induced Supraventricular Tachycardia Associated With Reflux Esophagitis (ACG 2026) - "The patient was started on flecainide, metoprolol succinate, and diltiazem and discharged with mobile cardiac outpatient telemetry (MCOT). Figure: Figure 1. Mobile cardiac outpatient telemetry demonstrating initiation of paroxysmal supraventricular tachycardia (197 beats/min) temporally associated with swallowing, supporting the diagnosis of swallowing-induced supraventricular tachycardia."

Barrett Esophagus • Cardiovascular • CNS Disorders • Coronary Artery Disease • Epilepsy • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Infectious Disease • Pulmonary Disease • Ventricular Tachycardia

Mitral valve posteromedial papillary muscle head rupture presenting after liposomal doxorubicin chemotherapy for metastatic lung liposarcoma: a case report. (PubMed, Eur Heart J Case Rep) - "Her acute heart failure was optimized medically with intravenous loop diuretics, low-dose lisinopril for afterload reduction, and metoprolol succinate, while home amlodipine and hydrochlorothiazide were discontinued. We present this 'two-hit' model as a hypothesis-generating observation, suggesting that chemotherapy-induced structural changes might compound underlying ischaemic or radiation-induced vulnerabilities. As such, advanced imaging modalities may offer value in future efforts to implement risk-adapted surveillance."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Liposarcoma • Oncology • Pulmonary Disease • Sarcoma • Solid Tumor

Development and Validation of a Capillary Zone Electrophoresis Method for the Determination of Lacosamide in Pharmaceutical Dosage Forms Using Box-Behnken Experimental Design. (PubMed, J AOAC Int) - "First CE method reported for the determination of LAC in dosage forms; BBD-optimized with metoprolol succinate as internal standard; superior LOD (0.034 µg/mL); stability-indicating under five ICH stress conditions; biorelevant dissolution profiling."

Journal • CNS Disorders • Epilepsy

Polypill for heart failure with reduced ejection fraction: the POLY-HF randomized trial. (PubMed, Nat Med) - P2 | "Adults with heart failure and left ventricular ejection fraction ≤40% were randomized to a once-daily polypill containing metoprolol succinate (25/50/100/150 mg), spironolactone 12.5 mg and empagliflozin 10 mg, or rapid uptitration of individual guideline-directed medical therapy medications ('enhanced usual care'). Participants also continued treatment with a renin-angiotensin system inhibitor or sacubitril/valsartan as a separate pill...A polypill for heart failure was associated with a significant improvement in cardiac function as compared with enhanced usual care. ClinicalTrials.gov registration: NCT04633005 ."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Thyrotoxic Periodic Paralysis in an Elderly Caucasian Woman with Delayed Neuromuscular Recovery (ENDO 2026) - "Antithyroid therapy with methimazole 20 mg daily was started, along with prednisone 20 mg daily for 30 days, and beta blocker (initially metoprolol succinate 50 mg orally once daily, later switched to propranolol 40 mg orally twice daily). TPP should be included in the differential diagnosis for any patient with acute flaccid paralysis and hypokalemia in the context of thyrotoxicosis, regardless of age, sex, or ethnicity. Prompt diagnosis, carefully titrated electrolyte replacement, nonselective beta-blockade, and definitive management of hyperthyroidism are essential. Ongoing weakness after laboratory correction requires attention to fall risk and multidisciplinary care."

Clinical • Cardiovascular • CNS Disorders • Congestive Heart Failure • Depression • Endocrine Disorders • Heart Failure • Hypertension • Insomnia • Movement Disorders • Sleep Disorder

Diagnostic Conundrum: A Functional Hemorrhagic Adrenal Mass with Conflicting Biochemical and Pathological Features (ENDO 2026) - "Three weeks prior, he started metoprolol succinate, apixaban, and amiodarone for new atrial fibrillation...Biochemical testing showed normal plasma metanephrine levels (0.32 nmol/L; ref: 0.00-0.49), morning cortisol of 2.0 μg/dL after low-dose oral dexamethasone suppression test (ref: at most 1.8), renin activity level less than 0.1 ng/mL/hr (ref: 0.2-1.6, supine), and serum aldosterone of 10.6 ng/dL (ref: at most 16.0, supine)...Lastly, we suspect the lesion's hemorrhagic appearance on pathology led to the misdiagnosis of an endothelial cyst, since they are highly vascularized structures. Based on these challenges, we advise an integrated approach of imaging, labs, and pathology toward timely and accurate diagnosis of adrenal lesions."

Atrial Fibrillation • Cardiovascular • Cushing’s Disease • Dyslipidemia • Endocrine Disorders • Nephrology • Pulmonary Embolism • Respiratory Diseases • Solid Tumor

Lenalidomide Induced Thyroiditis (ENDO 2026) - "MDS was managed with lenalidomide 5 mg daily and luspatercept injections every 3 weeks...Methimazole was briefly started and discontinued once autoimmunity was ruled out. He was discharged on metoprolol succinate 100 mg daily, prednisone 20 mg daily, and cholestyramine 4 g packets with outpatient endocrinology and oncology follow up...This case adds to limited literature by demonstrating severe thyrotoxicosis and emphasizes the need for serial thyroid monitoring every 4-6 weeks to monitor for hypothyroidism. Our case also promotes future education and raises awareness of a rare but serious adverse effect."

Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Gastroesophageal Reflux Disease • Hematological Malignancies • Laryngeal Cancer • Myelodysplastic Syndrome • Non-melanoma Skin Cancer • Otorhinolaryngology • Pulmonary Disease • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Skin Cancer • TNFA

Are Betablockers Safe Early After Transplant? (ATC 2026) - "This includes excess bradycardia and hypotension, especially if previous amiodarone was given prior to HTx. This study confirms that beta-blocker therapy use early after heart transplant must be used with caution as exaggerated responses are experienced."

Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Transplantation

Biventricular Heart Failure With Reduced Ejection Fraction in a Young Male: A Case Report. (PubMed, Cureus) - "Multidisciplinary teams optimized guideline-directed medical therapy (GDMT) during this hospitalization, including uptitration of sacubitril-valsartan, metoprolol succinate, spironolactone, and initiation of empagliflozin and digoxin. The patient was discharged home in stable condition after one week with an optimized regimen, with advanced therapy evaluation including transplant workup. This case highlights GDMT optimization in young patients with advanced HFrEF, potential for recovery, and bridging strategies, addressing a complex and tenuous disease status in an increasingly more common patient population."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Obstructive Sleep Apnea • Pain • Pulmonary Disease • Respiratory Diseases • Sleep Disorder • Transplantation

Comparative In Vitro Release Profiling of Brand and Generic Metoprolol Extended-Release Formulations in the Context of Product Switching. (PubMed, Pharmazie) - "The results underscore the importance of considering patient-specific variability when switching from branded to generic formulations. Incorporating physiologically relevant in vitro studies combined with physiologically based pharmacokinetic and pharmacodynamic modeling in future research may improve predictions of in vivo performance and support safer therapeutic decisions."

Clinical • Journal • Preclinical • Cardiovascular • Hypotension • Pain

Calcium Channel Blockade Versus Beta-Blockade for Hypertension in Heart Failure With Preserved Ejection Fraction: A Randomized Crossover Trial. (PubMed, Hypertension) - P4 | "In a double-blind, randomized, crossover trial, we studied the effect of amlodipine 5 to 10 mg versus metoprolol succinate 100 to 200 mg (doses previously demonstrated to have comparable antihypertensive efficacy) for 4 weeks among adults with HFpEF and hypertension, without contraindications to initiating or withholding either drug...Our findings support the use of dihydropyridine calcium channel blockers as a preferred alternative to β-blockers for the management of hypertension in HFpEF. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04434664."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension

Prognostic Impact of Carvedilol vs. Metoprolol on Long-Term Outcomes in Patients with Heart Failure and Mildly Reduced Ejection Fraction. (PubMed, J Clin Med) - "Exposure was β-blocker therapy at discharge (metoprolol succinate or carvedilol). In this observational HFmrEF cohort, treatment with metoprolol at index hospital discharge was associated with lower 30-month mortality compared with carvedilol. Given the observational study design in line with the higher burden of comorbidities in patients discharged on carvedilol, further prospective studies are needed to clarify the impact of different β-blocker types in heart failure patients."

Journal • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure

TRENDS IN GUIDELINE-DIRECTED MEDICAL THERAPY AMONG PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION (ISPOR 2026) - "GDMT consisted of an evidence-based β‑blocker (carvedilol/metoprolol succinate/bisoprolol); ACE inhibitor, ARB, or ARNI; MRA; and SGLT2i. Prescribing and dispensing of GDMT in patients with HFrEF improved during 2020-2024 but remained underutilized. Similar findings were observed with rapid initiation of GDMT. Greater effort is needed to ensure timely initiation of these therapies."

Clinical • Cardiovascular • Congestive Heart Failure • Genetic Disorders • Heart Failure • Obesity

Mechanistic Clinical Trial Comparing the Pharmacokinetics/Pharmacodynamics of Metoprolol in Heart Failure With Reduced Ejection Fraction Patients With Low vs. High Polygenic Score (clinicaltrials.gov) - P4 | N=100 | Recruiting | Sponsor: University of Michigan | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • Congestive Heart Failure • Heart Failure

Pharmacological Intervention to Prevent NOAF After TAVR (clinicaltrials.gov) - P=N/A | N=198 | Not yet recruiting | Sponsor: Shanghai East Hospital

New trial • Atrial Fibrillation • Cardiovascular

Continuous Manufacturing of Controlled-Release Metoprolol Succinate Tablets by Novel Hot-Melt Fragmentation Technology. (PubMed, AAPS PharmSciTech) - "Additionally, in vivo studies in rats supported the sustained release behaviour, while accelerated stability testing indicated retention of formulation integrity and dissolution performance for three months. This work describes the development and evaluation of a scalable and robust platform for controlled-release oral dosage forms which could serve as a practical alternative to conventional single-layer or pellet-based systems."

Journal

Technical challenges and quality considerations for dissolving microneedles. (PubMed, Int J Pharm) - "DMNs were manufactured using varying polyvinyl alcohol (PVA) concentrations with metoprolol succinate as the model drug, maintaining constant drug content across formulations...Optimizing PVA-to-drug ratio and controlling drug distribution in DMNs are necessary for improving performance, particularly regarding drug release and permeation characteristics. These findings provide insights for advancing DMN development and addressing quality control challenges in DMN systems."

Journal • Musculoskeletal Diseases • Orthopedics