Beta Blockers with Proven Benefit in Heart Failure
Beta Blocker Action Starting Dose Target Dose FDA Approved Carvedilol (Coreg) (a) Beta 1; Beta 2, Alpha 1 3.125 mg bid 25 mg bid Yes Metoprolol Succinate CR (Toprol XL) Beta 1 (c) 12.5 mg qd 100-200 mg qd Yes Metoprolol Tartrate (Lopressor) (b) Beta 1 (c) 6.25 mg bid 50-75 mg bid No Bisoprolol (Zebeta) Beta 1 (c) 1.25 mg qd 10 mg qd No
- There are no proven benefit data for other Beta blockers.
- (a) = When prescribe low dose, only Carvedilol has proven benefit (MOCHA, 1996)
- (b) = There is no mortality benefit data for Metoprolol tartrate (MDC, 1993)
- (c) = At target dose in clinical trials, the selective beta blockers may become non selective ones.
Beta blockers - Drug Formulary and Pricing
Brand Name Generic Medica
Coreg (a) Carvedilol Y Y Y Y Y Y Y Y 3.125 bid
Lopressor Metoprolol tartrate Y (G) Y (G) Y Y (G) Y Y (G) Y (G) Y(G)* 50 bid
Toprol XL Metoprolol succinate Y Y . Y PA Y . Y* 50/day
Zebeta (a) Bisoprolol . . . . . Y Y Y 5/day
= No data on motality reduction.
(a) = No price different of higher strength tablet.
(G) = Generic.
PA = Prior authorization.
* = Preferred agent in classification.
All tablets can be cut in half, and may need pill cutter.