How Do Doses Of Atenolol Compare To Metoprolol Succinate?

In our latest question and answer, the pharmacist discusses dose conversions between atenolol and Toprol XL (metoprolol succinate).

Question

I have been taking 25 mg atenolol and doctor switched me to Toprol XL 50 mg. Is this the same strength as the atenolol? Can the pill be cut in half?

Asked by peg On Feb 01, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Feb 02, 2018

There is no direct conversion from Tenormin (atenolol) to Toprol XL (metoprolol succinate). Generally, when switching between the two, your doctor will pick a similar "potency range" for the specific medication. In addition, there are published guidelines and dosage recommendations based on the indication the drug is being used for.


Dosage Conversation Between Atenolol and Toprol XL

Atenolol comes in the following dosages:

  • 25 mg
  • 50 mg
  • 100 mg


Toprol XL comes in the following dosages:

  • 25 mg
  • 50 mg
  • 100 mg
  • 200 mg


As mentioned, there is no direct conversion between atenolol and metoprolol succinate. However, if you were taking 25 mg of atenolol, it makes sense that you would be initiated on a low dose of metoprolol succinate, around 25 to 50 mg. In addition, the appropriate dosage depends on the specific indication being treated (e.g. angina, heart failure etc...). Below are some common indications and appropriate dosages based on those indications.


Common Toprol XL Dosages

Angina

Initiate therapy with 100 mg once daily. Effective doses can range from 100 mg to 400 mg per day.


Heart Failure

Initiate therapy at 25 to 50 mg once daily for Class II heart failure or 12.5 mg once daily for severe heart failure.


High Blood Pressure

Initiate therapy at 50 mg once daily and increase to appropriate response, up to 100 mg once daily.


Toprol XL can be split in half. Please see this article for a full explanation.


Common Atenolol Dosages

Angina

Initiate therapy at 50 mg once daily and increase to appropriate response, up to 100 mg once daily.


Post Myocardial Infarction

Initiate therapy at 50 mg twice daily (or 100 mg once daily).


High Blood Pressure

Initiate therapy at 25 to 50 mg once daily and increase to appropriate response, up to 100 mg once daily.


About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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