Metoprolol CR/XL in Patients With CHF
Metoprolol CR/XL in Patients With CHF
Metoprolol CR/XL (metoprolol succinate extended-release tablets) is a ß1-selective agent that improved survival and reduced hospitalization among patients with New York Heart Association class II-IV heart failure in a randomized trial. Metoprolol CR/XL differs from conventional metoprolol tartrate with respect to pharmacokinetic and pharmacodynamic properties that may be clinically important in patients with heart failure. A thorough patient evaluation should be performed to determine optimal dosage and titration of this drug, as with any ß-blocker, and to assess the potential for drug-drug or drug-disease interactions. By applying knowledge of drug-specific characteristics and designing therapy for each individual patient, improvement in patient outcomes can be realized with metoprolol CR/XL.
The medical management of heart failure has transitioned over the past decade. In no other area of cardiovascular medicine have scientists been as humbled by results of clinical trials that proved therapies thought to be beneficial, harmful, and therapies thought to be harmful, beneficial. Certainly, ß-blockers fall into the latter category. Although research with ß-blockers in the treatment of heart failure dates back to the 1970s, the drugs' mortality benefits in heart failure, in addition to standard therapy including an angiotensin-converting enzyme (ACE) inhibitor, were shown only recently. The first ß-blocker to receive Food and Drug Administration (FDA) approval for treatment of heart failure was carvedilol, based on results from the United States Carvedilol Program. In the prospective, double-blind Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF), with a primary end point of mortality, a statistically significant reduction in all-cause mortality was reported for patients treated with metoprolol CR/XL (Toprol-XL; AstraZeneca, Wilmington, DE).
Abstract
Metoprolol CR/XL (metoprolol succinate extended-release tablets) is a ß1-selective agent that improved survival and reduced hospitalization among patients with New York Heart Association class II-IV heart failure in a randomized trial. Metoprolol CR/XL differs from conventional metoprolol tartrate with respect to pharmacokinetic and pharmacodynamic properties that may be clinically important in patients with heart failure. A thorough patient evaluation should be performed to determine optimal dosage and titration of this drug, as with any ß-blocker, and to assess the potential for drug-drug or drug-disease interactions. By applying knowledge of drug-specific characteristics and designing therapy for each individual patient, improvement in patient outcomes can be realized with metoprolol CR/XL.
Introduction
The medical management of heart failure has transitioned over the past decade. In no other area of cardiovascular medicine have scientists been as humbled by results of clinical trials that proved therapies thought to be beneficial, harmful, and therapies thought to be harmful, beneficial. Certainly, ß-blockers fall into the latter category. Although research with ß-blockers in the treatment of heart failure dates back to the 1970s, the drugs' mortality benefits in heart failure, in addition to standard therapy including an angiotensin-converting enzyme (ACE) inhibitor, were shown only recently. The first ß-blocker to receive Food and Drug Administration (FDA) approval for treatment of heart failure was carvedilol, based on results from the United States Carvedilol Program. In the prospective, double-blind Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF), with a primary end point of mortality, a statistically significant reduction in all-cause mortality was reported for patients treated with metoprolol CR/XL (Toprol-XL; AstraZeneca, Wilmington, DE).
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