Can Metoprolol ER Tablets Be Dissolved In Liquid?

In our latest question and answer, our pharmacist discusses whether or not metoprolol succinate ER tablets can be dissolved in liquid and administered.

Question

Can metoprolol Succ ER 25 Mg be dissolved (not crushed) for a geriatric resident that takes oral medications with difficulty?

Asked by Nurse KVF On Aug 19, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 19, 2022
Last updated Aug 19, 2022

Key points

  • Metoprolol ER (metoprolol succinate) tablets are extended-release and cannot be crushed or dissolved in liquid without the extended-release properties being ruined.
  • However, metoprolol ER is one of the few extended-release drugs that can be split in half, and doing so may help ease administration.
  • If metoprolol ER tablets cannot be swallowed whole (or one-half at a time), alternatives include switching to metoprolol tartrate (immediate-release) or to Kapspargo sprinkle capsules.

Answer

Hello and thanks so much for your question!

Metoprolol ER (metoprolol succinate) is an extended-release form of metoprolol, and while the tablets can be split in half (one of the few extended-release drugs where this is okay to do), they cannot be crushed or chewed since that will destroy the extended-release properties of the drug. Additionally, there isn't really a way you could dissolve metoprolol ER tablets in a liquid without the release mechanism being compromised either.

The below image shows how these tablets are formulated. The tablets essentially contain many tiny pellets, each containing the active ingredient (metoprolol succinate). After a tablet is taken by mouth, the pellets dissolve slowly, which releases the drug over time.

Metoprolol Split In Half Tablet

Dissolving Metoprolol ER?

Getting back to your question, if you dissolve the tablets in liquid, this will also ruin the extended-releases properties of the drug since you will be destroying the pellets that are designed to dissolve slowly over time to release the drug.

Now, the drug-containing pellets in metoprolol ER tablets are designed to dissolve over a 24-hour or so period so, I suppose, technically, you could put the tablets in a liquid to be administered immediately so there wasn't a long enough time frame for the pellets to dissolve. However, I can't think of a way where you could crush up the tablets in a fine enough manner to put in a liquid without compromising the beads and in a way that makes that advantageous over splitting the tablets and taking them by mouth.

If you kept metoprolol ER tablets in liquid long enough to dissolve (which would take a considerable amount of time), the drug-containing pellets will also have already started to dissolve.

Alternatives

I can see two alternatives for you since there isn't a way to dissolve metoprolol ER tablets without destroying the release mechanism.

You could switch to metoprolol tartrate tablets, which are immediate-release and can be crushed or put in a liquid for immediate administration. It's also very commonly compounded as a suspension. The downside to this is that metoprolol succinate (the extended-release form) is generally preferred for most cardiovascular disease states since it has better health outcomes associated with it when compared to metoprolol tartrate.

The best alternative, although it may be cost-prohibitive, is to use Kapspargo sprinkle capsules, which were actually created with long-term care residents and those who cannot swallow solid dosage forms in mind.

Kapspargo is a capsule dosage form that contains pellets of extended-release metoprolol succinate. Kapspargo capsules can be opened and the contents sprinkled onto a soft food for immediate administration. The contents of Kapspargo capsules can also be mixed with 15mL or more of water and given that way as well. 

Final Words

I hope this answer helped and please feel free to reach out again in the future!

References

  • Metoprolol Succinate Bioequivalence Review, AccessFDA
  • Toprol-XL Prescribing Information, AccessFDA
  • KAPSPARGO SPRINKLE Prescribing Information, AccessFDA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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