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
(2002)

BCBS
(2002)
UCare
(2002)
Pref
One
(2002)
Health
Partner
Mayo
(2002)
Aetna
(2002)
PCS
(2002)
Dose/Day
(mg)
Cost/30 Days
($)
Coreg (a)
Carvedilol
Y
Y
Y
Y
Y
Y
Y
Y
3.125 bid
6.25 bid
12.5 bid
25 bid
90.67
90.67
90.27
90.67
Lopressor†
Metoprolol tartrate
Y (G)
Y (G)
Y
Y (G)
Y
Y (G)
Y (G)
Y(G)*
50 bid
100 bid
9.56 (G)
13.93 (G)
Toprol XL
Metoprolol succinate
Y
Y
.
Y
PA
Y
.
Y*
50/day
100/day
200/day
19.58
27.86
55.71
Zebeta (a)
Bisoprolol
.
.
.
.
.
Y
Y
Y
5/day
10/day
40.81
40.81

† = 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.