Table 2. Beta Blockers with Proven Benefit in Heart Failure
Beta Blocker Action Starting Dose Target Dose FDA ApprovedCarvedilol (Coreg) (a) Beta 1; Beta 2, Alpha 1 3.125 mg bid 25 mg bid YesMetoprolol Succinate CR (Toprol XL) Beta 1 (b) 12.5 mg qd 100-200 mg qd YesMetoprolol Tartrate (Lopressor) Beta 1 (b) 6.25 mg bid 50-75 mg bid NoBisoprolol (Zebeta) Beta 1 (b) 1.25 mg qd 10 mg qd NoThere are no proven benefit data for other Beta blockers. There is no mortality benefit data for Metoprolol tartrate.
(a) = When prescribe low dose, only Carvedilol has proven benefit.
(b) = There is no mortality benefit data for Metoprolol tartrate.
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
90.67Lopressor 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
55.71Zebeta (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.