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. Atenolol comes in the following dosages: 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. Below are some common indications and appropriate dosages based on those indications. 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Β-Adrenergic blocking agents (β-blockers) generally not preferred for initial management of hypertension, but may be considered in patients who have a compelling indication (e.g., prior MI, ischemic heart disease, heart failure) for their use or as add-on therapy in those who do not respond adequately to the preferred drug classes (ACE inhibitors, angiotensin II receptor antagonists, calcium-channel blockers, or thiazide diuretics). β-Blockers are considered first-line anti-ischemic drugs in most patients with chronic stable angina; despite differences in cardioselectivity, intrinsic sympathomimetic activity, and other clinical factors, all β-blockers appear to be equally effective for this use. National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children. Expert guidelines recommend initiation of oral β-blocker therapy within the first 24 hours in patients who do not have manifestations of heart failure, evidence of low-output state, increased risk of cardiogenic shock, or any other contraindications to β-blocker therapy. Isoptin (metoprolol tartrate) tablets and injection prescribing information. Report of the Second Task Force on Blood Pressure Control in Children—1987. Continue β-blocker therapy for secondary prevention in patients with stabilized heart failure and reduced systolic function (preferably with bisoprolol, carvedilol, or metoprolol succinate because of proven mortality benefit). Expert guidelines recommend initiation of oral β-blocker therapy within the first 24 hours in patients who do not have manifestations of heart failure, evidence of low-output state, increased risk of cardiogenic shock, or any other contraindications to β-blocker therapy. Because of conflicting evidence of benefit and potential for harm (e.g., cardiogenic shock), experts recommend limiting use of IV β-blockers to patients with refractory hypertension or ongoing ischemia at time of presentation. Continue β-blocker therapy for secondary prevention in post-MI patients with left ventricular systolic dysfunction (preferably with bisoprolol, carvedilol, or metoprolol succinate because of proven mortality benefit). Atenolol works on heart-specific receptors to lower blood pressure and slow heart rate; however, this selective effect on the heart may be lost with dosages greater than 50mg/day which increases the risk that atenolol may adversely affect breathing. Prescribed for Anxiety, High Blood Pressure, Alcohol Withdrawal, Angina, Angina Pectoris Prophylaxis, Esophageal Variceal Hemorrhage Prophylaxis, Heart Attack, Migraine Prevention, Mitral Valve Prolapse, Supraventricular Tachycardia, Ventricular Tachycardia. atenolol may also be used for purposes not listed in this medication guide. " Atenolol works on heart-specific receptors to lower blood pressure and slow heart rate; however, this selective effect on the heart may be lost with dosages greater than 50mg/day which increases the... more Metoprolol is a selective beta-blocker at dosages usually prescribed to lower blood pressure or relieve the symptoms of angina. Prescribed for High Blood Pressure, Supraventricular Tachycardia, Angina, Tapering Regimen, Heart Attack, Angina Pectoris Prophylaxis, Heart Failure, Left Ventricular Dysfunction, Mitral Valve Prolapse. Two different salts are available, metoprolol tartrate and metoprolol succinate. May also be prescribed off label for Atrial Fibrillation, Aortic Aneurysm, Benign Essential Tremor, Migraine Prevention, Premature Ventricular Depolarizations. Supposedly these two drugs are the same but something has made a real difference for me. I've been on Atenolol for the past 3 yrs, but previously have been on many other types of bp medications that did not work as well. " Metoprolol is a selective beta-blocker at dosages usually prescribed to lower blood pressure or relieve the symptoms of angina. Most of my nights I have had wakeful periods and generally non-restorative sleep. The problem is now I'm experiencing the side effects that others have reported on such as the sensitivity to light, decreased sexual arousal, dizziness occasionally, swollen ankles, and gout. 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