Procardia XL vs. Lopressor for Angina: Important Differences and Potential Risks.

Key takeaways

Nifedipine ER (Procardia XL) and metoprolol tartrate (Lopressor) are both used to treat chest pain and high blood pressure, but they belong to different medication classes and work differently. Nifedipine ER is a calcium channel blocker that relaxes blood vessels to lower blood pressure and improve oxygen flow to the heart. In contrast, metoprolol tartrate is a beta blocker that slows down the heart, reducing the pressure on blood vessels and the heart's oxygen demand. Nifedipine ER is typically taken once daily, while metoprolol tartrate is usually taken twice daily with food. Common side effects of nifedipine ER include swelling in the legs, dizziness, and headaches, whereas metoprolol tartrate can cause tiredness, dizziness, and diarrhea. Additionally, metoprolol tartrate is also used to lower the risk of death after a heart attack, a benefit not shared by Nifedipine ER. Both medications are available in generic forms, making them more affordable options.

Nifedipine ER

(Procardia XL)

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Metoprolol tartrate

(Lopressor)

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Summary for Procardia XL

Prescription only

Nifedipine (Procardia, Procardia XL) is a calcium channel blocker (CCB). It's used to treat certain heart conditions, such as chest pain (angina) and high blood pressure in adults. It mainly works by relaxing your blood vessels, making it easier for blood to flow. Nifedipine is available as an extended-release pill (ER) that's taken by mouth once daily, and a immediate-release pill (IR) that's taken three times a day. Keep in mind the nifedipine IR is rarely prescribed. Some side effects of nifedipine include swelling in the legs, dizziness, tiredness, and headache.

Indications for Procardia XL

Chest pain (angina)
High blood pressure (hypertension) - extended-release tablets only

Pros and Cons for Procardia XL

Pros

Lowers risk of heart attack and stroke in people with high blood pressure
Can take it alone or with other medications to help with blood pressure or chest pain
Calcium channel blockers, such as nifedipine ER (Procardia XL), work especially well for Black people to lower blood pressure
The extended-release tablets are taken once daily
Available as a lower-cost, generic form

Cons

Often causes swelling in the legs and feet
Not a good choice if you have heart failure because of risk for swelling
If you have severe heart disease, it can raise your risk of having a heart attack or worsening chest pain
The immediate-release capsule needs to be taken 3 to 4 times a day

Common Side Effects for Procardia XL

Extended-release tablets:

Swelling (edema) in the legs, feet, or hands (10-30%)
Headache (16%)
Fatigue (6%)
Dizziness (4%)

Immediate-release capsules:

Dizziness or lightheadedness (27%)
Flushing (25%)
Headache (23%)
Weakness (12%)
Nausea (11%)
Swelling (10%)

Warnings for Procardia XL

Low blood pressure
Risk of worsening chest pain or heart attack
Risk of heart failure
Swelling in legs and feet
Stomach or intestinal injury (extended-release form only)

Summary for Lopressor

Prescription only

Metoprolol tartrate (Lopressor) is a beta blocker used to treat chest pain and high blood pressure in adults. It can also lower the risk of death after a heart attack. You take it by mouth, typically once or twice a day, but your dose depends on your condition. Side effects include dizziness, shortness of breath, and it can make you tired.

Indications for Lopressor

High blood pressure
Chest pain (angina)
Lower risk of death after a heart attack

Pros and Cons for Lopressor

Pros

Fast-acting — works quickly after you take it
First choice treatment after a heart attack
Available in different strengths, so your dose can be adjusted easily
Possible option for those who are breastfeeding

Cons

Need to take with food
Typically need to take more than once a day
Not a first-choice treatment for high blood pressure, unless you have certain heart conditions
Can hide symptoms of low blood sugar