Two medicines, side by side
Spironolactone vs metoprolol
Spironolactone and metoprolol are both labeled for high blood pressure and heart failure. Drugs@FDA records approvals of spironolactone since 1960 and of metoprolol since 1978. Pharmacies paid $0.0426 per spironolactone 25 mg tablet and $0.085 per metoprolol succ ER 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Metoprolol's other strengths are brand-only: $1.20 per mL (Lopressor 10 mg/mL oral solution). In FDA's classes, spironolactone is an aldosterone antagonist and metoprolol a beta-adrenergic blocker.
Check it at the source: the spironolactone FDA label on DailyMed (effective November 28, 2025); the metoprolol FDA label on DailyMed (effective March 3, 2026).
Highlights of the spironolactone record
Spironolactone (Aldactone) · label of November 28, 2025
Used for
From the label: indicationsALDACTONE is an aldosterone antagonist indicated for: • The treatment of NYHA Class III–IV heart failure and reduced ejection fraction to increase survival, manage edema, and to reduce the need for hospitalization for heart failure ( 1.1 ). • Use as an add-on therapy for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- January 21, 1960
- Generic labelers
- 38 labelers
- Pharmacy cost
- $0.0426 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Highlights of the metoprolol record
Metoprolol (Lopressor) · label of March 3, 2026
Used for
From the label: indicationsTOPROL-XL, metoprolol succinate, is a beta-adrenergic blocker indicated for the treatment of: Hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and non-fatal cardiovascular events, primarily strokes and myocardial infarctions. ( 1.1 ) Angina Pectoris. […]
On the market
- Earliest approval on file
- August 7, 1978
- Generic labelers
- 74 labelers
- Pharmacy cost
- $0.085 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 39
Source: FDA drug labels via openFDA (Spironolactone label of November 28, 2025, Metoprolol label of March 3, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do spironolactone and metoprolol differ on the record?
In FDA's classes, spironolactone is an aldosterone antagonist and metoprolol a beta-adrenergic blocker.
How each works, in its label's words: Spironolactone, “Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent …”; Metoprolol, “Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent.”
Half-life, in each label's words: Spironolactone, “The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and …”; Metoprolol, “Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately …”
Generics: spironolactone since 1980; metoprolol since 1993 (Drugs@FDA).
| Spironolactone | Metoprolol | |
|---|---|---|
| Labeled for | Heart failure, Edema (fluid retention), High blood pressure | High blood pressure, Angina, Heart failure, Heart attack and coronary artery disease |
| Pharmacologic class | Aldosterone Antagonist | beta-Adrenergic Blocker |
| How it works (label) | Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted … | Metoprolol is a beta 1 -selective (cardioselective) adrenergic receptor blocking agent. |
| Half-life (label) | The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and 6-β-hydroxy-7-α-(thiomethyl) spirolactone (HTMS) are 16.5, 13.8, and 15 hours, respectively. | Elimination Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. |
| Earliest approval on file (Drugs@FDA) | January 21, 1960 | August 7, 1978 |
| First generic approved | May 7, 1980 | December 21, 1993 |
| Generic labelers (NDC) | 38 labelers | 74 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0426 per tablet (Spironolactone 25 mg tablet) | $0.085 per tablet (Metoprolol succ ER 100 mg tablet) |
| 12-month price change | -14% | -8% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 6 | 39 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 139,757 | 353,609 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to spironolactone
- every medicine labeled for the same conditions