There is no drug that can completely replace metoprolol tartrate, patients who want to replace the drug, can choose propranolol, diltiazem and other drugs under the guidance of the doctor according to the indications. 1. Metoprolol belongs to the beta-blocker, clinically has the effect of lowering blood pressure and slowing down the heart rate, the main indications are hypertension, tachyarrhythmia, etc. For the patients who can not tolerate metoprolol, they can choose diltiazem instead. 2. Propranolol is also a β-blocker, and the principle of action is the same as metoprolol, so the clinical indications are roughly the same, but the specific dosage and the frequency of use is different, the resulting adverse reactions also vary from person to person. If patients cannot tolerate metoprolol, they can consider replacing it with propranolol. 3. Diltiazem is a calcium antagonist, can dilate coronary arteries and peripheral blood vessels, the main indications are hypertension and coronary heart disease, at the same time, it has the effect of slowing down the heart rate, although it does not belong to the same class of drugs with metoprolol, but its role is similar. For some patients with high blood pressure who have a fast heart rate and cannot take beta-blockers such as metoprolol orally, diltiazem can be chosen. However, diltiazem is not a substitute for metoprolol in the treatment of hyperthyroidism, myocardial infarction, angina pectoris, or hypertrophic cardiomyopathy. In addition, the adverse effects of diltiazem include headache, dizziness, flushing, bradycardia, conduction block, nausea and vomiting, etc. Severe bradycardia, sinus node dysfunction, atrioventricular block without pacemaker protection of degree II III, lactation and pregnancy are prohibited. Specifically under the guidance of a physician to use the drug, choose the appropriate dose and usage.