The main differences between ivabradine and betalactam (generic name is metoprolol tartrate) are the population for which it is indicated, adverse effects and contraindications. Ivabradine is used in patients in sinus rhythm with a heart rate ≥75 beats per minute with chronic heart failure, or in combination with standard of care beta-blockers such as metoprolol, or in treatment where beta-blockers are contraindicated or not tolerated. Metoprolol is used in the treatment of hypertension, myocardial infarction, hypertrophic cardiomyopathy, aortic coarctation, hyperthyroidism, and heart failure. Ivabradine adverse reactions are mainly optical illusions, bradycardia, and atrial fibrillation. Metoprolol adverse reactions are mainly fatigue, headache, dizziness, coldness in the extremities, bradycardia, abdominal pain, nausea, vomiting, diarrhea and constipation. Ivabradine is contraindicated in people who are allergic to the product; heart rate less than 70 beats/min before treatment; cardiogenic shock; acute myocardial infarction; blood pressure <90/50mmHg; severe hepatic insufficiency; sick sinus syndrome; sinus atrial block; acute heart failure; heart rate is completely controlled by a pacemaker; unstable angina pectoris; and patients with third-degree atrioventricular block. Metoprolol is contraindicated in persons who are hypersensitive to the product; cardiogenic shock; sick sinus node syndrome; second- and third-degree atrioventricular block; unstable, decompensated heart failure; treatment with beta agonists, such as salbutamol; symptomatic bradycardia or hypotension; suspected acute myocardial infarction; and patients with severe peripheral vascular disease at risk of gangrene. The choice of ivabradine or metoprolol needs to be under the guidance of a specialized doctor.