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metoprolol + spironolactone + empagliflozin is an investigational, unapproved once-daily fixed-dose combination "polypill" developed by the University of Texas Southwestern Medical Center for the treatment of heart failure with reduced ejection fraction (HFrEF). It combines three guideline-directed medical therapies (GDMT) into a single capsule: metoprolol succinate (a beta-1 adrenergic receptor blocker), spironolactone (a mineralocorticoid receptor antagonist), and empagliflozin (a sodium-glucose cotransporter 2 inhibitor). In the Phase 2 POLY-HF trial, the polypill was manufactured by over-encapsulating the separate drugs in an inert gel capsule. The combination is designed to simplify complex medication regimens, reduce pill burden, and improve treatment adherence and clinical outcomes in patients with HFrEF.
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