Inderal LA and Inderal XL (propranolol)

Inderal LA and Inderal XL generic

Inderal LA and Inderal XL are brand-name drugs that contain the active drug propranolol. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in taking the generic form of Inderal LA or Inderal XL, talk with your doctor. They can tell you if it comes in forms and strengths that can be used for your condition.

Note: There’s another extended-release capsule version of propranolol called InnoPran XL. Propranolol also comes as an oral solution called Hemangeol, which is approved to be used only in children.

Inderal LA and Inderal XL for anxiety

The Food and Drug Administration (FDA) has not approved Inderal LA and Inderal XL to treat anxiety. However, doctors may prescribe the drugs off-label for the condition. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

One review of clinical trials looked at how well propranolol (the active ingredient in both Inderal LA and Inderal XL) works to treat anxiety. The results weren’t clear as to whether propranolol may be effective for the condition. Further research is needed to determine if the drug may be useful in treating anxiety.

If you’re interested in learning more about taking Inderal LA or Inderal XL for anxiety, talk with your doctor. Because this would be an off-label use, there isn’t a recommended dosage for anxiety. However, your doctor can help you determine the right dosage for you.

Inderal LA and Inderal XL side effects

Inderal LA and Inderal XL can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Inderal LA or Inderal XL. These lists do not include all possible side effects.

For more information about the possible side effects of Inderal LA and Inderal XL, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome. You can also refer to this article about side effects of Inderal LA and Inderal XL.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Inderal LA or Inderal XL, you can do so through MedWatch.

Mild side effects

Mild side effects* of Inderal LA and Inderal XL can include:

• decreased blood pressure
• numbness of your hands
• dizziness
• insomnia or vivid dreams
• weakness
• hallucinations or changes in vision
• nausea or vomiting
• diarrhea
• constipation
• sore throat
• skin rash
• difficulty breathing
• erectile dysfunction
• slightly slowed heart rate†
• fatigue†

Most of these side effects may go away within a few days to a couple of weeks. If they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Inderal LA and Inderal XL. To learn about other mild side effects, talk with your doctor or pharmacist, or view the prescribing information for Inderal LA and Inderal XL.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Inderal LA and Inderal XL aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Low levels of blood cells, such as white blood cells or platelets (cells that help blood clot). Symptoms can include:
  • fever
  • weakness
  • bruising
  • nosebleeds
• Heart problems, such as congestive heart failure. Symptoms can include:
  • shortness of breath
  • swelling of the legs or feet
  • cough
• Serious skin reaction, such as Stevens-Johnson Syndrome or toxic epidermal necrolysis. Symptoms may include:
  • skin rash
  • skin peeling
  • fever
  • skin pain
• Severely slowed heart rate* or low blood pressure. Symptoms may include:
  • dizziness
  • fatigue
  • fainting
  • blurry vision
• Allergic reaction.*

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects these drugs may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Inderal LA and Inderal XL.

Slowed heart rate

It’s possible for Inderal LA or Inderal XL to cause a slowed heart rate, which may also be called bradycardia. This was a common side effect of both medications in clinical trials of Inderal LA and Inderal XL.

In rare cases, a slowed heart rate can become severe and lead to complications such as heart block or cardiac arrest. Heart block is a problem with the heart’s electrical activity. Cardiac arrest is a condition in which the heart stops beating.

Symptoms of a slowed heart rate may include:

• dizziness
• fatigue
• fainting
• confusion

What you can do

If you experience symptoms of a slowed heart rate, talk with your doctor. Due to the risks mentioned above, your doctor will monitor your heart rate throughout your treatment with Inderal LA or Inderal XL. If your heart rate becomes too slow, they may lower your dose. In some cases, your doctor may switch you to a different treatment.

It’s also important to tell your doctor about any other medications that you take along with Inderal LA or Inderal XL. Some other medications may also lower your heart rate. So, taking them along with Inderal LA or Inderal XL may increase your risk of developing a severely slowed heart rate. Your doctor can help you determine if it may be safe for you to take Inderal LA or Inderal XL.

Fatigue

Inderal LA and Inderal XL may cause fatigue, which refers to low energy. This was one of the most common side effects of these medications in clinical trials of Inderal LA and Inderal XL.

Symptoms of fatigue can include:

• feeling sleepy during the day
• trouble concentrating
• feeling unmotivated
• muscle aches

What you can do

If you feel fatigued during your treatment with Inderal LA or Inderal XL, talk with your doctor.

In some cases, fatigue may be a symptom of other side effects of Inderal LA or Inderal XL. For example, low levels of white blood cells or a slowed heart rate can cause fatigue. Your doctor can help determine the cause and suggest ways to treat it. They can also recommend how to boost your energy.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Inderal LA or Inderal XL.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Inderal LA or Inderal XL, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Inderal LA and Inderal XL uses

The Food and Drug Administration (FDA) approves prescription drugs such as Inderal LA and Inderal XL to treat certain conditions. Inderal LA and Inderal XL may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Inderal LA for prevention of migraine headache

Inderal LA is FDA-approved to help prevent migraine headaches in adults. Inderal XL is not approved for this use.

Inderal LA should not be taken to treat a migraine episode that’s already happening. It’s not known if the drug is safe or effective when used for this purpose. Your doctor will likely recommend a different medication to treat your migraine symptoms.

Migraine headache explained

Migraine is a condition that can cause a headache with pain or throbbing. Migraine episodes can include other symptoms such as nausea, vomiting, or changes in vision. An episode can last for hours to days.

To learn more about migraine, see our headache and migraine hub.

Effectiveness for prevention of migraine headache

Inderal LA is an effective option to help prevent migraine headaches. In fact, propranolol (the active drug ingredient in Inderal LA) is recommended in guidelines for migraine prevention. The guidelines are from the American Academy of Neurology and American Headache Society.

For details about how Inderal LA performed in clinical trials, see its prescribing information.

Inderal LA for stable angina

Inderal LA is FDA-approved for use in adults with a condition known as stable angina. The drug is used to decrease how often stable angina occurs. The drug is also used to help improve the ability to exercise. This could mean that you’re able to do more activities without experiencing stable angina symptoms.

Inderal XL is not approved to treat stable angina.

Stable angina explained

Stable angina (also called angina pectoris) is a condition that can cause chest pain. Stable angina occurs during activities, such as exercise, or when you’re feeling stressed. It usually goes away when you rest. This condition is due to a decrease in blood flow to your heart, which causes your heart to receive less oxygen than it needs. Symptoms may include:

• dizziness
• chest pain
• squeezing or pressure in your chest
• shortness of breath
• sweating

To learn more about stable angina, see our cardiovascular health hub.

Effectiveness for stable angina

Inderal LA is an effective treatment option to treat stable angina. Beta-blockers such as Inderal LA are recommended medications for adults with stable angina in treatment guidelines. The guidelines are from the American College of Cardiology (ACC) and the American Heart Association (AHA).

For details on how Inderal LA performed in clinical trials, see the drug’s prescribing information.

Inderal LA for hypertrophic subaortic stenosis

Inderal LA is FDA-approved to treat symptoms of a heart condition called hypertrophic subaortic stenosis (HSS) in adults. The medication is used to help lessen the severity of HSS.

To measure the severity of HSS, doctors use a scale from the New York Heart Association. The scale ranks symptoms of certain heart conditions from I (least severe) to IV (most severe). The scale is typically used to rank symptoms of heart failure. However, it can be used for other heart conditions that cause similar symptoms. This includes HSS.

Inderal XL is not currently approved to treat HSS.

Hypertrophic subaortic stenosis explained

HSS is a condition that occurs when the heart muscle becomes too thick. This makes it harder than usual for blood to flow through your heart. Symptoms of this condition may include:

• shortness of breath
• fatigue
• heart palpitations
• weight gain

To learn more about HSS, see our cardiovascular health hub.

Effectiveness for hypertrophic subaortic stenosis

Inderal LA is an effective treatment option for adults with HSS. In fact, beta-blockers such as Inderal LA are recommended options in treatment guidelines for this condition. The guidelines are from the ACC and AHA.

For details on how Inderal LA performed in clinical trials, see the drug’s prescribing information.

Inderal LA and Inderal XL for high blood pressure

Both Inderal LA and Inderal XL are FDA-approved to help manage high blood pressure.

In some cases, your doctor may recommend taking another medication, called a thiazide diuretic, in combination with Inderal LA. This can help manage your blood pressure even more.

It’s important to note that Inderal LA is not approved to treat a hypertensive emergency (blood pressure that’s dangerously high).

High blood pressure explained

High blood pressure is a very common condition. Your blood pressure is determined by the force of your blood pushing against the walls of your arteries. If your blood pressure is too high, it can increase your risk of developing other problems such as:

• heart problems, such as heart failure
• heart attack or stroke
• kidney problems, such as kidney failure
• vision problems, such as double vision or loss of vision

High blood pressure usually doesn’t cause any symptoms. When it becomes very high, possible symptoms can include headache, nosebleeds, chest pain, and trouble breathing.

To learn more about high blood pressure, see our cardiovascular health hub.

Effectiveness for high blood pressure

Inderal LA and Inderal XL are effective treatment options for adults with high blood pressure. Although these medications may not be the first treatment options for high blood pressure, they are recommended in treatment guidelines.

Specifically, beta-blockers such as Inderal LA or Inderal XL are recommended as options for high blood pressure in treatment guidelines. The guidelines are from the ACC and AHA.

For details about how these medications performed in clinical trials, see the Inderal LA and Inderal XL prescribing information.

Inderal LA and Inderal XL and children

Neither Inderal LA nor Inderal XL are approved to be prescribed for children. It’s not known if these medications are safe or effective for this age group.

However, there’s another form of propranolol (the active drug ingredient in both Inderal LA and Inderal XL) that’s approved for use in children. The medication is called Hemangeol, and it’s used to treat blood vessel conditions called hemangiomas.

You can talk with your child’s doctor about the right treatment options for their condition.

Inderal LA and Inderal XL use with other drugs

It’s possible that your doctor will prescribe other medications in combination with Inderal LA or Inderal XL.

For example, to treat high blood pressure, Inderal LA may be prescribed alone or with a medication called a thiazide diuretic. The diuretic may help manage your blood pressure better than taking just Inderal LA. Examples of thiazide diuretics include:

• chlorthalidone (Thalitone)
• hydrochlorothiazide (Microzide)
• chlorothiazide (Diuril)
• indapamide
• metolazone

Your doctor can recommend whether you should use other blood pressure medications in combination with Inderal LA or Inderal XL.

If your doctor prescribes Inderal LA to help prevent migraine headaches, they may also recommend medication for when you experience migraine. Examples of migraine treatment drugs include:

• sumatriptan (Imitrex)
• caffeine/aspirin/acetaminophen (Excedrin Migraine)
• lasmiditan (Reyvow)
• rimegepant (Nurtec ODT)
• rizatriptan (Maxalt, Maxalt-MLT)

If you have additional questions about your treatment plan, talk with your doctor.

Common questions about Inderal LA and Inderal XL

Here are answers to some frequently asked questions about Inderal LA and Inderal XL.

Do Inderal LA and Inderal XL come in 20-mg and 40-mg strengths?

No, neither Inderal LA nor Inderal XL is available in 20-milligram (mg) or 40-mg strengths. Both of these medications are extended-release forms of the drug propranolol.

The immediate-release form of propranolol is available in strengths of 20 mg and 40 mg. The brand-name version of propranolol, called Inderal, has been discontinued.

For more information about the right form and dosage of propranolol for you, talk with your doctor.

Are Inderal LA and Inderal XL beta-blockers?

Yes, Inderal LA and Inderal XL belong to a class of drugs called beta-blockers.

Beta-blockers are usually prescribed to help manage cardiovascular problems, such as high blood pressure. (Cardiovascular refers to the heart and blood vessels.) However, the drugs are used to treat other conditions as well.

For more information about how Inderal LA and Inderal XL work to treat your condition, see the “How Inderal LA and Inderal XL work” section below. You can also talk with your doctor or pharmacist.

Are Inderal LA and Inderal XL approved to treat tremors?

No, Inderal LA and Inderal XL are not approved to treat tremors. At this time, it’s not known whether the drugs are safe or effective for that purpose.

However, doctors may prescribe Inderal LA or Inderal XL off-label for tremors. Off-label drug use is when a drug that the Food and Drug Administration (FDA) has approved is prescribed for a purpose other than what it’s approved for.

One review showed that propranolol (the active ingredient in Inderal LA and Inderal XL) is effective at managing tremors.

If you’re interested in taking Inderal LA or Inderal XL for tremors, talk with your doctor. They can help determine the right treatment for you.

Do Inderal LA and Inderal XL cause weight gain?

Weight gain was not a side effect reported in clinical trials of people taking Inderal LA or Inderal XL. However, weight gain may be a symptom of a more serious side effect, such as congestive heart failure. It can cause swelling of the legs or feet, which may increase your body weight.

If you experience unexpected weight gain while taking Inderal LA or Inderal XL, talk with your doctor. They can help determine what may be causing it and suggest ways to manage it.

Inderal LA and Inderal XL dosage

The Inderal LA and Inderal XL dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking Inderal LA or Inderal XL to treat
• whether you’re taking Inderal LA or Inderal XL
• other medical conditions you may have
• other medications you’re taking

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Both Inderal LA and Inderal XL come as oral capsules.

Inderal LA is available in the following strengths: 60 milligrams (mg), 80 mg, 120 mg, and 160 mg.

Inderal XL is available in strengths of 80 mg and 120 mg.

Dosage for prevention of migraine headache

Inderal LA is approved to help prevent migraine headache. Your doctor will likely start you on a dosage of 80 mg once daily. Then they may increase your dose until the medication starts working to help prevent your migraine headaches. The usual recommended dosage is between 160 mg and 240 mg once daily.

If Inderal LA doesn’t work for you within 4–6 weeks of starting treatment, your doctor may have you switch to a different medication. In this case, they may slowly decrease your dose of Inderal LA so that you don’t experience side effects. It’s important that you do not stop taking this medication before talking with your doctor.

Inderal XL is not approved to help prevent migraine headache.

Dosage for high blood pressure

Both Inderal LA and Inderal XL are approved to treat high blood pressure. Inderal LA and Inderal XL have some differences in when they’re taken and how they’re released into your body after you take them. (For more information, see “When to take” in the “How to take Inderal LA and Inderal XL” section below.) Your doctor can recommend whether Inderal LA or Inderal XL is right for you.

Keep in mind that both medications can take several weeks before they have their full effects. It’s important that you do not stop taking Inderal LA or Inderal XL before talking with your doctor.

Inderal LA

For Inderal LA, the recommended starting dosage to treat high blood pressure is 80 mg once daily. If the medication isn’t managing your blood pressure well enough, your doctor may increase the once-daily dosage to 120 mg or higher.

The usual recommended dosage of Inderal LA is between 120 mg and 160 mg once daily. It’s possible that you may require a dosage of up to 640 mg once daily. Your doctor can help determine the right dosage for you.

In some cases, your doctor may prescribe Inderal LA in combination with another blood pressure medication called a thiazide diuretic. To learn more, see the “Inderal LA and Inderal XL use with other drugs” section above.

Inderal XL

For Inderal XL, the recommended starting dosage to treat high blood pressure is 80 mg once daily. Your doctor may increase the once-daily dosage up to 120 mg if needed.

In clinical trials of Inderal XL, doses higher than 120 mg did not show a greater effect on blood pressure. Therefore, your doctor will not likely recommend a once-daily dosage of more than 120 mg.

Dosage for stable angina

Inderal LA is approved to treat stable angina. The recommended starting dosage is 80 mg once daily. Your doctor may increase your dose every 3–7 days until the medication is working for you. The typical dosage is about 160 mg once daily.

A dosage higher than 320 mg once daily is not usually recommended. This is because it’s not known if dosages higher than 320 mg once daily are safe or effective.

Inderal XL is not approved to treat stable angina.

Dosage for hypertrophic subaortic stenosis

Inderal LA is approved to treat hypertrophic subaortic stenosis.* The usual recommended dosage of Inderal LA for this condition is between 80 mg and 160 mg once daily.

Inderal XL is not approved to treat hypertrophic subaortic stenosis.

* For details, see the “Inderal LA and Inderal XL uses” section above.

What if I miss a dose?

If you miss a dose of Inderal LA or Inderal XL, talk with your doctor or pharmacist. They may recommend taking your missed dose as soon as you remember. However, if it’s almost time for your next dose, they may have you skip your missed dose and take your next dose at the regularly scheduled time.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to use either drug long term?

Inderal LA and Inderal XL are meant to be used as long-term treatments. If you and your doctor determine that either Inderal LA or Inderal XL is safe and effective for you, you’ll likely take it long term.

Note: In addition to the information above, you can refer to this article for details about Inderal LA and Inderal XL dosages.

Inderal LA and Inderal XL and alcohol

Your doctor may recommend avoiding alcohol or limiting how much you drink during treatment with Inderal LA or Inderal XL. This is due to possible risks.

Alcohol may interact with Inderal LA and Inderal XL. Alcohol can increase or decrease the level of either drug in your system. This means drinking alcohol with Inderal LA or Inderal XL may increase your risk of side effects from the drug. Or the combination may cause the drug not to work as well as it should. Exactly how alcohol may affect the level of Inderal LA or Inderal XL in your system depends on how much you drink and how often.

Talk with your doctor about how much alcohol, if any, is safe for you during Inderal LA or Inderal XL treatment.

Inderal LA and Inderal XL interactions

Inderal LA and Inderal XL can interact with several other medications. It’s not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Inderal LA and Inderal XL and other medications

Below is a list of medications that can interact with Inderal LA and Inderal XL. This list does not contain all drugs that may interact with Inderal LA and Inderal XL.

Many of the clinical trials that were done to see which interactions may occur are based on the drug propranolol. Inderal LA and Inderal XL are both extended-release forms of propranolol.

Before taking Inderal LA or Inderal XL, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Types of drugs that can interact with Inderal LA and Inderal XL include:

• Warfarin. The medication warfarin (Jantoven) is used to treat certain heart conditions. Taking this drug with propranolol may increase your risk of side effects from warfarin.
• Propafenone. The drug propafenone (Rythmol SR) may be prescribed for heart conditions such as atrial fibrillation. Taking this drug with propranolol can increase your risk of side effects from propafenone.
• CYP2D6 blockers or other drugs that work on CYP2D6. Propranolol is broken down by a protein in your body called CYP2D6. Other medications may also affect this protein, including certain heart medications and antidepressants. Taking these medications with propranolol may increase your risk of side effects from propranolol. Examples of these medications include:
  • bupropion (Wellbutrin SR, Wellbutrin XL)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • quinidine
• CYP1A2 blockers or other drugs that work on CYP1A2. Propranolol is broken down by a protein in your body called CYP1A2. Other medications may also affect this protein, including certain antibiotics and antidepressants. Taking these medications with propranolol may increase your risk of side effects from propranolol. Examples of these medications include:
  • ciprofloxacin (Cipro)
  • fluvoxamine (Luvox)
• CYP2C19 blockers or other drugs that work on CYP2C19. Propranolol is broken down by a protein in your body called CYP2C19. Other medications may also affect this protein, including certain heart medications, antifungals, and antidepressants. Taking these medications with propranolol can increase your risk of side effects from propranolol. Examples of these medications include:
  • fluconazole (Diflucan)
  • fluvoxamine (Luvox)
  • ticlopidine
• Drugs that cause the body to break down Inderal LA or Inderal XL more quickly than usual. Some drugs may cause your body to get rid of Inderal LA or Inderal XL too quickly. (These medications can be used for many different purposes, such as seizures, asthma, or infections.) They decrease the level of propranolol in your body, which can make propranolol less effective than usual. Examples of these medications include:
  • phenobarbital
  • phenytoin (Dilantin)
  • montelukast (Singulair)
  • rifampin (Rimactane)
• Certain cholesterol medications. Certain cholesterol medications can decrease the effectiveness of propranolol. Examples of these drugs include:
  • cholestyramine (Prevalite)
  • colestipol (Colestid)
• Clonidine. Taking clonidine (Catapres-TTS-1, Kapvay, Nexiclon XR) with propranolol may lead to a severely slowed heart rate. And stopping treatment with clonidine while taking Inderal LA or Inderal XL can cause high blood pressure. Be sure to tell your doctor if you plan to stop taking clonidine. They may monitor your blood pressure more often than usual during this time.
• Alpha-blockers. Drugs called alpha-blockers may be used to treat high blood pressure. Taking alpha-blockers with propranolol may cause very low blood pressure or even fainting. Examples of alpha-blockers include:
  • prazosin (Minipress)
  • doxazosin (Cardura)
• Dobutamine. A drug known as dobutamine may be used for certain heart tests. If you also take propranolol, it’s possible for propranolol to decrease the effectiveness of these tests.
• Monoamine oxidase inhibitors or tricyclic antidepressants. Drugs called monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) may be used to treat depression. These medications may increase the risk of low blood pressure when taken with propranolol. Examples of these medications include:
  • amitriptyline
  • nortriptyline (Pamelor)
  • tranylcypromine (Parnate)
  • phenelzine (Nardil)
• Nonsteroidal anti-inflammatory drugs. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) with propranolol may decrease the effectiveness of propranolol. Examples of NSAIDs include:
  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)
• Antiarrhythmic drugs. Medications called antiarrhythmics may be used for irregular heart rhythms such as atrial fibrillation. Taking one of these drugs with propranolol may increase the risk of side effects from the antiarrhythmic or propranolol. Examples of these drugs include:
  • quinidine
  • lidocaine (Xylocaine)
  • propafenone (Rythmol SR)
• Calcium channel blockers. Medications called calcium channel blockers (CCBs) may be used to help manage blood pressure. Taking a CCB with propranolol may increase the risk of side effects from either medication, including a slowed heart rate. Examples of these drugs include:
  • nifedipine (Procardia XL)
  • nisoldipine (Sular)
  • nicardipine
• Certain migraine medications. Taking certain migraine medications with propranolol may increase your risk of side effects from both of these drugs. Examples of other migraine medications include:
  • zolmitriptan (Zomig)
  • rizatriptan (Maxalt and Maxalt-MLT)
• Theophylline. A drug called theophylline (Theo-24) may be used to treat certain lung conditions, such as asthma. Taking theophylline with propranolol may make theophylline less effective than usual.
• Diazepam. A medication known as diazepam (Valium) may be prescribed for anxiety or seizure disorders. Taking diazepam with propranolol can increase the risk of side effects from diazepam.
• Chlorpromazine. This medication may be used for mood disorders, such as schizophrenia. Taking chlorpromazine with propranolol may increase the risk of side effects from propranolol.
• Digoxin. A medication called digoxin (Lanoxil) is prescribed for certain heart conditions, such as heart failure. Taking digoxin with propranolol may increase the risk of side effects from either medication, including a slowed heart rate.
• Certain ulcer medications. Taking certain medications to treat stomach ulcers with propranolol can increase the risk of side effects from propranolol. In other cases, the drug combination can make propranolol less effective than usual. Examples of certain ulcer medications include:
  • cimetidine (Tagamet HB)
  • aluminum hydroxide (Mylanta)

Inderal LA and Inderal XL and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Inderal LA and Inderal XL. However, you should still check with your doctor or pharmacist before using any of these products while taking Inderal LA or Inderal XL.

Inderal LA and Inderal XL and foods

It’s not known if food affects how well Inderal LA works. The manufacturer of the drug has not made any recommendations as to whether or not you should take the drug with food.

Inderal XL should be taken consistently either with food or without food. This means that if you start taking the medication on an empty stomach, you should continue taking each dose on an empty stomach. And if you start taking Inderal XL with food, you should keep doing so for future doses. This is because food may affect how well the medication works in your body.

Inderal LA and Inderal XL and lab tests

Inderal LA and Inderal XL may interact with certain lab tests, including the following:

• Potassium level test. Inderal LA and Inderal XL can increase your blood potassium level.
• Liver function tests. These tests measure the levels of certain liver substances to see how well the organ is working. It’s possible for Inderal LA or Inderal XL to increase the levels.
• Blood urea nitrogen test. This test (also called a BUN test) is a measure of kidney function. Inderal LA or Inderal XL can cause increased levels of BUN, especially if you also have severe heart failure.
• Thyroid function tests. These tests measure the levels of thyroid hormones. It’s possible for Inderal LA or Inderal XL to increase or decrease the levels.
• Dobutamine stress test. Stress tests measure how well your heart is working. Some of these tests involve taking a drug called dobutamine. If you have a dobutamine stress test while taking propranolol, the results may not be accurate.
• Glaucoma test. Tests for glaucoma measure the pressure in your eye. Inderal LA and Inderal XL can decrease eye pressure. If you have a glaucoma test during treatment with either medication, the results may not be accurate.

Before you have any of the above lab tests, tell your doctor that you’re taking Inderal LA or Inderal XL.

Inderal LA and Inderal XL cost

As with all medications, the cost of Inderal LA and Inderal XL can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks* for price estimates of Inderal LA and Inderal XL. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance: A program called eVoucherRx is available for Inderal XL. For more information and to find out if you’re eligible for support, visit the program website.

To learn more about saving money on prescriptions, check out this article.

Generic version: Inderal LA and Inderal XL are available in generic forms called extended-release propranolol capsules. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of extended-release propranolol compares with the cost of Inderal LA and Inderal XL, talk with your doctor or pharmacist.

* Optum Perks is a sister site of Medical News Today.

Inderal LA and Inderal XL overdose

Taking more than the recommended dosage of Inderal LA or Inderal XL can lead to serious side effects. Do not take more of the medication than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

• low blood pressure
• slowed heart rate
• difficulty breathing

What to do in case of overdose

If you think you’ve taken too much of either drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. If your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

How to take Inderal LA and Inderal XL

You should take Inderal LA or Inderal XL according to the instructions your doctor gives you.

Inderal LA and Inderal XL come as oral capsules.

When to take

If your doctor prescribes Inderal LA, take a dose once daily at any time of day. Taking Inderal LA around the same time of day helps keep a steady level of the drug in your body. This helps the medication work effectively.

If you’re prescribed Inderal XL, take a dose once daily at bedtime. The drug is designed to release into your body overnight and reach its highest levels in the morning. This helps better manage blood pressure increases that can happen after you wake up. Inderal XL continues working to manage your blood pressure throughout the day.

It’s important that you do not stop taking Inderal LA or Inderal XL before talking with your doctor. Suddenly stopping treatment can increase your risk of serious side effects such as chest pain or cardiac arrest. (The term cardiac arrest refers to a condition in which the heart stops beating.)

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Inderal LA and Inderal XL in an easy-open container. They also may be able to recommend tools that can make it simpler to open lids.

Taking Inderal LA or Inderal XL with food

It’s not known if food affects how well Inderal LA works. The manufacturer of the drug has not made any recommendations as to whether or not you should take the drug with food.

You should take Inderal XL consistently either with food or without food. This means that if you start taking the medication on an empty stomach, you should continue taking each dose on an empty stomach. And if you start taking Inderal XL with food, you should keep doing so for future doses. This is because food may affect how well the medication works in your body.

Can Inderal LA and Inderal XL be crushed, split, or chewed?

No, you should not crush, split, or chew Inderal LA or Inderal XL capsules. These capsules work slowly over time to release medication into your body throughout the day. This helps manage your condition all day with one dose. If you crush, split, or chew the capsules, all of the medication may be released at once. This can increase your risk of side effects.*

If you have difficulty swallowing Inderal LA or Inderal XL capsules, talk with your doctor or pharmacist.

* For information on the drugs’ side effects, see the “Inderal LA and Inderal XL side effects” section above.

How Inderal LA and Inderal XL work

Here’s some information on how Inderal LA and Inderal XL work.

Prevention of migraine

Inderal LA is used to help prevent migraine headaches. Migraine is a condition that can cause a headache with pain or throbbing. Migraine episodes can include other symptoms such as nausea, vomiting, or changes in vision. The episodes may be due to brain changes involving chemical balances, nerves, and blood vessels.

It’s not known exactly how Inderal LA works to help prevent migraine headaches. It’s possible that the drug may relax blood vessels in your brain. This may help prevent pain that’s due to migraine headache.

Stable angina

Inderal LA is approved to treat stable angina, which is a condition that can cause chest pain. Stable angina occurs during activities, such as exercise, or when you’re feeling stressed. It usually goes away when you rest. This condition is due to a decrease in blood flow to your heart, which causes your heart to receive less oxygen than it needs.

Inderal LA works by decreasing the amount of oxygen that your heart needs. The drug does this by lowering your heart rate and blood pressure, which eases symptoms of angina.

In addition, Inderal LA works to decrease angina pain during exercise. This allows you to do more activities without angina symptoms.

Hypertrophic subaortic stenosis

Inderal LA is approved to ease symptoms of a heart condition called hypertrophic subaortic stenosis (HSS). This condition occurs when the heart muscle becomes too thick, which makes it harder than usual for blood to flow through your heart.

The manufacturer of Inderal LA hasn’t reported exactly how it works to ease symptoms in people with HSS. However, it’s possible that the medication may relax your blood vessels. This can help your heart pump more blood throughout your body.

High blood pressure

Both Inderal LA and Inderal XL are approved to help manage high blood pressure.

Your blood pressure is determined by the force of your blood pushing against the walls of your arteries. The pressure can increase or decrease at different times during the day. In general, your blood pressure is lower while sleeping and increases in the morning after you wake up. If your blood pressure is too high, it can increase your risk of developing serious problems, such as heart disease or kidney problems.

It’s not known exactly how Inderal LA and Inderal XL work to manage high blood pressure. However, it’s believed that the drugs work by:

• decreasing the amount of blood that your heart pushes through your body
• decreasing the level of a hormone called renin that helps manage blood pressure
• relaxing your blood vessels, which decreases the pressure of blood pushing against vessel walls

­­­Inderal LA and Inderal XL have some differences in how they’re released into your body. For details, see “When to take” in the “How to take Inderal LA and Inderal XL” section above.

How long do they take to work?

Inderal LA and Inderal XL begin working as soon as you take your first dose. However, it may take weeks for these drugs to work at their full effect. As a result, you may not notice that the medication is working right away.

Even if you don’t notice changes in how you feel when taking Inderal LA or Inderal XL, you should still continue taking it. Suddenly stopping treatment may cause serious side effects, including chest pain and cardiac arrest (a condition in which the heart stops beating). If you’d like to stop taking Inderal LA or Inderal XL for any reason, be sure to talk with your doctor first.

Inderal LA and Inderal XL and pregnancy

It’s not known if Inderal LA and Inderal XL are safe to take while pregnant. At this time, there haven’t been any clinical trials of either of these medications during pregnancy.

However, there have been reports of growth problems and congenital anomalies (commonly known as birth defects) in children born to people who took propranolol during pregnancy. Propranolol is the active drug in both Inderal LA and Inderal XL.

When propranolol was taken at birth or just before delivery, some newborns had a slowed heart rate, hypoglycemia, or difficulty breathing.

Propranolol has also been tested in animal studies. Some results suggest that the drug may be safe. However, other results show that propranolol may increase the risk of pregnancy loss. Keep in mind that animal studies don’t always predict what may happen in humans.

It’s important to note that unmanaged high blood pressure or other heart problems during pregnancy may harm the fetus and pregnant person.

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Inderal LA or Inderal XL. Your doctor can help determine the right treatment plan for you.

Inderal LA and Inderal XL and fertility

It’s possible for propranolol to cause erectile dysfunction. The drug may also cause a decrease in sperm production.

If you have concerns about Inderal LA or Inderal XL affecting your fertility, talk with your doctor. They may be able to recommend a different treatment option for you.

Inderal LA and Inderal XL and birth control

It’s not known if Inderal LA and Inderal XL are safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs during Inderal LA or Inderal XL treatment..

For more information about taking Inderal LA or Inderal XL during pregnancy, see the “Inderal LA and Inderal XL and pregnancy” section above.

Inderal LA and Inderal XL and breastfeeding

It’s not known if it’s safe to take Inderal LA or Inderal XL while you’re breastfeeding a child. The drug passes into breast milk, which means the child will be exposed to it. However, it’s unknown if either medication may affect a breastfed child or breast milk production.

If you’re breastfeeding or considering it, talk with your doctor. They can advise you on the pros and cons of Inderal LA and Inderal XL.

Inderal LA and Inderal XL precautions

These drugs come with several precautions. Before taking Inderal LA or Inderal XL, talk with your doctor about your health history. Inderal LA and Inderal XL may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Inderal LA and Inderal XL, see the “Inderal LA and Inderal XL side effects” section above.

Smoking. Smoking can cause your body to break down Inderal LA and Inderal XL too quickly. Without enough medication in your system, the drug may not work as well as usual. If you smoke, tell your doctor before taking either medication. They may be able to suggest tips on quitting.

Liver problems. Inderal LA and Inderal XL are broken down by your liver. If you have liver problems, your body may not be able to break down these drugs as it usually would. This can cause the medication to build up in your body, which can increase your risk of side effects. If you have liver problems, talk with your doctor to see whether either drug is safe for you to take.

Kidney problems. Before you start treatment with Inderal LA or Inderal XL, be sure to tell your doctor whether you have any kidney problems. These problems may decrease your body’s ability to break down either drug. This can mean the medication could build up in your body, increasing your risk of side effects. Your doctor can help determine what treatment is right for you.

Glaucoma or other vision problems. Inderal LA and Inderal XL may decrease the pressure in your eye. This can affect the results of certain vision tests.* If you have glaucoma or any vision problems, be sure to tell your doctor that you’re taking Inderal LA or Inderal XL.

Slowed heart rate. If you have a slowed heart rate, your doctor may recommend a medication other than Inderal LA or Inderal XL. These drugs can decrease your heart rate further, which could become serious. If you have a slowed heart rate, tell your doctor before taking Inderal LA or Inderal XL.

Heart failure or other heart problems. Inderal LA and Inderal XL may worsen symptoms of heart failure. If you have or have had heart failure, it’s important to tell your doctor. In some situations, it may be safe to take Inderal LA or Inderal XL if you have heart failure. Your doctor may monitor your condition more often than usual. In other situations, your doctor may recommend a different treatment option.

Also, be sure to tell your doctor about any heart conditions you have, such as heart block or sick sinus syndrome. They can help determine whether it’s safe for you to take Inderal LA or Inderal XL.

Lung problems. Be sure to tell your doctor if you have any lung problems, such as emphysema or asthma. Inderal LA and Inderal XL may increase your risk of asthma attacks, which may make breathing difficult. The two medications may also affect drugs you may be taking to ease your symptoms of lung problems. If you have lung problems, your doctor will not likely recommend Inderal LA or Inderal XL. They can suggest a different treatment option.

Major surgery. Inderal LA and Inderal XL may affect anesthesia and other procedures used during surgery. In most cases, you won’t need to stop taking either Inderal LA or Inderal XL. However, if you have a major surgery planned, be sure your doctors are aware that you’re taking the medication.

Diabetes or high blood sugar. Beta-blockers such as Inderal LA or Inderal XL may block symptoms of low blood sugar. These symptoms can include changes in your heart rate and blood pressure. While you take either drug, your doctor may monitor your blood sugar levels more often than usual. This may help prevent them from becoming too low.

Thyroid problems. It’s possible for Inderal LA and Inderal XL to block symptoms of an overactive thyroid, which may also be known as hyperthyroidism. These drugs may also affect certain thyroid blood tests.* If you have thyroid problems, your doctor may monitor you more often than usual or recommend a different medication.

Wolff-Parkinson-White syndrome. If you have a heart condition called Wolff-Parkinson-White syndrome, Inderal LA and Inderal XL may cause a severely slowed heart rate. Before you start taking either drug, be sure to tell your doctor whether you have this syndrome. They may monitor your heart rate more often than usual or recommend a different treatment option.

Allergic reaction. If you’ve had an allergic reaction to Inderal LA, Inderal XL, or any of their ingredients, your doctor will likely not prescribe Inderal LA or Inderal XL. Ask your doctor about other medications that may be better options for you.

Pregnancy. It’s not known whether it’s safe to take Inderal LA or Inderal XL during pregnancy. For more information, see the “Inderal LA and Inderal XL and pregnancy” section above.

Breastfeeding. It’s not known whether it’s safe to take Inderal LA or Inderal XL while breastfeeding. For more information, see the “Inderal LA and Inderal XL and breastfeeding” section above.

* To learn more, see “Inderal LA and Inderal XL and lab tests” in the “Inderal LA and Inderal XL interactions” section above.