Inderal (propranolol) is a brand-name prescription medication that comes in two different forms: Inderal LA and Inderal XL. Both forms are extended-release drugs.*
The Food and Drug Administration (FDA) has approved both forms of Inderal to treat hypertension (high blood pressure) in adults.
Inderal LA is also approved to:
- reduce episodes of chest pain in adults with stable angina
- improve heart function in adults with hypertrophic subaortic stenosis (a condition that makes it hard for blood to flow through the heart)
- help prevent migraine headaches
Both Inderal LA and Inderal XL are typically taken long term for these uses.
Here are some fast facts about Inderal:
- Active ingredient: propranolol
- Drug class: beta-blockers
- Drug form: oral capsule
As with other drugs, Inderal can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Inderal, including details about its uses, see this article.
* Extended-release medications release the active drug slowly into your body over time. Both Inderal LA and Inderal XL have a long-acting effect. However, they release propranolol into your body in slightly different ways after you take a dose.
Inderal can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
These are just a few of the more common side effects reported by people who took Inderal LA or Inderal XL in clinical trials:
* For more information about this side effect, see “Side effect specifics” below.
Mild side effects can occur with Inderal use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to the prescribing information for Inderal LA and Inderal XL.
Mild side effects that have been reported with Inderal include:
- abdominal pain
- nausea and vomiting
- vivid dreams
- memory loss
- changes in vision, such as blurry vision
- dry eyes
- erectile dysfunction
- cold or numb hands or feet*
- slightly slowed heart rate*
- mild allergic reaction*
These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Inderal and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see “Side effect specifics” below.
Inderal may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to the prescribing information for Inderal LA and Inderal XL.
If you develop serious side effects while taking Inderal, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects that have been reported and their symptoms include:
- New or worsening heart failure. Symptoms can include:
- sudden weight gain
- shortness of breath
- swollen ankles or feet
- Thrombocytopenia (low levels of platelet cells). Symptoms can include:
- bruising easily
- bleeding, such as nosebleeds or bleeding gums
- Severe skin reactions, such as Stevens-Johnson syndrome (a rare and serious skin disorder). Symptoms can include:
- severe widespread skin rash
- skin blistering
- skin peeling
- Severely slowed heart rate.*
- Chest pain or heart attack if you suddenly stop taking Inderal*
- Severe allergic reaction.†
* To learn more about this side effect, see the “Side effect specifics” section below.
† An allergic reaction is possible after taking Inderal. However, it’s not clear whether this side effect occurred in clinical trials of Inderal LA or Inderal XL. To learn more, see the “Side effect specifics” section below.
Inderal may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.
Is weight gain a side effect of Inderal LA or Inderal XL?
Weight gain wasn’t reported as a side effect in clinical trials of Inderal LA and Inderal XL. However, Inderal can sometimes cause new or worsening heart failure. And sudden weight gain may be a symptom of heart failure. In this case, weight gain happens due to a buildup of fluid in your body.
If you have weight gain that’s sudden and unexpected while taking Inderal, talk with your doctor. They may want to check your heart.
Do Inderal LA or Inderal XL cause hair loss?
It’s possible for Inderal LA or Inderal XL to cause hair loss. This side effect has been reported in people taking various forms of propranolol (the active drug in Inderal LA and Inderal XL). However, this side effect is rare.
If you’re concerned about hair loss with Inderal LA or Inderal XL, talk with your doctor.
I’m taking Inderal LA for migraine headache. What side effects can I expect?
The possible side effects of Inderal are the same, whether you take it for migraine headache or any of its other uses. For more information, see the “Mild side effects of Inderal LA and Inderal XL” and “Serious side effects of Inderal LA and Inderal XL” sections above.
If you have questions about what side effects to expect from Inderal treatment, talk with your doctor.
Learn more about some of the side effects that Inderal may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Inderal LA and Inderal XL.
Inderal works to reduce blood pressure, so some people may experience dizziness or lightheadedness while taking the drug. In clinical trials, dizziness was one of the more common side effects reported with Inderal LA and Inderal XL.
Dizziness is more likely to happen with the first few doses of Inderal. It typically gets better as you continue to take the drug. Some people may only feel dizzy when standing up from lying down, sitting, or crouching.
You may be more likely to have dizziness with Inderal if you take it with certain other medications. Examples of these include:
- other blood pressure medications, especially alpha-blockers such as prazosin (Minipress)
- certain antidepressants
- certain antipsychotics
What you can do
You can help avoid dizziness if you move slowly when changing positions or standing up. If you feel dizzy while taking Inderal, sit or lie down until the feeling passes.
If you have dizziness after starting Inderal treatment, you should avoid driving or doing other potentially dangerous activities until your dizziness eases. It’s also best to avoid drinking alcohol, as this can worsen dizziness.
If you have dizziness that’s severe, bothersome, or lasts longer than 1 to 2 weeks, talk with your doctor. They may check your blood pressure. If needed, they may reduce your dosage of Inderal. (To learn more about Inderal’s dosage, see this article.)
Cold or numb hands or feet
Inderal can sometimes cause cold or even numb hands or feet. This is because the drug can reduce blood flow to these areas. It’s not known how often this side effect occurs with Inderal.
You’re more likely to have cold hands and feet with Inderal if you already have poor blood circulation in these parts of your body.
What you can do
If you have cold or numb hands or feet with Inderal treatment, it may help to massage or wiggle them to stimulate blood flow. Holding them under warm water can also be helpful.
Also, to decrease the risk of this side effect, you should avoid smoking and drinking caffeine. These can restrict blood flow to your hands and feet. Try to avoid wearing tight watches or bracelets for the same reason. It can be helpful to wear warm socks on your feet and mittens on your hands rather than gloves.
If you have this side effect and it’s bothersome to you, talk with your doctor. They may recommend switching to a different medication for your condition.
Slowed heart rate
Inderal can cause bradycardia (slower resting heart rate than is typical). This is because the drug works by slowing down your heart rate. What’s considered a slow heart rate depends on your age, physical health, and fitness. It’s not known how often this side effect occurs with Inderal LA and Inderal XL.
Typically, Inderal causes mild bradycardia that doesn’t tend to cause symptoms. However, it can sometimes cause:
- shortness of breath
- trouble exercising
In rare cases, Inderal may cause severe bradycardia. This can be serious because it can reduce blood flow around your body. Reduced blood flow can cause chest pain, heart failure, or kidney failure. It could even lead to a heart attack.
You may have an increased risk of severe bradycardia if you have certain heart conditions, such as heart block (a type of irregular heartbeat) or sick sinus syndrome (a type of abnormal heart rhythm).
You may also have an increased risk of this side effect if you take certain other medications with Inderal. Examples of these include:
- diltiazem (Cardizem CD, Cartia XT, Tiazac, others)
- verapamil (Verelan, Calan SR)
- clonidine (Catapres TTS, Nexiclon XR, Duraclon, Kapvay)
- digoxin (Lanoxin)
If you have a heart condition that increases your risk of severe bradycardia, your doctor will likely not prescribe Inderal.
What you can do
Your doctor will likely monitor your heart rate while you’re taking Inderal, especially when you first start treatment and after any dose changes. Talk with your doctor about what’s considered a healthy heart rate for you.
If you feel that your heart is beating too slowly or slower than is typical, talk with your doctor. They may check your heart and reduce your Inderal dosage if needed. (To learn more about Inderal’s dosage, see this article.)
Chest pain or heart attack if you suddenly stop taking Inderal
For some people who suddenly stop taking Inderal, their heart may suddenly start beating faster. This may cause chest pain and could even lead to a heart attack. It’s not known how often this side effect occurs with Inderal LA and Inderal XL.
Warning signs of a heart attack may include:
- pressure, tightness, or heaviness in the chest
- pain that spreads to the jaw, neck, back, or arms
- shortness of breath
- nausea or vomiting
What you can do
You should not suddenly stop taking Inderal. If you want to stop taking this medication, talk with your doctor first. They will typically recommend lowering your dosage gradually before completely stopping Inderal treatment.
As with most drugs, Inderal can cause an allergic reaction in some people. However, it’s not clear whether this side effect occurred in clinical trials of Inderal LA or Inderal XL.
Symptoms can be mild or serious and can include:
- skin rash
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it hard to breathe
What you can do
For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Inderal. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Be sure to talk with your doctor about your health history before you take Inderal. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are known as drug-condition or drug-factor interactions. The conditions and factors to consider include:
Allergic reaction. If you’ve had an allergic reaction* to Inderal or any of its ingredients, your doctor will likely not prescribe Inderal. Ask your doctor what other medications may be better options for you.
History of allergies. If you have a history of severe allergic reactions, your allergies may worsen during Inderal treatment. This may include allergies to certain foods, drugs, or insect stings. Also, Inderal can make epinephrine (Epipen, Adrenaclick, Adrenalin) less effective at treating severe allergic reactions, such as anaphylaxis. If you have severe allergies, talk with your doctor about whether Inderal is right for you.
Lung problems. Inderal can sometimes cause trouble breathing and may worsen lung conditions. These include asthma and chronic obstructive pulmonary disease (COPD). Due to this risk, your doctor will likely not prescribe Inderal if you have a lung problem, especially if you have asthma. Ask your doctor what other medications may be better options for you.
Heart failure, slow heart rate, and other heart problems. Inderal slows down your heart rate* and makes it beat less forcefully. This means the drug can worsen certain heart conditions, especially those that cause a slow heart rate or heart failure.
If you have a heart condition, talk with your doctor about whether Inderal is right for you. In some cases, you may be able to take Inderal if your heart condition is monitored more often than is typical. However, if you have heart failure that’s not managed, cardiogenic shock, sick sinus syndrome, heart block, or a very slow heart rate, your doctor will likely not prescribe Inderal. Ask them what other medications may be better options for you.
Diabetes. If you have diabetes, especially type 1 diabetes, your diabetes treatment could cause hypoglycemia. Inderal can reduce some of the symptoms of hypoglycemia, such as tremor and fast heartbeat. So if you have an episode of hypoglycemia while you’re taking Inderal, you may be less aware of it. This may increase your risk of severe hypoglycemia. If you have diabetes, your doctor may recommend monitoring your blood sugar more often while you’re taking Inderal.
Thyroid problems. Inderal can reduce some of the symptoms of hyperthyroidism, such as tremor and fast heartbeat. It may also affect the results of certain thyroid tests. If you have a thyroid problem, talk with your doctor about how Inderal may affect your condition. They’ll determine whether this drug is right for you.
Kidney or liver problems. If you have a kidney or liver problem, Inderal may build up in your body. This could raise your risk of side effects, so your doctor may prescribe a dosage† of Inderal that’s lower than is typical. And they may monitor your blood pressure and heart rate more often than usual.
Glaucoma. Inderal can reduce the pressure in your eyes, so it may affect the results of certain eye tests used to diagnose or monitor glaucoma. If you have glaucoma or have eye tests for glaucoma, be sure to tell your optometrist that you’re taking Inderal. If your doctor recommends you stop taking Inderal, your eye pressure may increase again.
Peripheral vascular disease or Raynaud’s syndrome. Inderal can reduce blood flow to your hands and feet, so it may worsen symptoms of peripheral vascular disease and Raynaud’s syndrome. If you have one of these conditions, talk with your doctor about whether Inderal is right for you.
Surgery. Inderal may change how your heart reacts to anesthesia and surgery. You can typically keep taking Inderal before and after surgeries. However, if you have upcoming surgery, make sure to tell your doctor you’re taking Inderal.
Smoking. Smoking may make Inderal less effective. If you smoke, be sure to tell your doctor. They can recommend ways to help you quit.
Other medications. Taking Inderal with certain other medications‡ may increase your risk of Inderal side effects. If you take any other medications, including over-the-counter medications, herbs, and supplements, be sure to talk with your doctor about whether these may interact with Inderal.
* For more information about this side effect, see “Side effect specifics” above.
† To learn more about Inderal’s dosages, see this article.
‡ For details about what can interact with Inderal, see this article.
Alcohol with Inderal
Alcohol can interact with Inderal. It can increase the level of this medication in your body, which may raise your risk of side effects.
Also, drinking alcohol with Inderal may increase side effects of the drug, such as fatigue and dizziness.
Your doctor will likely recommend that you avoid drinking alcohol or limit how much you drink while you’re taking Inderal. If you drink alcohol, talk with your doctor about how much alcohol, if any, is safe to consume while you’re taking Inderal.
Pregnancy and breastfeeding while taking Inderal
It isn’t known whether Inderal is safe to take during pregnancy or breastfeeding.
Inderal hasn’t been studied specifically in people who are pregnant. However, propranolol (the active drug in Inderal) has been used during pregnancy for many years. Reports over this time suggest that propranolol doesn’t appear to increase the risk of congenital anomalies (commonly known as birth defects). It also doesn’t seem to increase the risk of pregnancy loss.
However, other reports suggest that taking propranolol near to delivery may cause slow heart rate, breathing problems, and low blood sugar in the newborn.
If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of taking Inderal.
Propranolol may pass into breast milk in small amounts. However, it’s not known whether the drug affects a child who’s breastfed. If you’re breastfeeding or plan to breastfeed, talk with your doctor about the best way to feed your child while taking Inderal.
Inderal has a few common side effects, though these are typically mild. And they ease as your body gets used to the medication. However, as with many drugs, some serious side effects are also possible.
If you’d like to learn more about Inderal, talk with your doctor or pharmacist. They can help answer any questions you have about the drug’s side effects.
Besides talking with your doctor, you can do some research on your own. These articles might help:
- More information about Inderal. For details about other aspects of Inderal, refer to this article.
- Dosage. For information about the dosage of Inderal, view this article.
- A look at your condition. For details about your condition, see our:
- cardiovascular health hub and this list of high blood pressure articles
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.