Other names: Inderal LA (a combination product with hydrochlorothiazide)

Inderal Online - Prescription Consultation Through AccessMedNet Listings

Inderal is a beta-adrenergic blocker, more commonly known as a beta-blocker. This class of anti-hypertensive medication prevents high blood pressure by reducing the body's sensitivity to certain chemicals produced by the sympathetic nervous system that cause blood vessels to contract and blood pressure to go up. It isn't known exactly how Inderal works to reduce vascular headaches and tremors.

This medication is mainly prescribed for effort-induced angina, controlling irregular heartbeat, high blood pressure (hypertension), prevention of heart attacks or to decrease the likelihood of a second attack, reduction of migraine headache, reduction of certain tremors (essential and action), and as a combination therapy in cancer of the adrenal glands.

Other uses include the treatment of overactive thyroid, prescription drug related headaches, control of panic attacks or physical anxiety responses, reducing symptoms of narcotic withdrawal, preventing excess abdominal fluid accumulations in cirrhosis patients, and as a combination therapy to treat serious Giardia infection.

While it may take 6-8 weeks of continuous use to see the full benefits, some progress should be noted within 10-14 days. Individuals using this therapy are advised to have regular checkups with their doctor to monitor their progress. As high blood pressure has few or no symptoms until the advanced stages, it can be difficult to tell how treatment is progressing without consulting your doctor.

This medication is most effective in treating high blood pressure when combined with a low salt diet, smoking cessation, and weight control measures, as needed. As with all cardiovascular medications, Inderal works best when taken at the same time of day, every day, to maintain consistent blood levels.

Inderal is only available by prescription.

Inderal Side Effects

Common Side Effects: Cold extremities, lethargy, more frequent bowel movements, sensitivity to cold, slower heartbeat.

Possible Mild Side Effects: These side effects are unexpected, and should be reported to your doctor for evaluation. Allergic reaction (drug fever with sore throat, rash, temporary hair loss), altered blood sugar levels, constipation, diarrhea, dizziness, headache, indigestion, insomnia, joint pain, nausea, swollen feet or ankles, unusual dreams, vomiting, weight gain.

Possible Serious Side Effects: These side effects are very rare and potentially dangerous. Seek medical treatment immediately if you experience any of the following. Allergic reaction (anaphylactic shock), behavioral difficulties (amnesia, anxiety, confusion, depression, hallucination), blood cell disorders (low white cell or platelet counts), bronchial asthma (in asthmatics only), carpal tunnel syndrome, chest pain, congestive heart failure, difficulty walking, dizziness when standing, drug induced illness (lupus, myasthenia gravis, porphyria), hypertension, hyperthyroidism, kidney disease, peripheral neuropathy, shortness of breath, unusual bleeding or bruising.

Overdose: Signs of overdose begin with an unusually slow or fast and irregular heartbeat followed by severe dizziness and possible fainting. Difficulty breathing, bluish colored palms or fingernails, and seizures may result. Emergency medical attention is required in theses circumstances. If you or someone in your household takes this medication, be sure that everyone is familiar with these signs and knows to call for emergency help.

Cautions: This medication is not for everyone, and may require a degree of caution for use in some individuals. Be especially sure to discuss a history of any of the following with your doctor to ensure safe and effective treatment.

• Allergies: Inform your doctor if you have ever had an allergic reaction to other anti-hypertensive medications, bee stings, or airborne contaminants.
• Cardiovascular Conditons: Coronary artery spasm (Prinzmetal's); do not use. Heart failure; do not use. Unusually slow heartbeat (bradycardia); do not use. Serious heart block; do not use. History of heart disease; use with caution, examine all treatment options with your doctor. This medication may cause undesirable side effects in the cardiovascular system is abruptly stopped, especially for individuals with a history of heart conditions. Always follow your medication schedule exactly, and make sure you have an adequate supply available for vacations or holidays.
• Depression: May be worsened by beta-blockers.
• Diabetes: This medication may interact with treatments for diabetes by lowering blood sugar too drastically, producing hypoglycemia. It may also raise blood sugar in some individuals, Regular blood sugar tests may be necessary to gauge a safe and effective dose.
• Hypoglycemia: This medication may cause low blood sugar. If you are a migraine sufferer whose headaches are triggered in part by low blood sugar, you may want to examine your treatment options carefully. Signs of hypoglycemia like confusion, dizziness, irritability, or sweating won't be hidden by the effects of the medication.
• Lab Tests: X-Ray contrast preparations may increase the risk of severe allergic reactions which are dangerous and potentially life-threatening. Several types of blood tests may also be affected, as well as certain liver tests. Inform medical personnel in advance if you need to go in for any tests.
• Kidney or Liver Disease: Increased chance of side effects as the medication may stay in the body longer.
• Myasthenia Gravis: This weakness in the muscles my be exaggerated by beta-blockers.
• Overactive Thyroid: Beta-blockers can hide the racing heartbeat symptomatic of this condition.
• Psoriasis: This skin condition can be worsened by beta-blockers. It's not clear how many psoriasis cases are caused by allergies, though these medications are known to make other allergic conditions worse.
• Raynaud's phenomenon: This condition, characterized by chronic poor circulation in the extremities leads to sensations of cold, tingling, or numbness. Some individuals have developed Raynaud's while taking Inderal, or have had their condition worsened. Cold extremities are a common side effect of treatment, though you may want to check with your doctor if it occurs.
• Respiratory Conditions: Bronchial asthmatics should not use this prescription treatment. If you have asthma, chronic bronchitis, emphysema, recurrent hay fever or sensitivity to other airborne allergens, be cautious and get regular checkups if your doctor determines that this treatment is safe for you. Breathing trouble and allergy sensitivity can be increased by beta-blockers.
• Surgery: Inderal is reactive with certain drugs used in surgery. Inform your doctor or dentist well in advance of any procedure.

Inderal Online - Prescription Consultation Through AccessMedNet Listings

Some medications may interact with Inderal (propranolol) treatment, and may require either careful monitoring or the selection of a different treatment if their use is necessary. Certain over the counter treatments may result in interactions as well. Serious circulatory side effects could result fram drug interactions with this medicine.

Only your doctor can decide if it's safe for you to mix other medication with prescription treatments, but be especially sure to inform them if you use any of the following:

• Alcohol - Use of alcohol while being treated with Inderal may lead to low blood pressure or oversedation.
• Aldomet (methyldopa) - Risk of blood pressure increase with increased stress.
• Allergy medication or skin test agents - Propranolol may greatly increase the likelihood of a serious allergic reaction.
• Anesthetics like lidocaine may have their effects dangerously increased. Inform your doctor or dentist that you take Inderal before having any surgery.
• Antacids may decrease propranolol's effectiveness.
• Anti-diabetic drugs or Insulin - This combination may result in undesirably low blood sugar, regular testing for hypoglycemia is recommended.
• Anti-hypertensive drugs of any other type may result in undesirably low blood pressure. Reduced dosages could be necessary.
• Auralgan (antipyrine)
• Bronchodilators of the xanthine (thioxanthine) class (Aminophylline, Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur, etc...) - May be less effective asthma treatments when combined with propranolol.
• Caffeine (excess coffee or cola, No-Doz, Vivarin) - The effects of both caffeine and propranolol may cancel each other out.
• Calcium channel blockers - Medications like Bepadin (bepridil), Calan (verapamil), Cardene (nicardipine), Cardizem (diltiazem), DynaCirc (isradipine), Norvasc (amlodipine), Nimotop (nimodipine), Plendil (felodipine), Procardia (nifedipine), or Sibelium (flunarizine) may cause unwanted heart problems when combined with beta-blockers like propranolol.
• Catapres (clonidine) - Neither medication should be stopped abruptly if used together, increased risk of sudden high blood pressure.
• Cipro (ciprofloxacin) - Can cause propranolol buildup.
• Colestid (colestipol) - Treatment benefits may be decreased.
• Cordarone (amiodarone) - Do not combine, abnormal hearth rhythms or low pulse may result.
• Coumadin (warfarin) - Increased risk of bleeding, dosage adjustment may be needed.
• Diuretics may increase propranolols effects, as well as the risk of side effects.
• Epinephrine/Adrenalin - Increased blood pressure and slower heart rate may result.
• Ergotamine based migraine treatments such as DHE 45 injections, Cafergot, Ergostat, Migranal nasal spray, or Sansert, can cause blood vessel constriction or decreased blood flow to the extremities in combination with propranolol.
• Ginseng - May increase blood pressure.
• Goldenseal - May increase blood pressure.
• Hawthorn - May increase blood pressure.
• Indian Snakeroot - This herb is approved in Germany as an anti-hypertensive treatment. Consult your doctor if you wish to combine therapies, as there may be some risk of undesirably low blood pressure when two anti-hypertensive treatments are used together.
• Lanoxin (digoxin) - May result in undesirably slow heartbeat.
• Licorice - May increase blood pressure unless deglycyrrhizinated. Glycyrrhizin is a compound in licorice which seems to produce higher blood pressure. The majority of licorice flavored candies do not contain enough of the herb to make a difference, but herbal teas containing it should be avoided.
• Ma Huang - May increase blood pressure.
• MAO inhibitors - Inderal must never be mixed with MAO (monoamine oxidase) inhibitors, a class of antidepressants and antisenility drugs, such as Eldepryl (selegiline), Furoxone (furazolidone), Nardil (phenelzine), Marplan (isocarboxazid), or Parnate (tranylcypromine). Never use Inderal within 2 weeks of starting or stopping an MAO inhibitor. Patients over 65 should allow a longer wait period between using Inderal and an MAO, as MAOs may stay in their system longer than in other patients. Dangerously high blood pressure could result from this combination.
• Migraine medications of the triptan class such as Amerge (naratriptan), Imitrex (sumatriptan), Maxalt (rizatriptan), or Zomig (zolmitriptan) can increase the risk of side effects from either drug when used with propranolol. Speak to your doctor about the risks involved in your specific case, as some individuals have used them together safely.
• Nicotine can decrease the effectiveness of Inderal directly by speeding its elimination from the body, and indirectly by promoting high blood pressure and other cardiovascular problems. No current treatment for cardiovascular conditions can entirely cancel the negative effects of nicotine use on the circulatory system.
• Nipolept (zotepine) - These two treatments increase each other's potential toxicity.
• Non-steroidal anti-inflammatories (NSAIDs) such as Butazolidine (phenylbutazone), Clinoril (sulindac), Ibuprofen (Motrin), Indocin (indomethacin), Feldene (piroxicam), Naprosyn (naproxen), Toradol (ketorolac), and others, as well as combination pain killers which contain NSAIDs, may reduce the medication's effectiveness in reducing high blood pressure.
• Norpace (disopyramide) - Undesirable propranolol buildup may occur.
• Propacil (propylthiouracil) - May increase propranolol's effects.
• Propoxyphene - Can lead to medication buildup.
• Protease inhibitors such as Agenerase (amprenavir), Norvir (ritonavir), and perhaps others, may lead to higher levels of propranolol in the body.
• Proventil (albuterol) - May be less effective when combined with propranolol.
• Provigil (modafinil) - Dosage adjustments may be necessary.
• Quinaglute (quinidine) - Increases risk of heart failure, low blood pressure, or slow heart rate. If medications are to be used together, careful monitoring is advised. May increase the risk of adverse Inderal side effects.
• Reglan (metoclopramide) - Can increase the effects of immediate release forms of this treatment.
• Reserpine - This combination may cause central nervous system or cardiovascular depression.
• Rifampin (Rifadin, Rimactane) - May decrease usefulness of propranolol.
• Rythmol (propafenone) - These combined treatments may cause drug build up in the body, esp. with Rythmol doses higher than 150 mg daily.
• Saw Palmetto - May increase blood pressure.
• Sedatives like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal, Phenobarbitol, Seconal, or other barbiturates may decrease the effectiveness of your treatment.
• Selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline) may cause side effects like slow heartbeat, sedation, chest pain, or a toxic buildup of propranolol.
• Serzone (nefazodone) - This combination can decrease the usefulness of propranolol and increase the risk of a toxic buildup of Serzone.
• Street Drugs - Cocaine may lead to a heart attack if taken with this medication. Individuals taking prescription treatments are strongly advised to avoid all street drugs, as the possible interactions could be dangerous or life threatening.
• Tagamet (cimetidine) - May cause drug buildup in the body.
• Tapazole (methimazole) - Dosage adjustments may be needed.
• Thorazine (chlorpromazine) - Effects of propranolol may be increased.
• Wytensin (guanabenz) - Neither medication should be stopped abruptly if used together, there's increased risk of sudden high blood pressure.
• Yohimbe - May increase blood pressure.
• Zocor (simvastatin) - May decrease blood levels of propranolol.
• Zyflo (zileuton)

Inderal Dosages

The following starting and maximum dosages are generic prescription guidelines for adults. Dosages for the long-acting form may differ. If the instructions you receive from your doctor are different than the ones here, always follow your doctor's recommendations. Seniors and children between 12 and 17 will need to have their doses individually determined.

• Angina: 10 mg 4 times daily, up to 400 mg.
• Arrhythmia: 10 mg 3-4 times daily, up to 120 mg.
• Heart Disease: 20 mg 3-4 times daily, up to 160 mg.
• Hypertension: 40 mg twice daily, up to 640 mg.
• Migraine Headache: 20 mg 4 times daily, up to 240 mg.
• Tremor: 40 mg twice daily, up to 320 mg.

If you miss a dose of Inderal, take it as soon as you remember, unless you are within 4 hours of your next dose (or 8 hours for the extended release forms). In that case, skip the missed dose and go back to your schedule. Taking double doses of Inderal is not recommended, as it may lead to dangerously low blood pressure.

Inderal should be taken an hour before food for best absorption. While the immediate release tablets may be crushed into a small amount of soft food, the extended release forms must be swallowed whole.

While you are taking Inderal, avoid all known allergens.This medication can increase allergic response significantly, possibly dangerously, especially in individuals with respiratory disorders.

Stopping this medication abruptly may lead to complications, in some cases heart attack or stroke. No matter what condition you are taking this medication for, decrease your dose gradually according to the advice of your doctor if you must stop treatment for any reason.

Store Inderal away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.

Keep Inderal away from children; both when storing it, and when discarding any unused medication.

Inderal and Pregnancy

Adequate studies to confirm safety of this medication during pregnancy have not been completed. This medication should be avoided during the first trimester. Speak to your doctor if you are, or plan to become pregnant.

If adverse effects are noticed in the infant during nursing, either breastfeeding or treatment should be discontinued.

Inderal and Children

Safety and effectiveness have not been studied for children under 12. For children 13 and older, watch carefully for signs of low blood sugar (hypoglycemia), including fatigue, headache, irritability, and confusion.

Inderal and Seniors

Careful monitoring is required to ensure that blood pressure is not reduced too greatly. Lower starting doses and frequent monitoring may be required to determine the correct dose. Watch for confusion, depression, dizziness, falls, hallucination, lack of balance or coordination, or change in the frequency of urination.

Inderal Online - Prescription Consultation Through AccessMedNet Listings

Inderal and Inderal LA are trademarks of Wyeth-Ayerst

Back to top

This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.