Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.
Femi Aremu, PharmD, is a professional pharmacist with experience in clinical and community pharmacy. He currently practices in Chicago, Illinois.
Do not stop taking Inderal LA without talking to your healthcare provider first. If Inderal LA is stopped suddenly, it may cause chest pain or heart attack in some people.
Inderal LA (propranolol ) is an orally administered prescription medication categorized as a beta-blocker that is used to treat heart disease, help with anxiety, and prevent migraines in people 18 and older. "LA" refers to long-acting, corresponding to its route of administration as an extended-release (ER) capsule. This means the drug is designed to last longer in the body and require less intensive dosing than a standard-release drug.
Beta-blockers are a group of drugs used to treat cardiovascular diseases.
Inderal LA works by blocking beta-adrenergic receptors (binding sites). Blocking these receptors correlates to relaxed and widened blood vessels, less forceful heart contractions, and a slower heart rate.
The primary ingredient in Inderal LA, propranolol, is a generic product administered via ER capsules, immediate-release (IR) tablets, or as a liquid solution.
Marketed under varying brand names, such as Inderal LA, Innopran XL, or Hemangeol, propranolol is available as a liquid suspension and as an ER capsule.
This article will focus on the oral use of Inderal LA.
Brand Name(s): Inderal LA, Innopran XL, Hemangeol
Dosage Form(s): Tablet, ER capsule, liquid suspension
The Food and Drug Administration (FDA) approved Inderal LA for a number of medical conditions, including:
Angina pectoris: In angina pectoris, there are blockages in the arteries of the heart. The low blood flow and oxygen to the heart from these blockages lead to the common symptom of chest pain. Experts recommend beta-blockers for this medical condition.
Atrial fibrillation: Atrial fibrillation is an abnormal heart rhythm. Inderal LA helps control the heart rate in this medical condition.
Essential tremors: People with essential tremors have uncontrollable shaking movements. These tremors are not due to Parkinson's disease, head injury, or other medical conditions. Essential tremors do not happen during rest—but tend to occur with movements. Inderal LA is thought to lessen the severity of tremors by blocking non-heart beta-2 receptors.
Hypertension: Hypertension is also known as high blood pressure. Your blood pressure measurement is considered high when the top number is more than 130 millimeters of mercury and the bottom number is higher than 80 millimeters of mercury.
Although the FDA approved propranolol for high blood pressure, experts no longer consider beta-blockers as the go-to option for this condition.
Hypertrophic subaortic stenosis: Hypertrophic subaortic stenosis is also known as hypertrophic obstructive cardiomyopathy (HCM). People with this medical condition have an abnormally large or thick left ventricle. This can cause blood flow problems.
Migraines: Inderal LA is thought to help migraines by influencing certain blood vessels in the brain. Beta-blockers—like propranolol—are the go-to options for preventing migraines.
Myocardial infarction: A myocardial infarction is also known as a heart attack. Experts recommend beta-blockers after a heart attack.
Pheochromocytoma: Pheochromocytomas are tumors of the adrenal glands, which sit on top of the kidneys. These tumors tend to make too many hormones that can cause various symptoms—including high blood pressure.
The FDA approved Inderal LA to be used with another medication—like phenoxybenzamine, which is an alpha-blocker that blocks alpha receptors.
Potential consumers can purchase Inderal LA, or the generic version, propanolol, as an IR tablet, a solution (liquid), or an ER capsule to take orally (by mouth).
Inderal LA usually is taken once a day. Moreover, the ER capsule is usually taken at bedtime and should consistently be taken either always with or always without food each time.
IR propranolol tablets or solution may be taken two, three, or four times a day.
Be sure to take propranolol at around the same time daily. Follow the directions on your prescription label carefully, and ask your healthcare provider to explain any part you do not understand.
Take Inderal LA exactly as directed. Do not take more or less of it or take it more often than prescribed by your healthcare provider.
Swallow the tablets/capsules whole; do not split, chew, or crush them.
Since Inderal LA is a noncontrolled prescription (not regulated by law regarding use and possession), your healthcare provider may provide you with refills for up to one year from the originally written date on the prescription.
If you have never taken Inderal LA before or your dose is changing, however, your healthcare provider might authorize only a few refills at a time until you and your provider find a stable dose to help your medical condition and minimize side effects.
After you bring Inderal LA home from the pharmacy, the medication can be stored at room temperature (around 68 to 77 degrees F).
However, make sure to protect this medication from harsh light. Additionally, do not store in a bathroom or other areas suspectible to high levels of moisture, and be sure to keep out of reach of children and pets.
If you’re going to travel with propranolol, become aware of the regulations of your final destination. In general, consider making a copy of your propranolol prescription.
Also, keep the medication in its original container—with your name on it—from the pharmacy.
Historically, propranolol as an active ingredient has also been used for the following:
Antipsychotic-induced akathisia: Mood medications can potentially cause agitation and restlessness. Although experts state that propranolol is effective for this type of akathisia, more data is necessary.
Performance anxiety: Data from a few studies show that propranolol might lessen performance anxiety.
Postural tachycardia syndrome: In postural tachycardia syndrome, the heart rate rises when moving from lying down to standing up. A few studies suggest that propranolol may help some people with this medical condition.
Thyrotoxicosis: Thyrotoxicosis can occur because of hyperthyroidism (overactive thyroid). People who experience thyrotoxicosis have abnormal labs and physical symptoms due to too much thyroid hormone in the body. Some symptoms include anxiety and feelings of distress. Experts recommend propranolol to treat thyrotoxicosis.
Propranolol is also recommended in people with no symptoms—but are at a higher risk of complications from their overactive thyroid condition.
Lithium-induced tremors: Lithium is a mood-stabilizing medication that is usually used as a treatment option for mental health conditions—like bipolar disorder. Lithium also has a possible side effect of tremors. There is limited data that suggests propranolol might be helpful for people with these tremors.
Variceal hemorrhage prophylaxis: People with cirrhosis (scarring of the liver) tend to have varices (large veins) in the esophagus, which is a tube that carries food and liquids from your mouth to your stomach. Unfortunately, these large veins can rupture and bleed.
Experts recommend nonselective beta-blockers—like propranolol—to prevent this type of bleeding from ever occurring or a future bleed from happening again.
How long Inderal LA takes to work varies by person—but can range from days to weeks.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Some common side effects of Inderal LA include:
Do not stop taking Inderal LA without talking to your healthcare provider first. If it is stopped suddenly, it may cause chest pain or heart attack in some people.
Get medical help right away if you experience the following serious side effects:
Inderal LA can generally be taken for long periods of time without any lasting or harmful side effects.
Inderal LA may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Users should be aware of the following before beginning Inderal LA:
People with angina pectoris: If you have angina, don’t suddenly stop taking propranolol. Abruptly discontinuing this medication can worsen angina symptoms or lead to a heart attack. If you and your healthcare provider ever decide to stop propranolol, your provider will slowly lower your dose over a period of a few weeks.
People with overactive thyroid: If you have an overactive thyroid, suddenly discontinuing propranolol can worsen hyperthyroidism symptoms and result in a thyroid storm, which is a medical emergency.
Don’t abruptly stop taking this medication. If you have any questions or concerns, talk with your healthcare provider first.
Pregnant or nursing parents: There are reports of the following when taking Inderal LA during pregnancy:
If taken while pregnant, Inderal LA may cause the following in a newborn:
Thus, evaluate the potential risk of Inderal LA use during pregnancy with your healthcare provider.
As for nursing parents who are taking Inderal LA, low amounts of the medication can transfer into breast milk. However, the small amount is unlikely to have negative effects on the nursing baby.
In fact, studies show no Inderal LA-related side effects in nursing babies.
If you forget to take your dose, take it as soon as you remember.
If it’s close to your next scheduled dose, however, just wait to take the following dose at your next scheduled dosing time. Don’t try to double up and take more than one dose to make up for the missed dose.
If you missed too many doses in a row, you might experience worsening symptoms of your medical condition. Try to find ways to remember to take propranolol every day.
If you accidentally take too many Inderal LA capsules, you may experience a drastically slow heartbeat. If you believe you have potentially overdosed, seek immediate medical attention.
If you think you or someone else may have overdosed on Inderal LA, call a healthcare provider or the Poison Control Center. (800-222-1222).
If someone collapses or isn’t breathing after taking Inderal LA, call 911.
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects. .
Hemangeol® may increase the risk of heart or blood vessel problems (eg, bradycardia, hypotension). Check with your doctor right away if your child has blurred vision, chest pain or discomfort, confusion, lightheadedness, dizziness, or fainting, slow or uneven heartbeat, sweating, trouble breathing, or unusual tiredness or weakness.
This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.
Propranolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, or weight gain.
This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, including rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests. Call your doctor right away if you have anxiety, blurred vision, chills, cold sweats, coma, confusion, cool, pale skin, depression, dizziness, fast heartbeat, headache, increased hunger, nausea, nervousness, nightmares, seizures, shakiness, slurred speech, or unusual tiredness or weakness.
Make sure any doctor or dentist who treats you knows that you are using this medicine. Do not stop taking this medicine before surgery without your doctor's approval.
This medicine may cause some people to become less alert than they are normally. If this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while taking propranolol.
Do not interrupt or suddenly stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous.
Propranolol will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system and may cause drowsiness. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or medicine for seizures, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of these medicines while you are using this medicine.
This medicine may increase risk of stroke in PHACE syndrome patients with severe blood vessel problems in the brain. Talk to your child's doctor about this risk.
Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
Some men who use this medicine may cause erectile dysfunction. Check with your doctor right away if you have decreased interest in sexual intercourse, inability to have or keep an erection, or loss in sexual ability, drive, or performance. If you have questions about this, talk to your doctor.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Avoid taking it if you have any of the following:
Potential users should be cautious when considering taking the following medications alongside Inderal LA or any drugs that contain propranolol:
There are other possible drug interactions. For more information or answers to your questions about these drug interactions, talk with your healthcare provider.
There are many available medications in the beta-blocker medication class.
Out of all the beta-blockers, however, Corgard (nadolol) is probably one of the most similar medications to Inderal LA because they are nonselective beta-blockers. This means that they bind to beta receptors other than the ones in the heart.
Additionally, the FDA has approved both Inderal LA and nadolol for the treatment of high blood pressure and angina. Compared to nadolol, however, the FDA approved Inderal LA for substantially more medical conditions.
Because nadolol and Inderal LA are both defined as beta-blockers, they aren’t typically taken together. If you have any questions, discuss them with your healthcare provider.
In general, many people experience no side effects with beta-blockers. For some people who do experience side effects, the side effects are mild and go away with time.
However, if your side effects bother you or don’t go away within a few days, inform your healthcare provider.
Inderal LA lowers your resting heart rate. The medication also affects your heart during exercise.
Therefore, you will need to adjust your target heart rate and exercise goals.
For most FDA-approved uses, the medication will typically be taken for long periods of time. If you would like to stop, talk with your healthcare provider.
Never abruptly stop this medication before having a conversation with your healthcare provider.
In general, it’s important to consistently take Inderal LA and other medications for your condition—in addition to making the following lifestyle changes:
As previously mentioned, Inderal LA is used for various medical conditions. Many of these conditions can understandably take a toll on your emotions.
Take the first step to feeling better by sharing your medical condition with your loved ones.
As they become more aware, they can provide you with necessary support and encouragement—like eating a healthier diet, helping with driving responsibilities during your migraines, and more.
A mental health professional may also help by showing different coping strategies to change the way you feel, act, and think about your medical condition.
Additionally, for angina, migraines, and essential tremors, keeping a journal can help you know the potential triggers for your medical conditions.
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
DailyMed. Label: Inderal LA- propranolol hydrochloride capsule, extended release.
The Texas Heart Institute. Beta-blockers.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines [published correction appears in Hypertension. 2018;71(6):e136-e139] [published correction appears in Hypertension. 2018;72(3):e33]. Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons [published correction appears in Circulation. 2014;129(16):e462]. Circulation. 2012;126(25):3097-3137. doi:10.1161/CIR.0b013e3182776f83
Centers for Disease Control and Prevention. Facts about hypertension.
American Heart Association. Hypertrophic cardiomyopathy (HCM).
Ha H, Gonzalez A. Migraine headache prophylaxis. Am Fam Physician. 2019;99(1):17-24.
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association task force on practice guidelines [published correction appears in J Am Coll Cardiol. 2014;23;64(24):2713-4. Dosage error in article text]. J Am Coll Cardiol. 2014;64(24):e139-e228. doi:10.1016/j.jacc.2014.09.017
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines [published correction appears in Circulation. 2013;24;128(25):e481]. Circulation. 2013;127(4):e362-e425. doi:10.1161/CIR.0b013e3182742cf6
Concordia Pharmaceuticals. Label: Dibenzyline (phenoxybenzamine hydrochloride).
Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry. 2013;14(1):2-44. doi:10.3109/15622975.2012.739708
Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: systematic review and meta-analysis. J Psychopharmacol. 2016;30(2):128-139. doi:10.1177/0269881115612236
National Center for Advancing Translational Sciences. Postural orthostatic tachycardia syndrome.
Arnold AC, Okamoto LE, Diedrich A, et al. Low-dose propranolol and exercise capacity in postural tachycardia syndrome: a randomized study. Neurology. 2013;80(21):1927-1933. doi:10.1212/WNL.0b013e318293e310
Moon J, Kim DY, Lee WJ, et al. Efficacy of propranolol, bisoprolol, and pyridostigmine for postural tachycardia syndrome: a randomized clinical trial. Neurotherapeutics. 2018;15(3):785-795. doi:10.1007/s13311-018-0612-9
Raj SR, Black BK, Biaggioni I, et al. Propranolol decreases tachycardia and improves symptoms in the postural tachycardia syndrome: less is more. Circulation. 2009;120(9):725-734. doi:10.1161/CIRCULATIONAHA.108.846501
Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis [published correction appears in Thyroid. 2017;;27(11):1462]. Thyroid. 2016;26(10):1343-1421. doi:10.1089/thy.2016.0229
Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. Int J Bipolar Disord. 2016;4(1):27. doi:10.1186/s40345-016-0068-y
Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases [published correction appears in Hepatology. 2017 Jul;66(1):304]. Hepatology. 2017;65(1):310-335. doi:10.1002/hep.28906
Kim YD. Management of acute variceal bleeding. Clin Endosc. 2014;47(4):308-314. doi:10.5946/ce.2014.47.4.308
National Center for Advancing Translational Sciences. Wolff-Parkinson-White syndrome.
Marlex Pharmaceuticals. Label: nadolol tablets.
Srinivasan AV. Propranolol: a 50-year historical perspective. Ann Indian Acad Neurol. 2019;22(1):21-26. doi:10.4103/aian.AIAN_201_18
By Ross Phan, PharmD, BCACP, BCGP, BCPS Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.
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