What is Inderal?

Inderal is a prescription medication used to treat high blood pressure, heart rhythm disorders, angina (chest pain), and migraines. It’s also used to prevent heart attacks and improve survival after a heart attack.

Health Benefits

Inderal works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

It’s used to treat:

High blood pressure

Angina (chest pain)

Migraines

Heart rhythm disorders

Prevention of heart attacks

Survival after a heart attack

Inderal is also used off-label for anxiety, tremors, and performance anxiety.

Side Effects

Common side effects of Inderal include:

Dizziness

Tiredness

Weakness

Headache

Nausea

Vomiting

Diarrhea

Constipation

Rash

Other serious side effects include:

Low blood pressure (hypotension)

Shortness of breath (dyspnea)

Wheezing or difficulty breathing (bronchospasm)

Slow heart rate (bradycardia)

If you experience any of these serious side effects, stop taking Inderal and call your doctor right away.

Interactions with other drugs may occur. Be sure to tell your doctor about all the medications you’re taking,

Dosage

Inderal is available as an oral tablet in four different strengths: 10 mg, 20 mg, 40 mg, 60 mg. It’s also available as an injectable solution given by a healthcare provider.

The usual starting dose for high blood pressure is 40 mg twice daily. If you tolerate the medication well, your doctor may increase your dose to 80 mg twice daily.

For angina, the usual starting dose is 10-20 mg three or four times a day before activities that trigger the pain.

For migraines, the usual starting dose is 40 mg twice daily. If you don’t experience relief after the first week, your doctor may increase your dose up to 320 mg per day.

Interactions

Inderal may interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, herbs, and supplements you take.

Tell your doctor if you’re taking these drugs:

Cimetidine (Tagamet)

Fluoxetine (Prozac)

Ketoconazole (Nizoral)

Phenytoin (Dilantin)

Taking Inderal with these drugs can increase levels of Inderal in your body and cause more side effects.

Inderal may also interact with other beta blockers, calcium channel blockers, or heart medications.

Mechanism of Action

Inderal works by blocking beta-adrenergic receptors located on nerves of the heart. This prevents norepinephrine and epinephrine from binding to these receptors, which results in a decrease in heart rate, blood pressure, and strain on the heart.

In migraines, Inderal is thought to work by inhibiting the activity of serotonin, a neurotransmitter that plays a role in pain signaling.

Pharmacokinetics

Inderal is rapidly absorbed from the gastrointestinal tract and reaches peak levels in 30-60 minutes. The half-life of Inderal is 3-6 hours.

Inderal is metabolized in the liver by cytochrome P450 enzymes, specifically CYP2D6. People with a deficiency in this enzyme may have reduced clearance of Inderal and increased side effects.

Alternatives to Inderal

Inderal is a prescription medication used to treat high blood pressure, angina, and migraines. It belongs to a class of drugs called beta blockers.

Other drugs in this class include:

Atenolol (Tenormin)

Metoprolol (Lopressor, Toprol XL)

Propranolol (Inderal LA)

Nadolol (Corgard)

Clinical Trials

Hypertension

A large clinical trial showed that Inderal was effective at reducing blood pressure in people with hypertension. The trial enrolled 1,600 participants and found that Inderal reduced systolic blood pressure by an average of 9 mmHg and diastolic blood pressure by an average of 5 mmHg more than placebo.

Angina

Inderal has also been shown to be effective at reducing the frequency and severity of angina attacks. One study found that Inderal reduced the number of angina attacks by 50% compared to placebo.

Migraines

Inderal has been shown to be effective at reducing the frequency and severity of migraines. One study found that Inderal reduced the number of migraines by 50% compared to placebo.

Chemical Structure

Inderal is a synthetic drug with the chemical structure 6-[3-(4-methoxyphenyl)-1-methylpropyl]-1,3-dihydroindeno-[1,2-e]-1,3,5(6H)-isobenzofuran-2-one.

Symptoms of Overdose

Symptoms of an Inderal overdose may include:

Slow heart rate

Low blood pressure

Dizziness

Fainting

If you think you or someone else may have overdosed on Inderal, call 911 or seek medical attention immediately.