Inderal Uses, Dosage, Side Effects, Food Interaction and all others data.

Inderal is a non-cardioselective β-blocker that competitively blocks β1- and β2-receptors resulting in decreased heart rate, myocardial contractility, BP and myocardial oxygen demand. It has membrane-stabilising properties.

Inderal is a beta-adrenergic receptor antagonist used to treat hypertension. Inderal has a long duration of action as it is given once or twice daily depending on the indication. When patients abruptly stop taking propranolol, they may experience exacerbations of angina and myocardial infarctions.

Trade Name Inderal
Availability Prescription only
Generic Propranolol
Propranolol Other Names beta-Propranolol, Propanalol, Propanolol, Propranolol, Propranololo, Propranololum
Related Drugs amlodipine, aspirin, lisinopril, metoprolol, losartan, furosemide, carvedilol, hydrochlorothiazide, Xarelto, clopidogrel
Weight 10mg, 40mg, 1mg/ml,
Type Tablet, Injection, Intravenous
Formula C16H21NO2
Weight Average: 259.3434
Monoisotopic: 259.157228921
Protein binding

Approximately 90% of propranolol is protein bound in plasma. Other studies have reported ranges of 85-96%.

Groups Approved, Investigational
Therapeutic Class Beta-adrenoceptor blocking drugs, Beta-blockers
Manufacturer Abbott India Ltd, Abbott Healthcare Pvt Ltd, Ici Pakistan Ltd,, Astra Zeneca Ab Se
Available Country India, Australia, Pakistan, Philippines, United States, Portugal, Switzerland,
Last Updated: September 19, 2023 at 7:00 am


Inderal is used for:

  • essential and renal hypertension
  • angina pectoris
  • long term prophylaxis after recovery from acyte myocardial infarction
  • cardiac dysrhythmia
  • prophylaxis of migraine
  • essential tremor
  • anxiety and anxiety tachycardia
  • adjunctive management of thyrotoxicosis and thyrotoxic crisis
  • hypertrophic obstructive cardiomyopathy
  • phaeochromocytoma (with α-blocker)

Inderal is also used to associated treatment for these conditions: Akathisia caused by antipsychotic use, Angina Pectoris, Atrial Fibrillation, Cardiovascular Mortality, Gastroesophageal variceal hemorrhage prophylaxis, Hemangiomas, High Blood Pressure (Hypertension), Migraine, Myocardial Infarction, Obstructive Hypertrophic Cardiomyopathy, Performance Anxiety, Pheochromocytomas, Proliferating Infantile Hemangioma, Supraventricular Arrhythmias, Tachyarrhythmia caused by Digitalis intoxication, Tachyarrhythmia caused by catecholamine excess, Thyroid Crisis, Thyrotoxicosis, Tremor caused by lithium, Tremor, Essential, Ventricular Tachycardia (VT)

How Inderal works

Inderal is a nonselective β-adrenergic receptor antagonist. Blocking of these receptors leads to vasoconstriction, inhibition of angiogenic factors like vascular endothelial growth factor (VEGF) and basic growth factor of fibroblasts (bFGF), induction of apoptosis of endothelial cells, as well as down regulation of the renin-angiotensin-aldosterone system.


Inderal dosage



  • Hypertension: A starting dose of 80 mg twice a day may increased at weekly intervals according to response. The usual dose range is 160-320 mg per day. With concurrent diuretic or other antihypertensive drugs a further reduction of blood pressure is obtained.
  • Angina, anxiety, migraine and essential tremor: A staring dose of 40 mg two or three times daily may be increased by the same amount at weekly intervals according to patients response. An adequate response in anxiety, migraine and essential tremor is usually seen in the range 80-160 mg/day and an angina in the range 120-240 mg/day.
  • Situational and generalized anxiety: A dose of 40 mg daily may provide short term relief of acute situational anxiety. Generalized anxiety require long term therapy, usually responds adequately to 40 mg twice daily which ,which individual cases, may be increased to 40 mgthree times daily. Treatment should be continued according to responses. Patients should reviewed after 6 to 12 months treatment.
  • Dysrhythmias, anxiety tachycardia, hypertrophic obstructive cardiomyopathy and thyrotoxicosis: A dosage range of 10-40 mg three or four times a day usually achieves the required response.
  • Post myocardial infarction: Treatment should be started between days 5 and after 21 after myocardial infarction, with an initial dose of 40 mg four times a day for 2 or 3 days. In order to improve compliance the total daily doses three after be given as 80 mg twice a day. Phaeochromocytoma (Used only with an alpha receptor blocking drug).
  • Pre-operative: 60 mg daily for three days.
  • Non-operable malignant cases: 30 mg daily.
  • Migraine: Under 12 years: 20 mg two or three times daily.Over 12 years : The adult dose.


  • Sysrhythmias, Phaeochromocytoma, Thyrotoxicisis: Dosage should be individually determined and the following is only a guide 0.25-0.5 mg/kg three or four times daily as required.

Sustained Release Capsule:


  • Hypertension: The usual initial dose is 80mg Inderal SR once daily, whether used alone or added to a diuretic. The usual maintenance dosage is 120 to 160 mg once daily.
  • Angina pectoris: Starting with 80mg Inderal SR once daily, dosage should be gradually increased three to seven day intervals until optimum response is obtained.
  • Migraine: The initial oral dose is 80 mg Inderal SR once daily. T he usual effective dose range is 160 to 240 mg once daily. It may be advisable to withdraw the drug gradually over a period of several weeks.
  • Hypertrophic subaortic stenosis: 80 mg Inderal SR once daily


Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

The usual dose is 1 to 3 mg administered under careful monitoring, such as electrocardiography and central venous pressure. The rate of administration should not exceed 1 mg (1 mL) per minute to diminish the possibility of loweringblood pressureand causing cardiac standstill.

Sufficient time should be allowed for the drug to reach the site of action even when a slow circulation is present. If necessary, a second dose may be given after two minutes. Thereafter, additional drug should not be given in less than four hours. Additional propranolol hydrochloride should not be given when the desired alteration in rate or rhythm is achieved.

Transfer to oral therapy as soon as possible.

Side Effects

Inderal is usually well tolerated. Minor side effects such as cold extremities, nausea, diarrhea, sleep disturbances and lassitude are often transient. There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic blocking drugs.


Symptoms of overdose include hypotension, hypoglycemic seizure, restlessness, euphoria, insomnia. Patients with asthma may develop bronchospasm. In case of overdose, monitor vital signs, mental status, and blood glucose. Treat hypotension with intravenous fluids, bradycardia with atropine, and isoproterenol and aminophylline for bronchospasm. If patients do not respond to intravenous fluids, follow up with glucagon 50-150µg/kg intravenously, then 1-5mg/hour, followed by catecholamines. Dialysis will not be useful as propranolol is highly protein bound.


Beta-adrenoceptor blocking drugs should be avoided in over heart failure. Inderal modifies the tachycardia of hypoglycaemic therapy in diabetic patients. Inderal may prolong the hypoglycaemic response to insulin.


Beta-adrenoceptor blocking drugs interact with clonidine.If beta-adrenoceptor blocking drugs and clonidine are given concurrently, clonidine should be discontinued until several days after withdrawal of beta-adrenoceptor blocking drug. Care should be taken in prescribing a beta-adrenoceptor blocking drugs with class 1 antidysrhythmic agents (disopyramide).Beta-adrenoceptor blocking drugs should be used with caution in combination with verapamil in patients with impaired ventricular function.

Food Interaction

  • Avoid alcohol. Alcohol increases propranolol plasma concentrations.
  • Avoid natural licorice. Natural licorice inhibits the metabolism of propranolol, increasing drug exposure.
  • Take with food.

[Moderate] ADJUST DOSING INTERVAL: The bioavailability of propranolol may be enhanced by food.

MANAGEMENT: Patients may be instructed to take propranolol at the same time each day, preferably with or immediately following meals.

Inderal Alcohol interaction


Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation.

Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

Caution and close monitoring for development of hypotension is advised during coadministration of these agents.

Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs.

Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

Inderal Cholesterol interaction

[Moderate] Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles.

Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers.

Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.

Inderal multivitamins interaction

[Moderate] ADJUST DOSING INTERVAL: Concurrent administration with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers.

The exact mechanism of interaction is unknown.

In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively.

The elimination half-life increased by 44%.

Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone.

However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments.

The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.

It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours.

Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.

Volume of Distribution

The volume of distribution of propranolol is approximately 4L/kg or 320L.

Elimination Route

Patients taking doses of 40mg, 80mg, 160mg, and 320mg daily experienced Cmax values of 18±15ng/mL, 52±51ng/mL, 121±98ng/mL, and 245±110ng/mL respectively. Inderal has a Tmax of approximately 2 hours, though this can range from 1 to 4 hours in fasting patients. Taking propranolol with food does not increase Tmax but does increase bioavailability.

Half Life

The elimination half life of propranolol is approximately 8 hours. The plasma half life of propranolol is 3 to 6 hours.


The clearance of propranolol is 2.7±0.03L/h/kg in infants 90 days. Inderal clearance increases linearly with hepatic blood flow. Propanolol has a clearance in hypertensive adults of 810mL/min.

Elimination Route

91% of an oral dose of propranolol is recovered as 12 metabolites in the urine.

Pregnancy & Breastfeeding use

There are no adequate and controlled studies in pregnant women. Inderal is excreted in human milk. Caution should be exercised when propranolol is administered to a nursing mother.


Inderal Hydrochloride is contraindicated in patients with known Hypersensitivity to any component of the formulation. If there is a history of bronchial asthma of bronchospasm.

Acute Overdose

The symptoms of over dosage may include bradycardia, hypotension, acute cardiac insufficiency and bronchospasm. Treatment of over dosage include close supervision, treatment in an intensive care ward, he use of gastric lavage, activated charcoal and a laxative to prevent absorption of any drug still present in the gastrointestinal tract, the use of plasma or plasma substitutes to treat hypotension and shock.

Storage Condition

Store in a cool dry place. Protect from light.

Innovators Monograph

You find simplified version here Inderal

Inderal contains Propranolol see full prescribing information from innovator Inderal Monograph, Inderal MSDS, Inderal FDA label


What is Inderal usually prescribed for?

Inderal usually prescribed for high blood pressure and other heart problems, but it can also help with the physical signs of anxiety, like sweating and shaking.Inderal slows down your heart rate and makes it easier for your heart to pump blood around your body. 

Is Inderal good for anxiety?

Inderal blocks the physical effects of anxiety, meaning you won't experience an increased heart rate, sweating and shakiness when you feel nervous. By blocking the physical symptoms of anxiety, propranolol can help you feel calmer, less nervous and more composed.

When should not I take Inderal?

You should not use Inderal if you are allergic to it, or if you have:

  • asthma;
  • very slow heart beats that have caused you to faint; or.
  • a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker).

Can I take Inderal every day?

Inderal can be used daily for migraine prevention. It's only approved for prevention and shouldn't be used to stop a migraine that's already started. A common starting dose for migraine prevention is 80 mg per day, broken up into smaller, equal size doses throughout the day.

What time of day should I take Inderal?

Inderal extended release capsules should be taken at bedtime (10 pm). This medicine may be taken with or without food. However, you should take it the same way each time.

Does Inderal help me sleep?

Brand as well as other beta blockers, has been shown in some studies to reduce your body's secretion of melatonin an important hormone for optimal sleep. For a small percentage of propranolol users, this can lead to difficulties falling and staying asleep.

What are the worst side effects of Inderal?

Serious side effects of Inderal:

  • Hallucinations.
  • Cold hands or feet.
  • Muscle weakness.
  • Muscle cramps.
  • Shortness of breath.
  • Memory loss.
  • Fluid retention.
  • Blood sugar changes.

What can't I take with Inderal?

Some products that may interact with this drug include: alpha blockers (e.g., prazosin), aluminum hydroxide, anticholinergics (e.g., atropine, scopolamine), chlorpromazine, drugs affecting liver enzymes that remove Inderal from your body such as cimetidine, St.

What should be checked before giving Inderal?

Before administering Inderal, the nurse should always assess the patient's blood pressure and apical pulse.

Can Inderal harm for me?

Inderal 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.

Can Inderal cause stroke?

Inderal will comes with serious risks if you don't take it as prescribed. If you don't take it at all: Your condition will get worse and you may be at risk of serious heart problems, such as heart attack or stroke.

Does Inderal affect breathing?

Inderal has a "nonselective" action. This means that it also blocks beta-2 receptors in the bronchioles, which can cause a narrowing of the bronchioles which may cause breathing difficulties in people with pre-existing lung disease.

Does Inderal cause hair loss?

Inderal is one of several beta blockers that can cause hair loss. The hair loss from Inderal is not permanent and is typically a result of the medication causing some hair follicles to enter their shedding phase prematurely.

Can I drink alcohol with Inderal?

Mixing Inderal and alcohol is generally not advised by doctors or medical experts. This is because beta-blockers like Inderal lower your blood pressure by slowing your heart rate and reducing the force of each beat. Alcohol can also lower your blood pressure.

How many hours does Inderal last?

Inderal is usually taken once a day, and the effects last for 24 hours.

Is Inderal addictive?

Inderal is not a physically addictive, habit-forming medication. 

What foods interact with Inderal?

Caffeine-containing food items and beverages when taken along with Inderal may decrease the effectiveness of the drug. It is better to avoid tea or coffee while taking Inderal.

How much does Inderal lower pulse?

The effects of oral Inderal were evaluated in 10 normal volunteers. The resting heart rate decreased from the mean control value of 68 plus or minus 3.3 (SE) to 56 plus or minus 2.8 beats per minute (bpm) on Inderal (p smaller than 0.001, paired test).

What is the antidote for Inderal?

Isoprenaline proved to be the best antidote for the treatment of Inderal intoxication antagonizing the bradycardia by 76% and the hypotension completely.

What is Inderal used for in mental health?

Inderal has been used for many years to treat high blood pressure and heart disease, and has been found useful in treating anxiety states such as social phobia and migraine.
Inderal for the Treatment of Acute Stress Disorder.

Can I Inderal if I have asthma?

Despite safety concerns, Inderal is still prescribed to some people with asthma and anxiety. Brand exposure is associated with an increased risk of asthma hospitalisation in susceptible people which appears to vary by dose and duration of exposure.

Can Inderal disturb sleep?

For a small percentage of Inderal users, this can lead to difficulties falling and staying asleep. Inderal is also linked to other sleep related issues, including nightmares and drowsiness. Like fatigue, sleep issues from Inderal are most common shortly after you start to use the medication.

Can Inderal cause permanent damage?

If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure.

Does Inderal affect appetite?

Inderal does effected depression,confusion, hallucinations; liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

Can Inderal cause death?

We report on an 18-year-old man who ingested a massive dose of Inderal HCl in a suicide attempt. The patient was brought to the hospital in an unresponsive state within 30 minutes of ingestion. He was initially stabilized but subsequently died nine hours after the drug was ingested.

Can Inderal damage my heart?

Brand 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.

Can Inderal affect my eyesight?

This Inderal can cause certain eye problems. If left untreated, this can lead to lasting eyesight loss. If eye problems happen, signs like change in eyesight or eye pain most often happen within hours to weeks of starting Inderal and hydrochlorothiazide. Call your doctor right away if you have these signs

What happens if I stop taking Inderal suddenly?

While stopping any beta-blocker may cause a mild response, abruptly stopping Inderal may lead to a withdrawal syndrome. Beta-blocker withdrawal can result in a rise in blood pressure, and in patients with heart disease, chest pain, heart attack, and even sudden death.

Is Inderal bad for my kidneys?

Inderal types of beta-blockers may reduce cardiac output and subsequently renal perfusion pressure, thereby exacerbating renal dysfunction.

Is Inderal safe during pregnancy?

Inderal has been used safely to treat a variety of conditions during pregnancy, including hypertension and pheochromocytoma in the mother, and tachyarrhythmias in both the mother and fetus. There are a number of abnormalities associated with the use of Inderal during pregnancy, but many of these may be attributable to underlying diseases. These abnormalities include some signs of beta-blockade, such as bradycardia, hypoglycemia, and respiratory depression. Other abnormalities that may be due to Inderal include intrauterine growth retardation, small placentas, polycythemia, thrombocytopenia, and hypocalcemia.

Is Inderal to safe during breastfeeding?

Inderal is not recommended for mothers who are breastfeeding because it could potentially cause the baby's heart rate to slow down or its blood sugar to fall.

*** Taking medicines without doctor's advice can cause long-term problems.