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Inderal LA (propranolol) is a beta blocker medication used to alleviate or prevent symptoms in a range of heart- and blood pressure-related conditions. It also sees some use in reducing the frequency and severity of migraine headaches and to treat some phobia and anxiety disorders.

The LA in this product stands for Long Acting; the medication is steadily released over the course of the day, so it only needs to be administered once per day. In contrast, regular Inderal tablets are typically taken 2 to 3 times per day. If debating between these two formulations or considering switching, keep in mind that:

• The two products are not interchangeable mg per mg. The LA version usually requires higher doses to achieve the same effect as the regular version at lower doses.
• Patients switching to LA tablets from regular tablets will likely need to increase doctor visits until ideal dosage is determined.
• While once-a-day doses are convenient, it is not always as effective as taking multiple, faster-acting regular tablets per day.
• LA tablets must be swallowed whole and not crushed or dissolved; doing so releases all the medication and can be dangerous. Patients who have difficultly swallowing whole tablets will want to stick with the regular tablets.

In most cases, choosing between the two types of tablets is a matter of personal preference and individual response; the long-acting version works well for most patients but others will have better results with the regular version.

Getting Started with Inderal LA

This medication is used to treat a variety of conditions, most of which are related to blood pressure and heart or circulation problems, but also a handful of seemingly unrelated issues. Common uses include:

• Hypertension (high blood pressure)
• Angina (chest pain)
• Atrial fibrillation (irregular heart rate)
• Tachycardia (rapid heart rate)
• Pheochromocytoma (adrenal gland tumor)
• Essential tremor
• Migraines
• Anxiety
• Some phobias

Treatment with Inderal LA typically begins with with relatively low doses of 80 mg per day, which is usually increased over the course of several days to several weeks to standard doses of 160 to 240 mg per day. Tablets are taken once per day, ideally at the same time each day.

It takes a week or two for full benefits to be felt. In the majority of applications Inderal LA is a long-term maintenance treatment; it is not a fast-acting "rescue" treatment, and rescue treatments should continue to be utilized as-needed. For example, if taking Inderal LA to treat migraines, it will reduce the frequency and severity of migraines over time, but if a migraine does occur patients should still utilize fast-acting treatments, such as a triptan medication. Likewise, Inderal LA will reduce the frequency of angina, but if angina does occur nitroglycerin can be utilized.

If treatment with Inderal LA ends, it's very important that dosage be gradually reduced over several weeks. Abruptly stopping---especially if the medication has been taken long-term---can cause very dangerous, even potentially deadly, complications. It is critical to consult a doctor about an appropriate discontinuation plan.

Taking Inderal LA with Other Medications

Inderal LA is often an effective treatment on its own, but it's also very common for other medications to be taken along with it. In most cases there are no problems, but some medications can interact with Inderal LA in dangerous ways. Of particular concern are:

• Steroids
• Antidepressants
• Heart or blood pressure medications
• Blood thinners
• Prostate treatments

Because of how Inderal LA works---it slows the heart rate and relaxes blood vessels---any medication that influences heart rate, circulation, or blood pressure has potential to cause dangerous complications if taken with this medication or any other beta blocker. Likewise, taking more than one beta blocker is very dangerous.

Even some seemingly-harmless over-the-counter medications, like NSAIDs (aspirin, ibuprofen, etc) can cause problems; NSAIDs can raise blood pressure. Check with a doctor or pharmacist before adding, removing or adjusting dosage of any medications while taking Inderal LA.