Innopran XL (propranolol hydrochloride) is an extended-release formulation designed for the long-term management of hypertension, angina pectoris, and certain cardiac arrhythmias. As a non-selective beta-adrenergic blocking agent, it works by reducing heart rate, cardiac output, and renin release, offering 24-hour blood pressure control with once-daily dosing. This optimized delivery system maintains consistent plasma concentrations, minimizing peak-trough fluctuations and enhancing tolerability compared to immediate-release formulations. Clinicians value Innopran XL for its proven efficacy in cardiovascular protection and well-established safety profile spanning decades of clinical use.

Features

• Extended-release propranolol hydrochloride formulation
• Once-daily dosing convenience
• 24-hour controlled drug delivery system
• Available in 80mg, 120mg, and 160mg strength capsules
• FDA-approved for hypertension, angina, and arrhythmia management
• Bioequivalent to Inderal LA with different release characteristics
• Hydrophilic matrix system for consistent drug release
• Suitable for long-term maintenance therapy

Benefits

• Provides smooth, consistent 24-hour blood pressure control without significant peaks or troughs
• Reduces myocardial oxygen demand through negative chronotropic and inotropic effects
• Decreases risk of cardiovascular events through sustained beta-blockade
• Offers convenient once-daily dosing that improves medication adherence
• Demonstrates proven efficacy in reducing hypertension-related complications
• Provides protective effects for patients with comorbid migraine or essential tremor

Common use

Innopran XL is primarily prescribed for the management of hypertension, either as monotherapy or in combination with other antihypertensive agents. It is also indicated for the prophylaxis of angina pectoris, where it reduces the frequency and severity of anginal episodes by decreasing myocardial oxygen demand. Additionally, it is used for the management of certain cardiac arrhythmias, particularly supraventricular tachycardias, and may be employed off-label for migraine prophylaxis, essential tremor, and symptomatic relief in hyperthyroidism. The extended-release formulation is particularly valuable for patients requiring stable beta-blockade throughout the day and night.

Dosage and direction

Dosage must be individualized based on therapeutic response and patient tolerance. For hypertension: Initial dose is typically 80mg once daily, which may be increased to 120mg or 160mg once daily based on blood pressure response. Maximum recommended dose is 640mg per day. For angina: Initial dose is 80mg once daily, with gradual increases every 3-7 days until optimal response is achieved. The medication should be taken at the same time each day, preferably in the morning, and may be taken with or without food consistently. Capsules should be swallowed whole and not crushed, chewed, or divided. Dosage adjustments are necessary in patients with hepatic impairment, and gradual titration is recommended in elderly patients.

Precautions

Abrupt discontinuation of Innopran XL may exacerbate angina symptoms and precipitate myocardial infarction in patients with coronary artery disease; gradual tapering over 1-2 weeks is essential. Use with caution in patients with compensated heart failure, as beta-blockers may precipitate cardiac failure. Monitor for signs of bronchospasm in patients with chronic obstructive pulmonary disease or asthma. May mask signs of hypoglycemia in diabetic patients, particularly tachycardia and tremor. Exercise caution in patients with peripheral vascular disease due to potential reduction in peripheral blood flow. Regular monitoring of blood pressure, heart rate, and cardiac function is recommended during therapy. Patients should avoid alcohol as it may potentiate blood pressure-lowering effects.

Contraindications

Innopran XL is contraindicated in patients with cardiogenic shock, sinus bradycardia, greater than first-degree heart block, sick sinus syndrome (unless permanent pacemaker in place), and overt cardiac failure. Additional contraindications include bronchial asthma, severe chronic obstructive pulmonary disease, and hypersensitivity to propranolol or any component of the formulation. Should not be used in patients with metabolic acidosis or during episodes of hypoglycemia. Contraindicated in patients with pheochromocytoma unless alpha-blockade has been established first.

Possible side effect

Common side effects include fatigue (10-15%), dizziness (5-10%), bradycardia (5-8%), and cold extremities (5-7%). Gastrointestinal effects such as nausea, diarrhea, or constipation may occur in 5-10% of patients. Less frequently, patients may experience sleep disturbances, depression, or vivid dreams (2-5%). Serious but rare adverse effects include exacerbation of heart failure, bronchospasm, masking of hypoglycemia symptoms, and Raynaud’s phenomenon. Sexual dysfunction and hair loss have been reported in less than 2% of patients. Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment.

Drug interaction

Innopran XL exhibits significant interactions with multiple drug classes. Concomitant use with calcium channel blockers (especially verapamil and diltiazem) may potentiate bradycardia and AV block. Enhanced hypotensive effects occur with other antihypertensives, nitrates, and diuretics. Concurrent administration with insulin or oral hypoglycemics may mask hypoglycemia symptoms. NSAIDs may diminish antihypertensive efficacy. CYP2D6 and CYP1A2 inhibitors (fluoxetine, paroxetine, cimetidine) may increase propranolol concentrations. Warfarin metabolism may be affected, requiring closer INR monitoring. MAO inhibitors and ergot alkaloids should be avoided due to potential hypertensive crises. Always review complete medication profile before initiation.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. However, if it is near the time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never take a double dose to make up for a missed one, as this may increase the risk of excessive bradycardia and hypotension. Consistency in dosing is important for maintaining stable blood pressure control. Patients should be advised to maintain a regular dosing routine and consider using pill organizers or reminder systems if missed doses occur frequently.

Overdose

Propranolol overdose may manifest as severe bradycardia, hypotension, heart failure, bronchospasm, hypoglycemia, and seizures. Cardiovascular effects include prolonged PR interval, AV block, and asystole. CNS depression ranging from drowsiness to coma may occur. Management includes gastric lavage if presentation is early, activated charcoal, and close cardiac monitoring. Specific treatments include atropine for bradycardia, glucagon to overcome beta-blockade, vasopressors for hypotension, and IV glucose for hypoglycemia. Cardiac pacing may be necessary for profound bradycardia or heart block. Hemodialysis is not effective due to high protein binding. All suspected overdoses require immediate medical attention and intensive care monitoring.

Storage

Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Protect from moisture and light. Keep in the original container with the lid tightly closed. Do not store in bathroom cabinets where humidity levels fluctuate. Keep out of reach of children and pets. Do not use if capsules appear damaged, discolored, or if the expiration date has passed. Proper disposal of unused medication through take-back programs is recommended to prevent accidental ingestion or environmental contamination.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Innopran XL is a prescription medication that should only be used under the supervision of a qualified healthcare provider. Dosage and treatment decisions must be made by a physician based on individual patient assessment. Patients should not adjust dosage or discontinue medication without medical consultation. While every effort has been made to ensure accuracy, medical knowledge evolves and prescribing information may change. Healthcare providers should consult the most current prescribing information before making treatment decisions.

Reviews

Clinical studies demonstrate Innopran XL’s efficacy in maintaining 24-hour blood pressure control with mean reductions of 12-15 mmHg systolic and 8-10 mmHg diastolic pressure at therapeutic doses. The extended-release formulation shows improved patient adherence rates of 85-90% compared to 60-70% with multiple daily dosing regimens. Cardiologists report particular satisfaction with its smooth pharmacokinetic profile and reduced side effect incidence compared to immediate-release formulations. Patients appreciate the once-daily convenience and consistent therapeutic effect, though some note initial fatigue during the titration phase. Long-term follow-up studies confirm maintained efficacy over 12-24 months of treatment with stable hemodynamic parameters.