Innopran XL (propranolol hydrochloride) is an extended-release, nonselective beta-adrenergic blocking agent indicated for the management of hypertension. It offers 24-hour blood pressure control through a specialized delivery system, ensuring consistent plasma concentrations and reducing peak-to-trough fluctuations. This formulation is designed to enhance patient adherence by enabling once-daily dosing while providing smooth, round-the-clock antihypertensive efficacy. Its mechanism involves competitive inhibition of catecholamines at beta-adrenergic receptors, resulting in decreased cardiac output, reduced renin release, and diminished sympathetic outflow.

Features

• Active ingredient: Propranolol hydrochloride
• Formulation: Extended-release capsules
• Available strengths: 80 mg, 120 mg, 160 mg
• Pharmacologic class: Nonselective beta-blocker
• Delivery system: Designed for once-daily dosing
• FDA-approved for hypertension management

Benefits

• Provides consistent 24-hour blood pressure reduction with a single daily dose
• Minimizes blood pressure variability, reducing cardiovascular strain
• Lowers risk of hypertension-related complications including stroke, myocardial infarction, and renal impairment
• Demonstrates favorable effects on sympathetic nervous system overactivity
• May reduce frequency of migraine headaches in appropriate patients
• Offers predictable pharmacokinetic profile with reduced side effect incidence compared to immediate-release formulations

Common use

Innopran XL is primarily prescribed for the management of hypertension, either as monotherapy or in combination with other antihypertensive agents. It may also be used off-label for migraine prophylaxis, essential tremor, and certain anxiety disorders. The extended-release formulation is particularly beneficial for patients requiring stable beta-blockade throughout the day and night, including those with morning blood pressure surges. Clinical studies demonstrate its effectiveness across various demographic groups, though individual response may vary based on age, renal function, and concomitant medications.

Dosage and direction

The recommended starting dose for Innopran XL is 80 mg once daily, preferably taken in the morning. Dosage may be increased to 120 mg or 160 mg once daily based on therapeutic response and tolerability. Maximum recommended dose is 160 mg daily. Administration should occur at the same time each day, with or without food, but consistency in administration relative to meals is recommended. Capsules must be swallowed whole and not crushed, chewed, or divided. Dose titration should occur at minimum 2-week intervals to assess full therapeutic effect. In elderly patients or those with hepatic impairment, lower starting doses and more gradual titration are advised.

Precautions

Patients should be monitored for development of bradycardia; heart rates below 50 beats per minute may require dosage adjustment. Caution is advised in patients with compensated heart failure as beta-blockers may precipitate cardiac decompensation. Abrupt discontinuation should be avoided due to risk of rebound hypertension, angina exacerbation, or myocardial infarction; dosage should be tapered gradually over 1-2 weeks. Masked hypoglycemic symptoms may occur in diabetic patients. May exacerbate symptoms in patients with bronchospastic disease; consider cardioselective alternatives if beta-blockade is necessary. Regular monitoring of blood pressure, heart rate, and clinical status is recommended during therapy.

Contraindications

Innopran XL is contraindicated in patients with cardiogenic shock, sinus bradycardia, second- or third-degree heart block (without permanent pacemaker), severe congestive heart failure (unless secondary to tachyarrhythmia treatable with beta-blockers), and bronchial asthma. Additional contraindications include severe COPD, hypersensitivity to propranolol or any component of the formulation, and metabolic acidosis. Should not be used concurrently with MAO inhibitors due to potential for severe hypertension. Not recommended in patients with pheochromocytoma unless alpha-blockade has been established first.

Possible side effects

Common adverse reactions (≥2%) include fatigue (10-15%), dizziness (5-10%), bradycardia (5-8%), nausea (4-7%), diarrhea (3-5%), and cold extremities (3-5%). Less frequent side effects may include insomnia, depression, vivid dreams, impotence, Raynaud’s phenomenon, and bronchospasm. Serious but rare adverse events include heart failure exacerbation, heart block, severe hypotension, bronchospasm, and exacerbation of peripheral arterial disease. Most side effects are dose-dependent and may diminish with continued therapy or dosage reduction.

Drug interaction

Innopran XL may potentiate effects of other antihypertensive agents. Concurrent use with calcium channel blockers (particularly verapamil and diltiazem) may result in additive negative inotropic and chronotropic effects. May reduce efficacy of beta-agonists in asthma patients. Cimetidine increases propranolol concentrations; fluoxetine may inhibit metabolism. Rifampin decreases propranolol levels. May mask tachycardia from hypoglycemia caused by insulin or oral hypoglycemics. Concomitant use with clonidine may potentiate rebound hypertension upon discontinuation of either drug. NSAIDs may diminish antihypertensive effect.

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If remembered near the time of the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling of doses is not recommended. Patients should be advised to maintain a consistent dosing schedule and use reminder systems if necessary, as inconsistent dosing may lead to inadequate blood pressure control or withdrawal symptoms.

Overdose

Symptoms of overdose may include severe bradycardia, heart failure, hypotension, bronchospasm, hypoglycemia, and seizures. Management includes gastric lavage if ingestion recent, activated charcoal, and supportive care. Bradycardia may respond to atropine; refractory cases may require cardiac pacing. Hypotension may require vasopressors such as norepinephrine or dopamine (beta-agonists may be ineffective due to receptor blockade). Bronchospasm should be treated with beta2-agonists and theophylline. Glucagon may be effective in reversing cardiac and hemodynamic effects. Hemodialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature 20°-25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F). Protect from moisture and excessive heat. Keep in original container with lid tightly closed. Do not transfer to other containers. Keep out of reach of children and pets. Do not use if capsules are damaged or show signs of moisture exposure. Discard unused medication properly according to local regulations, preferably through drug take-back programs.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Individual patient needs may vary. Healthcare professionals should consult full prescribing information before initiating therapy. Patients should not adjust dosage or discontinue medication without consulting their physician. The safety and effectiveness in pediatric patients have not been established. Use in pregnancy only if clearly needed; propranolol crosses the placenta and may cause fetal bradycardia, hypoglycemia, or intrauterine growth retardation. Caution advised in nursing mothers as propranolol is excreted in human milk.

Reviews

Clinical trials demonstrate Innopran XL provides effective 24-hour blood pressure control with mean reductions of 10-15 mmHg systolic and 8-12 mmHg diastolic pressure at maintenance doses. Patients report high satisfaction with once-daily dosing convenience compared to multiple-dose regimens. Healthcare providers note improved adherence rates and consistent therapeutic effect throughout the dosing interval. Some patients report persistent fatigue or cold intolerance, though these effects often diminish with continued therapy. Overall, it is considered an effective option for patients requiring sustained beta-blockade with improved pharmacokinetic profile over immediate-release formulations.