| Migraine Disorders
Inderal LA vs Onzetra Xsail
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Inderal vs Onzetra Xsail with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsOnzetra Xsail has a higher rate of injection site reactions vs Inderal based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Onzetra Xsail but not Inderal, including UnitedHealthcare
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Category
Inderal
Onzetra Xsail
At A Glance
Oral
Once daily
Nonselective beta-blocker
Nasal powder
As needed
5-HT1B/1D agonist (triptan)
Indications
- Hypertensive disease
- Coronary Arteriosclerosis
- Migraine Disorders
- Idiopathic hypertrophic subaortic stenosis
- Migraine Disorders
Dosing
Hypertensive disease Initial 80 mg once daily; may increase to 120 mg or higher; usual maintenance 120-160 mg once daily; up to 640 mg may be required.
Coronary Arteriosclerosis Start 80 mg once daily; increase at 3-7 day intervals; average optimal dose 160 mg once daily; maximum established dose 320 mg once daily.
Migraine Disorders Initial 80 mg once daily; usual effective range 160-240 mg once daily; discontinue if no response within 4-6 weeks at maximal dose.
Idiopathic hypertrophic subaortic stenosis Usual dosage 80-160 mg once daily.
Migraine Disorders 22 mg (one 11 mg nosepiece per nostril) intranasally as a single dose; if migraine unresolved at 2 hours or returns, a second 22 mg dose may be administered at least 2 hours after the first; maximum 44 mg per 24 hours.
Contraindications
- Cardiogenic shock
- Sinus bradycardia and greater than first-degree block
- Bronchial asthma
- Known hypersensitivity to propranolol hydrochloride
- Ischemic coronary artery disease or coronary artery vasospasm, including Prinzmetal's angina, or other significant underlying cardiovascular disease
- Wolff-Parkinson-White Syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke, transient ischemic attack (TIA), or hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medications, or another 5-HT1 agonist
- Concurrent administration or recent use (within 2 weeks) of an MAO-A inhibitor
- Hypersensitivity to sumatriptan
- Severe hepatic impairment
Adverse Reactions
Cardiovascular Bradycardia, congestive heart failure, intensification of AV block, hypotension, paresthesia of hands, thrombocytopenic purpura, arterial insufficiency (Raynaud type)
Central Nervous System Light-headedness, mental depression, insomnia, lassitude, weakness, fatigue, catatonia, visual disturbances, hallucinations, vivid dreams, disorientation, short-term memory loss, emotional lability
Gastrointestinal Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, ischemic colitis
Allergic Hypersensitivity reactions including anaphylactic/anaphylactoid reactions, pharyngitis, agranulocytosis, erythematous rash, fever with aching and sore throat, laryngospasm, respiratory distress
Respiratory Bronchospasm
Hematologic Agranulocytosis, nonthrombocytopenic purpura, thrombocytopenic purpura
Autoimmune Systemic lupus erythematosus
Skin and Mucous Membranes Stevens-Johnson Syndrome, toxic epidermal necrolysis, dry eyes, exfoliative dermatitis, erythema multiforme, urticaria, alopecia, SLE-like reactions, psoriasisiform rashes
Genitourinary Male impotence, Peyronie's disease
Most common (>=2%) Abnormal taste, nasal discomfort, rhinorrhea, rhinitis
Serious Myocardial ischemia, myocardial infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain/tightness/pressure, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, increased blood pressure, hypersensitivity reactions, seizures
Postmarketing Epistaxis
Pharmacology
Propranolol is a nonselective beta-adrenergic receptor-blocking agent that competitively blocks beta-receptor-stimulating agents, reducing chronotropic, inotropic, and vasodilator responses to beta-adrenergic stimulation; at doses greater than required for beta blockade, it also exerts a quinidine-like membrane action affecting the cardiac action potential.
Sumatriptan is a selective 5-HT1B/1D receptor agonist that constricts intracranial blood vessels and inhibits pro-inflammatory neuropeptide release from the trigeminal system, relieving migraine headache.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Inderal
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (5/12)
Onzetra Xsail
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (9/12)
UnitedHealthcare
Inderal
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Onzetra Xsail
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (1/8)
Humana
Inderal
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Onzetra Xsail
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Inderal.
No savings programs available for Onzetra Xsail.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.