| Migraine Disorders
Inderal LA vs Tosymra
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Inderal vs Tosymra 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 signalsTosymra has a higher rate of injection site reactions vs Inderal based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tosymra but not Inderal, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Inderal
Tosymra
At A Glance
Oral
Once daily
Nonselective beta-blocker
Nasal spray
Per migraine attack
5-HT1B/1D receptor agonist
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 10 mg as a single spray in one nostril; max 30 mg in 24 hours with doses separated by at least 1 hour.
Contraindications
- Cardiogenic shock
- Sinus bradycardia and greater than first-degree block
- Bronchial asthma
- Known hypersensitivity to propranolol hydrochloride
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or coronary artery vasospasm, including Prinzmetal's angina
- Wolff-Parkinson-White syndrome or arrhythmias associated with other cardiac accessory conduction pathway disorders
- History of stroke or transient ischemic attack (TIA) or history of hemiplegic or basilar migraine
- Peripheral vascular disease
- Ischemic bowel disease
- Uncontrolled hypertension
- Recent use (within 24 hours) of ergotamine-containing or ergot-type medication, 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%) Atypical sensations, tingling, dizziness/vertigo, warm/hot sensation, burning sensation, feeling of heaviness, flushing, weakness, neck pain/stiffness, chest discomfort, drowsiness/sedation
Serious Myocardial ischemia/infarction, arrhythmias, cerebrovascular events, vasospasm reactions, serotonin syndrome, increase in blood pressure, hypersensitivity reactions, seizures
Postmarketing Hypotension, palpitations, dystonia, tremor
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 exerts its therapeutic effects through agonist activity at 5-HT1B/1D receptors on intracranial blood vessels and sensory nerves of the trigeminal system, resulting in cranial vessel constriction and inhibition of pro-inflammatory neuropeptide release.
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)
Tosymra
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
UnitedHealthcare
Inderal
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Tosymra
- 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)
Tosymra
- 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 Tosymra.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
InderalView full Inderal profile
TosymraView full Tosymra profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.