| Migraine Disorders

Inderal LA vs Zavzpret

Side-by-side clinical, coverage, and cost comparison for migraine disorders.
Deep comparison between: Inderal vs Zavzpret with Prescriber.AI
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Safety signalsZavzpret has a higher rate of injection site reactions vs Inderal based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zavzpret but not Inderal, including UnitedHealthcare
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Inderal
Zavzpret
At A Glance
Oral
Once daily
Nonselective beta-blocker
Intranasal
As needed
CGRP receptor antagonist
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 as needed; maximum 10 mg (one spray) per 24-hour period; safety of treating more than 8 migraines in a 30-day period has not been established.
Contraindications
  • Cardiogenic shock
  • Sinus bradycardia and greater than first-degree block
  • Bronchial asthma
  • Known hypersensitivity to propranolol hydrochloride
  • History of hypersensitivity reaction to zavegepant or any component of ZAVZPRET, including anaphylaxis
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%) Taste disorders (dysgeusia, ageusia), nausea, nasal discomfort, vomiting
Serious Hypersensitivity including facial swelling and urticaria (less than 1%)
Postmarketing Hypersensitivity (anaphylaxis), hypertension, Raynaud's phenomenon
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.
Zavegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist; it blocks CGRP receptor signaling implicated in migraine pathophysiology.
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Most Common Insurance
Anthem BCBS
Inderal
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (0/12) · Qty limit (5/12)
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Zavzpret
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (10/12) · Qty limit (10/12)
View full coverage details ›
UnitedHealthcare
Inderal
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Zavzpret
  • Covered on 4 commercial plans
  • PA (5/8) · Step Therapy (4/8) · Qty limit (4/8)
View full coverage details ›
Humana
Inderal
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
View full coverage details ›
Zavzpret
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Inderal.
Cost estimate not availablePAF Co-Pay Relief: Migraine
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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InderalView full Inderal profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.