| Migraine Disorders
Inderal LA vs Zembrace SymTouch
Side-by-side clinical, coverage, and cost comparison for migraine disorders.Deep comparison between: Inderal vs Zembrace Symtouch 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 signalsZembrace Symtouch has a higher rate of injection site reactions vs Inderal based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Zembrace Symtouch but not Inderal, including UnitedHealthcare
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Category
Inderal
Zembrace Symtouch
At A Glance
Oral
Once daily
Nonselective beta-blocker
SC injection
As needed
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 3 mg SC injection per dose; max 12 mg per 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 (CAD) (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 (within 24 hours) use of ergotamine-containing medication, ergot-type medication (such as dihydroergotamine or methysergide), or another 5-HT1 agonist
- Concurrent administration of an MAO-A inhibitor or recent (within 2 weeks) use of an MAO-A inhibitor
- Known hypersensitivity to sumatriptan (angioedema and anaphylaxis seen)
- 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%) Injection site reactions, atypical sensations, tingling, dizziness/vertigo, warm/hot sensation, flushing, feeling of heaviness, burning sensation, pressure sensation, weakness, neck pain/stiffness
Serious Myocardial ischemia/infarction, Prinzmetal's angina, arrhythmias, chest/throat/neck/jaw pain or tightness, cerebrovascular events, vasospasm reactions, medication overuse headache, serotonin syndrome, hypertensive crisis, 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 therapeutic effects through agonist activity at 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)
Zembrace Symtouch
- 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)
Zembrace Symtouch
- Covered on 4 commercial plans
- PA (0/8) · 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)
Zembrace Symtouch
- 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 Zembrace Symtouch.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.