Inderal LA and Inderal XL (propranolol hydrochloride) are prescription drugs for high blood pressure that may be used off-label to treat anxiety. Research on this use is limited, and evidence of benefits for anxiety is inconclusive.

The Food and Drug Administration (FDA) has formally approved Inderal for the management of high blood pressure, certain heart conditions, and migraine.

The active ingredient in Inderal is propranolol, which is part of a group of drugs called beta-blockers that slow the heart and lower blood pressure.

In some cases, a doctor may also prescribe Inderal off-label to people who have physical symptoms of anxiety or panic attacks. Off-label use means the medication is prescribed to treat a condition that has not been officially approved for.

In sum, Inderal relieves physical symptoms, such as:

  • increased or rapid heart rate
  • shaking
  • sweating
  • tense muscles

Reducing these physical symptoms can help someone with anxiety feel physically calmer, which in turn may soothe their mind.

Physical symptoms of anxiety occur when your body releases a hormone called epinephrine, also known as adrenaline. This hormone triggers the fight, flight, or freeze response. It speeds up your heart rate and increases blood flow to your muscles.

Inderal works by blocking the action of epinephrine on your heart and blood vessels. This slows your heart rate, reduces your blood pressure, and helps reduce sweating, shaking, and muscle tension, giving you a sense of calm.

Inderal LA and Inderal XL are extended-release capsules you swallow. Extended-release capsules release the medication slowly over time. They have a long-acting effect.

Is Inderal safe for children with anxiety?

The FDA has not approved Inderal LA or Inderal XL for any use in anyone under 18 years of age. It’s not known if these drugs are safe or effective in children.

Doctors are unlikely to prescribe Inderal LA or Inderal XL for anxiety in children. However, they may prescribe other forms of propranolol (the active ingredient in Inderal).

Because anxiety is not an approved use for Inderal, the drug manufacturer hasn’t studied the effects of this drug on anxiety symptoms, and there’s limited research on it.

Propranolol, the active ingredient in Inderal, has been widely used for anxiety symptoms for many years. But there is little new evidence in favor of this medication for chronic or longstanding anxiety.

In fact, a 2024 study concluded that the drug carries multiple safety concerns and has limited evidence of benefits for anxiety.

Although the drug does reduce heart rate and other physical symptoms common in anxiety episodes, the evidence does not support propranolol as a reliable treatment for anxiety disorders.

Inderal LA and Inderal XL come as extended-release oral capsules. Extended-release capsules release the medication slowly over time to provide a long-acting effect.

Both forms of Inderal start to reduce physical symptoms of anxiety soon after you take a dose. But Inderal XL releases the medication into your body more slowly than Inderal LA, so it may take a few more hours to produce its maximum effect.

Inderal XL is meant to be taken at bedtime to produce its maximum effect by early morning.

Using Inderal off-label for anxiety may cause side effects in some people.

The following are some of the main side effects reported in people using Inderal for its FDA-approved uses. The side effects of Inderal, when used off-label for anxiety, are expected to be similar.

Inderal may cause mild side effects in some people. These include:

In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage, too. But if side effects last longer, bother you, or become severe, talk with your doctor or pharmacist.

Taking Inderal may also lead to rare but serious side effects. Examples include:

Call your doctor right away if you have any serious side effects while using Inderal. If the side effects seem life threatening or if you think you’re having a medical emergency, call 911 or your local emergency number immediately.

Medical Perspective

Q: How do doctors decide someone needs medication for anxiety?

A: “Doctors will ask specific questions regarding anxiety symptoms. Some things that may warrant medication for anxiety include symptoms that cause a significant disruption to your work or home life.”

— Alyssa Walton, PharmD

Read more: What are all the treatment options for anxiety?

Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

If you’re interested in taking Inderal for anxiety, which is an off-label use, talk with a primary physician or a psychiatrist. They can help determine whether Inderal might be a good choice for you and provide a prescription.

Another easy way to obtain Inderal is by using a reputable telehealth service, such as:

Through these reputable telehealth services, a licensed telehealth professional (such as a doctor) will evaluate your symptoms and needs.

If they determine that Inderal may be right for anxiety symptoms, they’ll provide an electronic prescription. You can then order the medication. The services also provide coaching and other support.

If you get an Inderal prescription through a telehealth service, it’s important to let your primary doctor know.

Inderal LA and Inderal XL are prescription medications formally approved to treat high blood pressure, migraine, and some heart conditions. Some doctors may prescribe them for physical symptoms of anxiety, such as shaking, rapid heartbeat, and sweating.

Research on the benefits of Inderal LA and Inderal XL for anxiety symptoms is limited. If you experience anxiety episodes, sharing your symptoms with a healthcare professional can help them determine if you need medication and which drug may be safe and effective for your case.

Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.