Propranolol (Inderal XL, InnoPran XL)

Propranolol (Inderal XL®, InnoPran XL®)

SELF ADMINISTRATION - ORAL

Indications for Prior Authorization:

• Treatment of hypertension
• Not indicated for the treatment of hypertensive emergencies

Patients must meet the following criteria for the above indication(s):

• Prescribed by or in consultation with a cardiologist, AND
• Patient must try and fail both propranolol IR and propranolol ER (each trial for at least 2 months)

Dosing:

• Administer once daily at bedtime
• Initiate dosage at 80 mg and titrate up to 120 mg if needed

Approval:

• One year